Revisiting cultural theory in the era of biomedical HIV prevention: Risk, sexual practice, and belonging among MSM in Amsterdam.

How is risk experienced, reframed, and redistributed in a sexual culture shifting from HIV prevention toward elimination? Drawing on ethnographic research conducted from March 2016 to August 2019 among men who have sex with men (MSM) in Amsterdam's sex clubs and private party scenes, this article revisits Mary Douglas's cultural theory of risk, particularly her grid (degree of social regulation) and group (strength of group incorporation/norms) typology. In the context of contemporary biomedical HIV prevention strategies, notably PrEP and the U=U (undetectable equals untransmittable) principle, Douglas's framework, which links risk perceptions to social organization and community norms, is reconceptualized by applying Rabinow's concept of biosociality to develop a biosocial grid-group framework (degree of biomedical regulation and biosocial incorporation). Biomedical advancements have significantly reshaped sexual cultures, normalizing condomless sex, chemsex, and other sexual experimentation. Ethnographic findings indicate that risk orientations often treated as stable in applications of grid-group theory are enacted fluidly, with men navigating them according to sexual setting, biomedical status, and collective norms. The article brings sexual fields theory into dialogue with the reconceptualized biosocial grid-group framework to highlight how different sexual venues mediate desirability, status hierarchies, and collective norms, and so mediate engagement with biomedical prevention. This is important for understanding why men navigate biosocial positions and use of biomedical prevention situationally rather than consistently. Sexual field contexts shape which orientation makes sense, is valued, or becomes practically possible. This theoretical synthesis illustrates how evolving biomedical realities continue to reshape cultural understandings of risk, offering a flexible analytical framework to capture these ongoing transformations.