Why do we use terms like men who have sex with men? I mean it's a term that I've gotten to be very comfortable with over the years. It's a term that emerged through work with the Centers for Disease Control over the years because the term gay and bisexual was not working in work with non-white men. And so African- American particularly and Latino communities emerged and said, "Look, we need to have a different language.” But even that language doesn't meet the mark because men who have sex with men has itself become a label, and some people don't identify with that.

And so in our qualitative work, we have a whole litany of terms that people told us they use to describe themselves, and in a quantitative instrument that we use, we have a drop menu. I think it had 45 different things that you could call yourself. And so we have to go back and look and see how people have called themselves, but really I mean in terms of HIV prevention, the label may have some significance, but it's ultimately the behavior.

AIDS is transmitted through a behavior, not through a label. Maybe the label conscribes and contributes something. People like to think so. But it's still the behavior, and we're finding a lot of inconsistencies with labels. We have a lot of men who identified as gay who have primary female partners. We have a lot of men who identify as heterosexual who haven't had sex with a woman in four years.

So who is heterosexual and who is not becomes a real critical question. So the term men who have sex with men, MSM, we use as a broad label to capture the whole experience of the behavior, and not just the label.