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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 Bisexual black female men "on the down-low," have been cited as the main reason for the increase in HIV infections in black women.

A total of 24 articles and two conference abstracts were selected for review.

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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 Bisexual black female active or identified; and, compared with white MSM, are less likely to disclose their bisexual or homosexual activities to others. 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.

However, 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 Bisexual black female to HIV cases among black women. National Center for Biotechnology InformationU.


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