Subjective social status and health among HIV-positive Latino men who have sex with men

The current study investigated the utility of two measures of subjective social status (in the nation or in the community) in predicting health outcomes among Latino HIV-positive men who have sex with men. One-hundred-fifty-five Latino men completed computer-assisted questionnaires as part of a larger study on HIV status disclosure. A validated visual-spatial index, the Ladder, was used to assess national subjective status (NSS) and community subjective status (CSS). Income level, education level, and occupational prestige were included as SES indicators; health outcomes included the Physical Health and Mental Health scale scores from the Medical Outcomes Study 12-Item Short-Form Health Survey along with self-reported HIV viral load and CD4+/T-cell count. After controlling for age, self-esteem, and severity of HIV disease, NSS was not associated with any of the health outcomes, but CSS showed a trend toward an association with CD4+/T-cell count (Delta R2 = .026, F[1,125] = 3.68, p < .10). Traditional SES measures were not related to health outcomes in this HIV-positive sample. Rather, self-esteem and severity of HIV disease were the strongest predictors of health. Correlates of subjective social status included experienced discrimination, which was associated with subjective status in the nation and in the community (F[1,147] = 4.03, p < .05 and F[1,147] = 5.14, p < .05, respectively). Overall, the results do not support the utility of NSS but provide partial support for CSS with this sample. Future research can build on this and promising prior studies by exploring the subjective constructs' meanings among diverse populations with larger samples and more sophisticated statistical modeling. Continued research may contribute to understanding the mechanisms through which social status impacts health.