Change in subjective social status following HIV diagnosis and associated effects on mental and physical health among HIV-positive gay men in Australia

Abstract

Objective: This study investigates the impact of HIV diagnosis on subjective social status and if changes are linked to health outcomes.Design: Two measures of subjective social status, socio-economic and standing in the community were examined in 342 Australian HIV-positive gay men in 2014. Participants recalled ratings at diagnosis were compared with current ratings.Main outcome measures: Self-reported mental (psychological distress, self-esteem, positive mental health and satisfaction with life) and physical health (self-rated health, CD4 count, viral load).Results: Half of the participants reported improvements in subjective socio-economic status (59%) or standing in the community (52%) since diagnosis, yet one quarter reported socio-economic status (25%) or standing in the community had decreased (23%). Increases in either measure of subjective social status were linked to higher self-esteem, positive mental health, satisfaction with life and better self-rated health. Decreases in subjective social status, however, were strongly linked to poorer outcomes on all mental health measures. Decreases in standing in the community were also associated with poorer physical self-rated health.Conclusion: Most participants reported their subjective social status were the same or better since diagnosis. Changes in subjective social status following diagnosis were strongly linked to mental health outcomes. Those who reported a decrease in subjective social status were particularly vulnerable to mental health problems.