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Often these men do not consider themselves gay or bisexual and their female partners are not aware that they have sex with other men, thus the term "down low" or "in hiding".Ford of Columbia University in New York City urges caution when assuming down low men are the primary cause of high African-American HIV infection rates:"Part of what has happened as a result of that initial burst of stories reporting the ‘down low’ is that those stories often tied the down low to high rates of HIV infection among African-American women, which was not supported by epidemiological data." Ford added, "There were a lot of assumptions, there were a lot of leaps of faith that led to that."Is the down low only an African-American issue?

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