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.

 

Australian Burden of Disease Study: Illicit Drug Use, Intimate Partner Violence, Unsafe Sex

 Australian Institute of Health and Welfare, Last updated: 

Burden of disease is a measure of the years of healthy life lost from living with, or dying from disease and injury. A portion of this burden is preventable, being due to modifiable risk factors. This report provides information on the deaths and burden of disease due to risk factors included in the Australian Burden of Disease Study 2015. 

New analyses of the key drivers of change over time in the burden of disease due to selected risk factors have recently been added to these data visualisations (August 2020).

The following excerpts may be of interest:

Or you can see all the data here

 

 

Medical Board releases new guidelines for practitioners and students on blood-borne viruses

Medical Board of Australia, 23 Jun 2020

The Medical Board of Australia is encouraging practitioners and students to review the new Guidelines for registered health practitioners and students in relation to blood-borne viruses before they take effect on 6 July 2020.

The Board’s guidelines are for practitioners and students who perform exposure-prone procedures and registered health practitioners who are treating registered health practitioners or students living with a blood-borne virus who perform exposure-prone procedures.

 

 

 

Factsheet: Your rights and responsibilities when living with hepatitis B or hepatitis C

Hepatitis Australia,  23 April 2020

This brief factsheet provides an overview of peoples’ rights and responsibilities when living with hepatitis B or hepatitis C.

New COVID Taskforce website from ASHM

ASHM, UPDATED ON: 14 April 2020

ASHM’s Taskforce on BBVs, Sexual Health and COVID-19 was established on 20 March 2020. It provides a timely opportunity for the BBV and sexual health sectors to discuss the scientific, clinical, BBV and sexual health service delivery and social implications of COVID-19, and provides consistent and evidence-based messaging to the health workforce, sector partners and community.

The website contains interim recommendations on:

  • adults living with HIV
  • adults living with chronic hepatitis B.
  • adults living with hepatitis C, or the complications of previous hepatitis C infection
  • people who are incarcerated in criminal justice settings during the COVID-19 pandemic including those who are living with HIV, hepatitis B and hepatitis C.

 

Position Statement on LARC access during the COVID-19 pandemic

SHINE SA, April 7, 2020

SHINE SA, along with Family Planning VictoriaFamily Planning NTFamily Planning TasmaniaSexual Health and Family Planning ACTSexual Health Quarters, and True Relationships & Reproductive Health have co-signed a Position Statement on LARC access during the COVID-19 pandemic.

Extended use of and ongoing access to LARCs during the COVID-19 pandemic

Provision of contraception is essential during the COVID-19 pandemic to prevent unintended pregnancies. This is particularly important for individuals most at risk, including young people due to their high levels of fertility, people with serious health conditions, and for those who are post-abortion. Long Acting Reversible Contraceptive methods (LARCs) are more effective than shorter acting methods and increased community access and uptake is associated with lower abortion rates.

Ongoing access to LARC insertion is essential during the pandemic

Contraception is essential health care and all efforts should be made to continue the insertion of LARCs during the pandemic. To reduce the risk of infection with COVID-19, this may require different approaches to insertion such as a wearing mask during insertion of contraceptive implant or using an inserter-only approach for IUD insertion (with an assistant outside the room for emergencies).

Summary of recommendations during the pandemic

  • All efforts should be made to continue access to insertion of LARCs during the pandemic, particularly for younger people, people with serious health conditions, and post-abortion
  • The etonogestrel implant (Implanon NXT) can be extended off-label for use up to 4 years
  • The 52mg LNG IUD (Mirena) can be extended off-label for use up to 6 years
  • The 19.5mg LNG IUD (Kyleena) cannot be extended beyond 5 years
  • Standard sized T shaped banded copper IUDs can be extended off-label for use up to 12 years
  • 5-year copper IUDs (Load 375 and Copper T short) can be extended off-label for use up to 6 years
  • Additional use of condoms and/or a contraceptive pill should be discussed with users for whom the risk of an unintended pregnancy is unacceptable during extended use.