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Focusing "Down Low": Bisexual Black Men, HIV Risk and Heterosexual
Transmission
Black men who have sex with men (MSM) and women
but who do not identify as gay or disclose their bisexual activities
to main female partners, also known as men "on the down-low,"
have been cited as the primary reason for the increase in HIV infections
in black women, according to a report in the July 2005 issue of
the Journal of the National Medical Association
Three
online databases (PsychInfo, MEDLINE and AIDSLINE) were searched
for scientific articles related to men on the down-low. A total
of 24 articles and two conference abstracts were selected for review.
Results
Data
from existing studies of MSM reveal low agreement between professed
sexual identity and corresponding sexual behavior among black and
other MSM; show that black MSM are more likely than MSM of other
racial or ethnic groups to be bisexually active or identified; and,
compared with white MSM, are less likely to disclose their bisexual
or homosexual activities to others.
However,
black MSM who do not disclose their homosexual or bisexual activities
engage in a lower prevalence of HIV risks than black MSM who do
disclose; and black men who are currently bisexually active account
for a very small proportion of the overall population of black men
(2%).
Conclusions
· The
high prevalence of HIV in the black community and the greater likelihood
of bisexuality among black men place heterosexual black women at
risk for HIV infection.
· The
contribution of high-risk heterosexual black men to the rising HIV
caseload among black women has been largely ignored.
· Future
research must evaluate the relative contributions of bisexual men
and exclusively heterosexual black men to HIV cases among black
women.
Centers for Disease Control
and Prevention, Atlanta, GA 30033, USA. GMillett@cdc.gov
08/12/05
Reference
G
Millett and others. Focusing "down low": bisexual black
men, HIV risk and heterosexual transmission. Journal of the National
Medical Association 97(7 Supp): 52S-59S. July 2005.
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