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

 

 

Diagnosis and Management of Syphilis in Patients With HIV Co-infection

Khaw, C., Malden, C., Ratnayake, M. et al. Diagnosis and Management of Syphilis in Patients With HIV Co-infectionCurr Treat Options Infect Dis (2020). https://doi.org/10.1007/s40506-020-00225-6

Published

Purpose of review

Syphilis cases are on the increase especially in men who have sex with men (MSM) in urban areas of high-income countries.

There is a strong association between syphilis and HIV infections.

We review the more recent literature regarding the epidemiology, clinical manifestations, diagnostic investigations, treatment and follow-up of syphilis in HIV infection.

  • Read abstract here (For full text access you can purchase from the publisher or see your librarian)

Coronavirus disease (COVID-19), HIV & hepatitis C: What you need to know

CATIE (Canada), 17 March 2020

  • An HIV-positive person on effective treatment is not expected to be at higher risk of becoming seriously ill with COVID-19
  • A person with untreated HIV or a low CD4+ cell count may be at higher risk of becoming seriously ill with COVID-19
  • People with HIV or hepatitis C are more likely to have other conditions that carry a greater risk of becoming seriously ill with COVID-19

 

 

Female genital cutting (FGC) & cervical screening: A guide for practitioners

CANCER COUNCIL VICTORIA & WOMEN’S HEALTH WEST FARREP
PROGRAM, First published 2017

The World Health Organization defines female genital cutting (FGC) as ‘all procedures that include partial or total removal of female genital organs or other injury to female genital organs for non-medical reasons’.

‘Female genital mutilation’ is the term used in Australian and Victorian legislation, but the preferred way to refer to the practice using culturally sensitive language is ‘female circumcision’ or ‘traditional cutting’. The age at which this occurs varies from infancy to 15 years.

The practice is referred to as FGC throughout this document.

This 2-page guideline document includes facts about prevalance, type, appropriate questioning, examination technique, and more.

 

Updated Guidelines: Australian STI & HIV Testing Guidelines 2019 for Asymptomatic MSM

Sexually Transmissible Infections in Gay Men Action Group (STIGMA), September 2019

Most sexually transmitted infections (STIs) are asymptomatic. Testing and treatment of asymptomatic men who have sex with men (MSM) is the most effective method to interrupt transmission and reduce the burden of illness. In particular, syphilis is increasingly common, is often asymptomatic, and can cause significant morbidity.

The main barriers to STI control are insufficient frequency of testing in MSM, and incomplete testing. For example, chlamydia and gonorrhoea tests should be performed at all three sites (swab of oropharynx and anorectum, and first
pass urine), and syphilis serology should be performed every time a HIV test or HIV treatment monitoring is performed.

HIV is now a medically preventable infection. All men who are eligible under the Australian HIV Pre-Exposure guidelines should be actively offered PrEP: www.ashm.org.au/HIV/PrEP All people with HIV should be advised to commence treatment and, where possible, have an undetectable viral load.
These guidelines are intended for all MSM, including trans men who have sex with other men .

This current version is endorsed by the Australasian Society for HIV, Viral Hepatitis, and Sexual Health Medicine, Australasian Sexual Health Alliance, Australasian Chapter of Sexual Health Medicine of the Royal Australasian College of Physicians and is approved as an accepted clinical resource by the Royal Australian College of General Practitioners.