The down low, social stigma, and risky sexual behaviors: insights from African-American men who have sex with men.

The "down low" is purported to contribute to social stigma associated with being homosexual and may influence risk behaviors. This article examines communication patterns among stigmatized groups and reports the findings from 32 structured interviews and five focus groups with African-American men who have sex with men. Results indicate negative emotions associated with labels based on sexual practices, the influential role of organized religion in social stigma, and barriers to reaching stigmatized groups. These findings can be used to build culturally appropriate sexual risk interventions for this population.