About AIDS

"Living on the down low," it's called in the African-American community, or "down low" for short. That's a colorful term for male bisexuality.

An interesting secret about human sexuality highlighted by the AIDS epidemic is the wide range of sexual behaviors -- and how often they are explored. Turns out that there are lots of men who have sex with other men, perhaps casually, but who do not self-identify as gay or homosexual. Indeed, HIV epidemiologic reports now categorize Men who have Sex with Men as MSM, not gay, because it's the behavior that counts, not the label.

For several years, we've known that some heterosexual women, especially minority women, are at risk from having unprotected sex with bisexual men, including their boyfriends and husbands. However, the evidence has been largely anecdotal; little data have been available. In July, however, a massive 10-state study confirmed the issue, pointing to disparities in risk among women of different races.

Latinos had more bisexual encounters than white men, and black men had the most. Homophobia in Hispanic and African-American cultures coerced men into a bisexual closet. One assumes white men would more likely feel free to just come out as gay, having male-male sex only.

The interesting disparity, however, was in how often the wife or girlfriend was in the dark: 13% of white women knew about their partners, but only 6% of minority women knew.

The study suggests that HIV- and STD-prevention messages targeted toward minority women should be frank about the matter and that, over the long term, communities of color address the corrosive issue of homophobia.

In some ways, this is not new for our prevention programs. We've always said that if you don't know your partner well enough to discuss sexual experiences openly, then you probably shouldn't be in bed together. Alternatively, complete honesty is mandatory -- especially with someone you care about.

Sandy Bartlett

Community Education Coordinator, AIDS Services of Austin