Being "down low" refers to living a secret life as a gay, bisexual, or lesbian individual. Historically, it was associated with those afraid to come out of the closet, but now includes recently released prisoners and married men having secret same-sex relationships. Living on the down low can spread HIV and other diseases due to unprotected sex with multiple partners who are unaware of one's sexuality. Educating youth and promoting open communication about sexuality issues may help reduce the negative impacts of staying closeted.