SIT and health

Tuesday 26 February 2013

Sometimes students can surprise you.  When reading through a stack of essays on Social Identity Theory, I came across a study that I did not know.  The study (Cole, Kemeny & Taylor, 1997) looked at the role of Social Identity on the progression of HIV in gay men.  The study provides an interesting link between SIT and our health.

The study

The researchers wanted to see if HIV might progress more rapidly in gay men who were sensitive to social rejection. In other words, if the men experienced feelings of being in an out-group that impacted on their self-esteem, would they be more likely to develop full-blown AIDS more quickly than other infected men?

The study was a nine-year prospective study of 72 initially healthy HIV infected gay men.  The sample was taken from a larger sample of well-educated, affluent, and largely White participants in a long-term biomedical study conducted in an urban west-coast setting.

In order to determine the men’s level of rejection sensitivity, they were given the "Social Situations Scale test."   The questionnaire asks gay male respondents to consider a variety of social situations in which their homosexuality might be particularly salient to others.  Those with high “rejection sensitivity” scored high on both “family-friend” questions (e.g., attending a family function with a partner) and “stranger-public” questions (getting a motel room for yourself and your partner.)

Every six months, blood was drawn and the lymphocyte count taken.  Interviews were also done with each participant to determine if any other factors may have played a role in a change in health.  This included discussions of exercise, diet, changes at work or among friendship circles and sexual activity.

The researchers found that rejection sensitive individuals experienced a significant acceleration to a low CD4 T lymphocyte level to AIDS diagnosis and to HIV related mortality. HIV infection advanced significantly more rapidly in gay men who showed high levels of stranger-public rejection sensitivity. Family-friend rejection sensitivity failed to significantly predict a rapid decline in health.

These results consistently indicate that HIV infection progressed more rapidly in gay men who were particularly sensitive to rejection by unfamiliar others. These differences were substantial, with gay men at the 75th percentile of rejection suffering AIDS onset and HIV-related mortality roughly 2 years earlier than their counterparts at the 25th percentile

Gay men who were particularly sensitive to rejection by unfamiliar others (stranger-public) were also significantly more likely to conceal their homosexual identity.  And interestingly, concealing homosexuality reduced the progression of the disease.

On each measure of disease progression studied, rejection-sensitive gay men who were in the closet experienced significantly weaker accelerations in HIV progression than did those who were out.

These results suggest that the physical health risks associated with rejection sensitivity stem directly from responses to the threat of social rejection rather than from some other behavioral, affective, or temperamental correlate of rejection sensitivity.

Although these data suggest that sensitivity to social rejection may relate to the rate of HIV progression, they do not provide any information on the physiologic mechanisms linking these two variables.


Cole, S., Kemeny, M., and S. Taylor (1997). Social Identity and Physical Health: Accelerated HIV progression in Rejection-Sensitive Gay Men.  Journal of Personality and Social Psychology; 1997; Vol 72; No 2 320 – 335.

Tags: Social identity theory, health, HIV, gay, infection, immune system, rejection


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