increase in the share of men and women who self-report a bisexual orientation in their 2011–2013 study compared to previous surveys. Likewise, in the Second Australian Study of Health and Relationships, whose data was collected in 2012 and 2013, researchers noticed significant growth in the share of women who report bisexual orientation and attraction, and the share of men who report exclusive homosexual attraction, compared to the results of the First Australian Study of Health and Relationships, executed in 2001. Cultural perceptions The population that has come to be referred to as gay in the West is not a descriptive term that would be recognized by all men who have sex with men (MSM) as known in the rest of the world. While gay culture is increasingly open and discussed, the world of MSM consists of a diverse population that often may respond differently depending on how communications in clinical settings are framed. Gay is generally used to describe a homosexual sexual orientation, while MSM describes sexual behavior between men. Some men who have sex with other men will not relate to the term gay or homosexual, and do not regard sexual activity with other men as actual sexual activity. Instead, they view sexual relations with women as valid. This is particularly true among individuals from non-Western cultures, but it is also common in the US. Terms such as MSM or same gender loving are often used in place of the word gay. Men in Africa and Latin America engage in sexual relationships with other men while still referring to themselves as heterosexual, which is known as being on the "down-low". There is a relative lack of information on sexual behavior in most developing countries. The limited sources that are available indicate that although homosexual self-identification might occur relatively infrequently, the prevalence of homosexual behavior is higher. These men are not taken into consideration in some sexual identity surveys which may lead to under-reporting and inaccuracies. Importance of having reliable demographics Reliable data on the size of the gay and lesbian population would be valuable for informing public policy. For example, demographics would help calculate the costs and benefits of domestic partnership benefits, of the impact of legalizing gay adoption. Further, knowledge of the size of the "gay and lesbian population holds promise for helping social scientists understand a wide array of important questions—questions about the general nature of labor