HIV's Bisexual Bridge to Women
Risk Posed By 'Down Low' Men Still Unknown
The Down Low: Not Just Black Men
Black men call it the DL: the down low. Fearing loss of community support, men living this lifestyle keep their bisexuality -- and their sexual relationships with other men -- secret from their female partners.
Whether they call it the DL or not, many white and Latino men also keep their sexual affairs with men secret from their female sex partners.
"Most people believe this is only something happening with black men," CDC scientist Greg Millet, MPH, tells WebMD. "We see it in Latino and white men, too. They say they are heterosexual but report sex with other men in the last three months, in the last year, in the last five years. Sexual identity is not destiny."
John Peterson, PhD, professor of psychology at Atlanta's Georgia State University, has studied the issue for a long time.
"The DL is a new name for an old issue," Peterson tells WebMD. "Bisexual men not telling their female partners about their male relationships takes place across all races and ethnicities. But what we really don't know is how these men behave when they have primary male or female partners."
Sex, Risky Sex, and Very Risky Sex
What is known about bisexual men suggests that those who have long-term relationships with women may have different HIV risks than those who do not.
"In previous studies, those with mainly female partners engaged in far fewer sex behaviors with men than men with no female partners," Millet says. "So we have to be careful about how we characterize these men. The little data we have is that is not the case -- they don't have the same risks."
Secret affairs put the unwary partner at risk of HIV and STDs. But there are different levels of risk. Not all sex behaviors carry the same risk of spreading HIV, says Joseph P. Stokes, PhD, professor emeritus at the University of Illinois in Chicago. Stokes is well known for his studies of bisexual men.
"We found a long time ago that two-thirds of the time, the female was not aware of the extracurricular sex the behaviorally bisexual man was doing," Stokes tells WebMD. "But it is a stretch to say this always puts the women at risk of HIV infection."