Abstract
Among bisexual MSM also called “men-on-the-down-low”, sexuality driven risks stimulate spectrum of vulnerabilities for both genders. Pressure to marry may drive a greater proportion of MSM to have female partners, indicating the potential for bridging HIV transmission. However, these interactions are poorly understood and measurement of potential risk to MSM and their female partners is inconsistent especially in conservative societies like Bhutan, where sex is tabooed and homosexuality is restricted even in programmatic discussions.
Highlights
The most generic definition of the term “down-low” is “to keep something private”
Down-low has most often been associated with African American men. This theoretical conception draws attention to the concept of a transmission bridge between bisexual men and heterosexual women [1]. This phenomenon makes the researchers think out of box and draw their attention to questions like: Are bisexually active men more likely than other groups of men to be HIV (Human Immunodeficiency Virus) infected? Do men on the down low engage in fewer or more sexual risk behaviors than men who are not on the down low? and what effect this behavior has on the vulnerabilities of female partners of these men?
Our data support other studies across the world that has observed that a large proportion of MSM are married
Summary
Only 19 (6.5%) out of 293 respondents were from age group below 20. Educational attainment of these MSM portrays that, more than half (56%) had completed 10 or more years of schooling. Number of non-commercial partners is high among those who are illiterate, are never married and are migrant as compared to their counterparts It was surprisingly high for the MSM with 6-10 years of education. Mean duration of involvement Mean number of non-commercial male in anal sex (in years) partner during the last 6 months. Relatively larger proportion of ever married MSM reported 1-2 non-commercial partners in the last 6 months than their never married counterparts. It is evident from table 3 that 83 percent MSM used a condom and 19 percent used lubricant in their last non-commercial MSM activity. One possible reason may be less exposure and access to condom and lubricants among MSM in the middle age group, which may be the age when they enter the professional and family life
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