Among bisexual MSM also called "men-on-the-down-low", sexuality driven risks stimulate spectrum of vulnerabilities for both genders. Pressure to marry may drive a greater proportion of MSM to have female partners, indicating the potential for bridging HIV transmission. However, these interactions are poorly understood and measurement of potential risk to MSM and their female partners is inconsistent especially in conservative societies like Bhutan, where sex is tabooed and homosexuality is restricted even in programmatic discussions.