1/2 March 2021
Objectives of the module
- can explain the influence of sex and gender on the risk of sexually transmitted infections (STI) and HIV and know the core group theory, sexual behaviour and networks, and the most important factors for STI and HIV epidemics.
- know anatomical and physiological sex differences in lung health and disease, the effects of sex hormones on various lung diseases and the importance of social aspects, health behaviour and symptom perception.
- are aware of gender differences in the diagnosis and treatment of urological tumours, urinary tract infections and bladder dysfunction and understand the role of anatomy and hormones.
Content of the module
The module combines the fields of infectiology, pneumology and urology. Different risk behaviour, the influence of gender roles, differences in anatomy and sex-specific characteristics of the immune system lead to important differences in the epidemiology, expression, course and treatment of diseases.
In concrete terms, the module comprises the following blocks:
Depending on sexual identity and orientation, risk behaviour with regard to certain infectious diseases differs. However, anatomical and genetic differences also contribute to different susceptibilities and differences in the pathogenesis of infectious diseases. The block Infectiology deals in particular with
- the role of sex and gender in the epidemiology of HIV and sexually transmitted infections (STI): the spread of these infections is influenced by interactions between the pathogen, the host and the environment. And both sex and gender are important determinants of risk. Sexual and gender identity, which influence the choice of same-sex or opposite-sex sexual partners, also influence the risk of acquiring and transmitting STI. For example, men who have sex with men (MSM) are at greater risk of acquiring and transmitting STI than men who only have sex with women or women. We will discuss the epidemiology of bacterial, viral and protozoal STI.
- sex- and gender-specific aspects relating to prevention, infection risk, transmission, diagnosis and treatment of HIV.
- differences in the symptoms of sexually transmitted diseases.
- consequences of sexually transmitted diseases for women and men (fertility, obstetric complications, vertical transmission).
- access to therapy/prevention.
In the past, men were more frequently affected by chronic lung diseases than women, although the prevalence of smoking-related lung diseases has converged in recent decades. Awareness of sex and gender differences in risk and susceptibility to lung disease, the effects of lung disease on morbidity and mortality, and differences in response to treatment are growing. In this block, we discuss sex and gender differences in lung health and disease, anatomical and physiological sex differences, the underlying biology, and in particular the effects of sex hormones on different lung diseases. Other social aspects, health behaviour and symptom perception will be addressed, including reflections on personalised and gender-specific management of lung diseases. Specific topics will be:
- sex- and gender-specific differences in the prevalence and severity of numerous immunological diseases have long been known. The reasons for this seem to lie in sex chromosomes per se as well as in differences in gene regulation caused by sex hormones, in interactions with the microbiome and in membrane receptor-mediated reactions. The fact that the incidence of rheumatoid arthritis in women increases both postpartum and at the onset of menopause indicates that absolute hormone levels do not necessarily play a role in the development of the disease.
- In addition to different pathophysiological sex differences, differences in response to therapeutics (e.g. in patients with psoriatic arthritis and therapy with TNFa inhibitors) could also be shown. Thus, sex and gender seems to be of crucial importance also with regard to an optimal personalized therapy.
Urology includes both benign and malignant diseases of the urinary tract (kidney, ureter, bladder and urethra) in men and women as well as the external male genitals. These include tumors of the urothelium (urothelial carcinoma), the entire urinary tract, as well as kidney tumors, stone disease and bladder dysfunction including urinary tract infections. This block deals specifically with the differences between the sexes in the diagnosis and treatment of urological diseases, including cancer, urinary tract infections and bladder dysfunction (irritable bladder, incontinence). The anatomical differences and the role of hormones are explained.
Dr. med. Christoph Hauser, Universitätsklinik für Infektiologie, Inselspital, Universität Bern (Chair)
Prof. Dr. med. Hansjakob Furrer, Universitätsklinik für Infektiologie, Inselspital, Universität Bern
Prof. Dr. med. Nicola Low, Institut für Sozial- und Präventivmedizin, Universität Bern
Dr. med. Christine Thurnheer, Universitätsklinik für Infektiologie, Inselspital, Universität Bern
Prof. Dr. med. Annelies Zinkernagel, Klinik für Infektionskrankheiten und Spitalhygiene, Universitätsspital Zürich
Dr. med. Silvio Brugger, Klinik für Infektionskrankheiten und Spitalhygiene, Universitätsspital Zürich
Prof. Dr. med. Thomas Geiser, Universitätsklinik für Pneumologie, Inselspital, Universität Bern
Prof. Dr. med. Fiona Burkhard, Universitätsklinik für Urologie, Inselspital, Universität Bern
2 February 2021