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• What are the origins of this term down low and what does it refer to?

  The most generic definition of the term down low, or DL, is “to keep something private,” whether that refers to information or activity.

  The term is often used to describe the behavior of men who have sex with other men as well as women and who do not identify as gay or bisexual. These men may refer to themselves as being “on the down low,” “on the DL,” or “on the low low.” The term has most often been associated with African American men. Although the term originated in the African American community, the behaviors associated with the term are not new and not specific to black men who have sex with men.

• What are the sexual risk factors associated with being on the down low?

  Much of the media attention about men on the down low and HIV/AIDS has focused on the concept of a transmission bridge between bisexual men and heterosexual women. Some women have become infected through sexual contact with bisexual men [ 1]. However, many questions have not yet been answered, including:

  • Do bisexually active men account for more cases of HIV infection in women than do men who inject drugs?
  • Are bisexually active men more likely than other groups of men to be HIV infected?
  • What proportion of HIV-infected men who have sex with male and female partners identify with the down low?
  • Do men on the down low engage in fewer or more sexual risk behaviors than men who are not on the down low?
  • Do people other than bisexually active men who do not disclose their behavior to sex partners identify with the down low?
• What are the implications for HIV prevention?

  The phenomenon of men on the down low has gained much attention in recent years; however, there are no data to confirm or refute publicized accounts of HIV risk behavior associated with these men. What is clear is that women, men, and children of minority races and ethnicities are disproportionately affected by HIV and AIDS and that all persons need to protect themselves and others from getting or transmitting HIV.

• What steps is CDC taking to address the down low?

  CDC and its many research partners have several projects in the field that are exploring the HIV-related sexual risks of men, including men who use the term down low to refer to themselves. The results of these studies will be published in medical journals and circulated through press releases in the next few years as each study is concluded and the data are analyzed. CDC has also funded several projects that provide HIV education, counseling, and testing in minority racial and ethnic communities. CDC’s research and on-the-ground HIV prevention efforts will continue as more information about the demographics and HIV risk behaviors of men who do and men who do not identify with the down low becomes available.

Reference

• CDC. HIV/AIDS Surveillance Report, 2004 (Vol. 16). Atlanta: US Department of Health and Human Services, CDC; 2005:1–46.