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Down-low is an African American slang term [1] that typically refers to a subculture of black men who usually identify as heterosexual, but who have sex with men ; some avoid sharing this information even if they have female sexual partner sthey are married, or they are single. The term originated in the Black community, and was originally used to describe "any kind of slick, secretive behavior, including infidelity in heterosexual relationships". According to a study published in the Journal of Bisexuality"[t]he Down Low is a lifestyle predominately practiced by young, urban Black men who have sex with other men and women, yet do not identify as gay or bisexual".

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This is not explained by individual risk behaviour: young gay black men actually have fewer partners and lower rates of recreational drug use than other gay men. Researchers from the University of California, San Francisco, and the San Francisco Department of Public Health, used data from surveys of gay men that were conducted from to to find out if young men and black men had a higher per-contact risk of HIV infection that was not explained by other behavioural or demographic factors. Receptive anal intercourse refers to the act of being penetrated during anal intercourse.

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From trailblazing pioneers such as openly gay novelist James Baldwin and transgender rights activist Marsha P. Johnsonto modern-day heroes such as actress Laverne Cox and basketball star Jason CollinsLGBTQ African Americans have made enormous contributions to the ongoing fight for social, racial and economic justice. LGBTQ African Americans are disproportionately young and disproportionately female, and nearly one-third of all African American same-sex couples are raising children.

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Source: CDC. HIV Surveillance Report ; Accessed January 24,

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Black young gay, bisexual, and other men who have sex with men YGBMSM are at high risk for negative health outcomes, though this population is underrepresented in the health literature. An extensive literature review and content analysis of health-related peer-reviewed articles was conducted that targeted Black YGBMSM, examining five content areas: sexual health, health care, substance use, psychosocial functioning, and sociostructural factors. A coding sheet was created to collect information on all content areas and related subtopics and computed descriptive statistics.

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In its upper stories, the Flex bathhouse in Cleveland feels like a squash club for backslapping businessmen. There's a large gym with free weights and exercise machines on the third floor. In the common area, on the main floor, men in towels lounge on couches and watch CNN on big-screen TV's.

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