The popular media has reinforced stereotypes of the down-low identity and Black men who have sex with men (BMSM) and women as being synonymous and directly responsible for the increased HIV infection rates among Black women in the United States. This review of literature found that the down-low identity was most often classified with the other MSM activities. HIV/AIDS were also closely associated with the down-low identity in much of the literature, either directly or indirectly. Results from this systematic literature, however, failed to support claims that risky sexual behaviors were directly associated with the down-low identity. None of the literature reviewed considered BMSM and women's gender expression within a bisexual context. Instead, this literature review generated new questions pertaining to the reductive manner in which Western societies organize BMSM and women's sexual identities, behaviors, and expressions.