In same-sex sexual contexts, Down-low refers to men who have sex with men (MSM) but are either closeted or do not identify as gay. The term is most often associated with and has its origins in African American culture in the United States but it is not exclusive to that group. This usage emerged during the 90s in inner-cities across the United States, and early in the 2000s when a series of mainstream media reports emerged, some equating the phenomenon with men who have sex with both men and women, and some tying the behaviour to the ongoing AIDS pandemic.