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With 80% of the cases of HIV in women related to heterosexual transmission, 9 MSM who have sex with women while keeping their sexual activity with men a secret can place women at high risk for acquiring HIV infection. 6 Further, straight and bisexual men in that study reported low incidence of condom use with either women or men. Carballo-Dieguez and Dolezal found that among a group of Puerto Rican MSM, men who self-identified as straight reported that as long as they are the insertive partner in same-sex contact, they do not view their behavior as homosexual. 7, 8 Many of these men have sex with both men and women. 4 However, a number of studies have shown that many MSM do not self-identify as gay, but rather as bisexual or straight 5, 6 and have little contact with the organized gay community. found that socialization into the gay community had a positive effect on safe sex practices such as condom use. 2, 3 This upward trend in HIV infection among MSM supports the critical need to explore factors that may be contributing to increasing transmission of HIV infection among MSM and their sex partners. 1 There is growing evidence that safe sex practices, once thought to be having significant effects in reducing HIV infection among gay men, may be becoming less prevalent. epidemic is increasing most rapidly among members of ethnic minority groups, men who have sex with men (MSM) continued to account for 53% of new HIV infections in 2006. have been underestimated by as many as 16,000 per year using previous projection models. In fact, a recent report from the Centers for Disease Control and Prevention indicates that the number of new cases of HIV in the U.S. Despite 25 years of educational and prevention efforts, significant numbers of individuals in the United States become infected with the human immunodeficiency virus (HIV) each year.