Monday, September 1, 2014
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The American public has now heard of the term Men on the Down-Low. It has become the colloquial term to refer to Black men who are bi-sexual. The concept is not new, and there are been other terms to refer to brothers who "act straight but bend with the wind."

Historically it was easy to get away with, so long as your spouse or girl friend didn't find out. Sometimes, she was the only one who didn't know. It was common for the guy to go away, be with other men, then return home to be with his wife. The psyche of this man is such that often when he was with other men, he was being receptive. So when he returned home, he was very sexual with his wife. That provided assurance to him that he was heterosexual and that he could do the manly things. This was sometimes interpreted by the wife/girlfriend as " he missed me." Since sex was often better and more frequent after times away, she assumed he had been faithful and with no other woman. Half of her assumptions were correct!

A typical story in the past is that Joe went to a meeting in St. Louis. While there he met up with Xavier. Also got involved with Louis. He had a good time and on his return home he can look his wife straight in the eye and say " you're the only woman I've been with since we got together," and all the time his thoughts were on Louis and he could still feel the soreness in his rear from the work out he got from Louis and Xavier. He even kept their numbers- business associates of course. That is, until he gets a call from Louis informing him that he (Louis) had been treated for syphilis, or more commonly, gonorrhea. Louis was being nice enough to let him know since he didn't want the wife to find out. The only problem is Joe has already been with his wife. So he runs to his doctor. He tells the doctor that while he was away he "you know, played, and this chick may have had something. He doesn't want his wife to find out, so doc, please help me" The doctor never gives it a second thought and the idea of Joe being bisexual never enters his mind. So he calls the wife in. Tell her about a strain of Strep throat that is going around and give her the appropriate shot. So if he did expose her, she is treated. Most likely she was not exposed since the likely spot of Joe's infection is his rectum, or the back of his throat. But that story has played on many returns home. Over time hopefully the husband learns to be discrete, or he and his wife become less sexual to asexual, so there is no concern about infecting her. She simply thinks his libido has gotten weak over time. It really hasn't. It's just that as a younger man, it was easy for him to become aroused. Arousal was independent of whom he was with. Now as he gets older, he relies more on his mental stimulation and for many "bi-sexual" men it is easier to get that from another man. Also, if he is being penetrated, which tends to occur more often as the age goes up, Joe does not need to become aroused initially. That often leads to him seeking more men as he gets older. That is, with his wife or any woman, he has to become aroused to penetrate her and sometimes he really "can'' maintain an erection, whereas, with another man penetrating him, it is easier and he becomes aroused as the act progresses.

Today HIV adds a complex ingredient to this formula. I'm not trying to justify it , but simply explain it. Remember, there are many scenarios and not one will fit all. But with HIV comes the problem "brother" that you can't do what you used to. That is, if you become HIV infected, your lifestyle has to change. For instance, if Joe were to have found that he might have been exposed to HIV what should he have done. It takes 3-6 months for a newly infected individual to convert and develop antibodies to HIV. Therefore has to wait at least 3 months, and if he were my patient, it would be 6 months. So for this period of time he has to either abstain or use a condom. He may not tell her about his fear of HIV or he may confess, crying, blaming it on some prostitute. But if he is any kind of a man, with any backbone, then he has to protect his queen.

Unfortunately that usually does not happen. We do not have any data on what percent of HIV+ men who know they are positive are always using a condom with their female partners, but we do know that in many cities, the overwhelming majority of Black women who are infected with HIV are infected by a man who knew he was positive at the time of intercourse. That doesn't mean that he hated her, or had no regard for her. I'm not sure what it means. Often, the guy dimply doesn't know how to tell or explain why they should be using condoms. And too often Black women are aggressive , saying something like " I want to feel my man"...or "ain't nothing wrong with me so you come on in here and let me feel you." Some Black women feel that the guy is implying that he thinks she is playing around and that he is protecting himself. Too often in her desperation to keep him and let him know how much she "luvs" him, the Black woman will actively dismiss the condom idea. The result is 6 months later we have another HIV+ Black woman.

You see Joe can't run to his doctor and get him to give the girlfriend or wife some penicillin if it is HIV. And because Joe is afraid someone is going to think that he is bi-sexual or homosexual, he is not going to say anything to anyone. He lives in denial. Sometimes seeking prayer or a healing.

I had one man who knew he was positive went to a church and had the hands laid on him. He was told he was healed by the blood of Jesus. Therefore since he was healed, he did not feel it was appropriate to go and get tested again. " That would have been like not trusting God and believing in his power," he said. He eventually died, but he left a HIV + wife to care for her 3 kids by her prior marriage. And he left three heart broken kids who don't understand how this could have happened. What do you say? What can you say? But you can do !!

You can get tested and know your status. Now if you are HIV negative, then you do what ever it is necessary to stay HIV negative. You can start by looking in the mirror and learning to love that person staring back at you -if you haven't already learned to do that. No one is worth your life. And frankly there is no orgasm or good looks worth what you will have to endure to stay healthy.

The good news is there are treatments available. There is no cure. Prayer is great to get one to deal with their reality, but prayer will not cure HIV.

You may quote me. The stigma of HIV leads to the desperation of searching for alternatives. Too many patients seek therapies that offer no hope. The result is that they will present with a severely damaged immune system, requiring more medication and making the likelihood of immune reconstitution and improvement less likely. Some seek religious intervention. One went to a healer who prayed over him and told him he had been saved and healed. Since he had been healed he did not go and get tested again, but he did proceed to have sex with his new girlfriend and infect her. He felt getting tested would imply he has no faith so he "went out of faith" as he described it and ended up with a wife that was HIV positive.

HIV cannot be prayed away and there is no cure. The good news is that there are many medications and the healthier an individual is when he/she is found to be HIV+ the easier it is to keep them healthy. Each of us has a responsibility. It is inexcusable for someone to have unprotected sex when they know their HIV status. Still, not knowing your partner's status is no excuse to not protect yourself. 

Category: Health


 

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