Sexuality has also had a significant impact on HIV/AIDS in the Caribbean. The prevalence of HIV among men who have sex with men (MSM) seems to be high, though reliable, current data is lacking. The HIV prevalence rate across the Caribbean between MSM varies, ranging from 11.7 percent in the Dominican Republic (1996) to 18 percent in Suriname (1998) to 33.6 percent in Jamaica (1996). While unprotected sex between men is undoubtedly a major contributing factor to the epidemic, it remains largely hidden in the data. In many Caribbean countries, gay sexual relations remain illegal. This has led to a heavy stigma associated with same-sex relationships. This stigma and widespread discrimination are definite factors in the spread of HIV. In Trinidad and Tobago, one in five MSM were HIV positive, and out of those, one in four said they also have sex with women. Because of the stigma and discrimination, these men hide their same sex behavior and become involved with women who do not know about their sexuality. This has created a bridge for HIV to pass from the gay community to the general population.