Sex and gender: modifiers of health, disease, and medicine

The Lancet, Volume 396, Issue 10250, 22–28 August 2020, Pages 565-582
Mauvais-Jarvis, F., et al

Clinicians can encounter sex and gender disparities in diagnostic and therapeutic responses. These disparities are noted in epidemiology, pathophysiology, clinical manifestations, disease progression, and response to treatment. This Review discusses the fundamental influences of sex and gender as modifiers of the major causes of death and morbidity. We articulate how the genetic, epigenetic, and hormonal influences of biological sex influence physiology and disease, and how the social constructs of gender affect the behaviour of the community, clinicians, and patients in the health-care system and interact with pathobiology. We aim to guide clinicians and researchers to consider sex and gender in their approach to diagnosis, prevention, and treatment of diseases as a necessary and fundamental step towards precision medicine, which will benefit men’s and women’s health.

 

‘I’m over the moon!’: patient-perceived outcomes of hepatitis C treatment

I’m over the moon!’: patient-perceived outcomes of hepatitis C treatment

Davoud Pourmarzi, Andrew Smirnov, Lisa Hall, Gerard FitzGerald, and Tony Rahman

Australian Journal of Primary Health 26(4) 319-324 https://doi.org/10.1071/PY20013

Submitted: 22 January 2020  Accepted: 29 April 2020   Published: 25 June 2020

Abstract

Understanding patient-perceived outcomes is crucial for assessing the effectiveness and acceptability of hepatitis C virus (HCV) treatment. This study aimed to explore patient-perceived outcomes of receiving direct-acting antivirals (DAAs). This study was a part of a mixed-methods case study of the Prince Charles Hospital program for improving access to HCV treatment in community settings. Data were collected using semi-structured interviews with nine patients who were in different stages of their treatment for HCV. The participants were recruited using purposive sampling. All interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis. Patients emphasised ‘having more energy’ when reporting improvements in their physical health following treatment. They also reported a newly developed sense of freedom and hope. Improved physical and mental health empowered them to start a healthy lifestyle and to practise self-protection from the risk of re-infection. Patients highlighted their desire to help other patients to receive treatment, which was connected to their experience of the services that they received and their perceived health outcomes. Patients expect and experience various outcomes that are related to the physical, psychological and social aspects of living with, and being cured of HCV. Emphasis on the short-term outcomes of receiving HCV treatment may improve HCV treatment uptake and adherence rates.

Calls for segregated mental health wards to reduce sexual assault risk

ABC (Katherine Gregory on AM), February 2020

Sexual violence against women in mental health wards is going unchecked, despite service providers’ awareness of the problem.

A new report has found women in Victorian mental health wards are vulnerable to sexual assault, harassment and violence from male patients and staff.

It’s calling for stricter separation of male and female patients in mental health wards and an overhaul of how assault complaints are dealt with.

Broadcast: 
Duration: 3min 49sec
Featuring:

– Doctor Juliet Watson, RMIT University
– Charlotte Jones, Victorian Mental Health Legal Centre

 

 

Healthcare providers should discuss U=U with all their HIV-positive patients

aidsmap/nam, 18/03/2019

Healthcare providers should inform all patients with HIV they cannot transmit HIV to a sexual partner when their viral load is undetectable, argue the authors of  a strongly worded comment in The Lancet HIV.

The authors note that despite overwhelming scientific data supporting the undetectable = untransmittable (U=U) message, significant numbers of healthcare providers do not educate their patients about U=U when telling them their viral load is undetectable.

 

 

 

‘Sussing that doctor out’: Experiences of people affected by hepatitis C regarding private GPs in SA

‘Sussing that doctor out.’ Experiences and perspectives of people affected by hepatitis C regarding engagement with private general practitioners in South Australia: a qualitative study

BMC Fam Pract. 2017 Nov 29;18(1):97. doi: 10.1186/s12875-017-0669-2.

Abstract

Background: Australians with chronic hepatitis C (HCV) can access affordable Direct Acting Antiviral (DAA) treatments with high cure rates (>90%), via General Practitioners (GPs). Benefits from this treatment will be maximised if people with HCV readily disclose and engage with private GPs regarding HCV-related issues. Investigating the perceptions and experiences of people affected by HCV with GPs can allow for this pathway to care for HCV to be improved.

Methods: In 2013–2014, 22 purposively sampled participants from South Australia (SA) were interviewed. They a) had contracted or were at risk of hepatitis C (n = 10), b) were key workers who had clients affected by HCV (n = 6), and c) met both a) and b) criteria (n = 6). The semi-structured interviews were recorded, transcribed and thematically analysed.

Results: People affected by HCV viewed GPs as a source of general healthcare but, due to negative experiences and perceptions, many developed a strategy of “sussing” out doctors before engaging with and disclosing to a GP regarding HCV-related issues. Participants were doubtful about the benefits of engagement and disclosure, and did not assume that they would be provided best-practice care in a non-discriminatory, non-judgemental way. They perceived risks to confidentiality and risks of changes to the care they received from GPs upon disclosure.

Conclusion: GPs may need to act in ways that counteract the perceived risks and persuade people affected by HCV of the benefits of seeking HCV-related care.

Newly available: WHO HIV PrEP Implementation Tool Mobile App

World Health Organization, August 1, 2018

The WHO PrEP Implementation Tool App for Health Workers App is now available.

On-the-go access to the following modules from the WHO PrEP Implementation Tool:

  • Clinical: for clinicians, including physicians, nurses and clinical officers
  • Counsellors: for staff who counsel people as they consider or start taking PrEP, and support them in coping with side effects and adherence strategies
  • Pharmacists: for pharmacists and people working in pharmacies; to provide information on the medicines used in PrEP as well as storage conditions
  • Testing providers: for people who provide testing services at PrEP sites and laboratories
  • PrEP users: for people taking PrEP and people interested in taking PrEP to reduce their risk of acquiring HIV; to support them in their choice and use of PrEP.

For more information and to download app, click here 

You can also visit these two websites: