A new study out of the University of Toronto confirms what I cited the Radical Faerie Middle claiming anecdotally back in October. The study (link requires access) -- published in the Journal of Health and Social Behavior -- is based on interviews with 70 gay men and is coupled with three years of "fieldwork" (you just have to wonder what that included!). Here's the abstract, which conveys the meat of the argument:

In this article, I apply the stress process model as a framework to understand sexual sociality and its impact on health among urban gay men in a large North American gay enclave. Data consisting of in-depth interviews with 70 gay men coupled with three years of fieldwork demonstrate a sexual status order that privileges caucasian, middle-class men in their twenties and early thirties, and that disadvantages black and Asian men, men over 40 years of age, and poor men. Men with low sexual status faced significant stressors in the form of avoidance from others, stigmatization, and rejection. These stressors, in turn, taxed personal resources, including self-esteem, sense of social support, and sense of control, and they also negatively affected emotional states in the form of depression and anxiety. Finally, some low status men were unable to consistently negotiate condom use as a consequence of a history of field stressors and diminished personal resources. The results suggest that more work on sexual status structures and their connection to health is needed, both within gay enclaves and across a broader spectrum of sexual subcultures.

In my mind, this is a game-changer. It fully repudiates the behavioral and rational-choice theory bullshit that's been spewing out of Public Health research centers for the past decade. It evidences what many of us have known since we started getting laid in the gay culture: sexual status is the nexus of a complex network of factors (age/race/dick size/body type/class/mannerisms/etc) that influence: 1) how often you get laid; 2) who / what kind of person is willing to sleep with you; and, 3) how much control you have over the situation when you do get laid.

We've got to start reformulating how HIV research is done if we want to be able to understand these complex processes. We've got to care more about culture and negotiation than we do behavior and demographics. We need to destroy the epidemiology paradigm. Evidence like this puts ammo in our hands. We need to take it to the institutions that control funding streams and demand that change.