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.

SEXUAL HEALTH MATTERS: new clinical podcast from SHINE SA

SHINE SA, May 2020

Filled with quality clinical guidance and tips for best practice, SHINE SA’s new Sexual Health Matters – Clinical Podcast delves into the intimate regions of the body and broaches the uncomfortable conversations necessary to ensure client safety and sexual/reproductive well-being.

Through discussion, interview and explanation, experienced sexual health clinicians raise awareness of guidelines, resources, research and emerging trends to ensure that clinicians everywhere can provide excellent sexual and reproductive care to improve client outcomes.

If you have a topic you would like us to cover in future podcasts, email courses@shinesa.org.au to let us know!

Intersex people and COVID-19

Intersex Human Rights Australia, 12 April 2020

COVID-19 can infect any individual, irrespective of age or health but its impact exacerbates existing inequalities. All populations that suffer health inequalities are disproportionately affected, and people with intersex variations are no exception.

Current health is determined to some extent by biological factors.

Internet-based self-sampling for Chlamydia trachomatis testing

Söderqvist JGullsby KStark L, et al
Internet-based self-sampling for Chlamydia trachomatis testing: a national evaluation in Sweden

Abstract:

Objective Internet-based testing for Chlamydia trachomatis (CT) with self-sampling at home has gradually been implemented in Sweden since 2006 as a free-of-charge service within the public healthcare system. This study evaluated the national diagnostic outcome of this service.

Methods Requests for data on both self-sampling at home and clinic-based sampling for CT testing were sent to the laboratories in 18 of 21 counties. Four laboratories were also asked to provide data on testing patterns at the individual level for the years 2013–2017.

Results The proportion of self-sampling increased gradually from 2013, comprising 22.0% of all CT tests in Sweden in 2017. In an analysis of 14 counties (representing 83% of the population), self-sampling increased by 115% between 2013 and 2017 for women, compared with 71% for men, while test volumes for clinic-based sampling were fairly constant for both sexes (1.8% increase for women, 15% increase for men). In 2017 self-sampling accounted for 20.3% of all detected CT cases, and the detection rate was higher than, but similar to, clinic-based testing (5.5% vs 5.1%). The proportion of self-sampling men was also higher, but similar (33.7% vs 30.8%). Analysis of individual testing patterns in four counties over 5 years showed a higher proportion of men using self-sampling only (67%, n=10 533) compared with women (40%, n=8885).

Conclusions Self-sampling has increased substantially in recent years, especially among women. This service is at least as beneficial as clinic-based screening for detection of CT, and self-sampling reaches men more than clinic-based testing.

Snapshot of mental health and suicide prevention statistics for LGBTI people

The National LGBTI Health Alliance (The Alliance), February 2020

Although many lesbian, gay, bisexual, transgender and intersex (LGBTI) Australians live healthy and happy lives, research has demonstrated that a disproportionate number experience poorer mental health outcomes and have higher risk of suicidal behaviours than their peers.

These health outcomes are directly related to experiences of stigma, prejudice, discrimination and abuse on the basis of being LGBTI. This document aims to provide a snapshot of what is known of the current mental health and wellbeing outcomes of LGBTI people in Australia.