Photo Credit: iStock.com/bowie15

Worldwide, men show higher hypertension, diabetes, and HIV/AIDS prevalence and mortality, according to a recently published global scoping review.

A global scoping review published in PLOS Medicine revealed that men exhibit higher hypertension, diabetes, and HIV/AIDS prevalence and mortality, whereas women generally achieve better diagnosis, treatment, and disease control, highlighting complex bidirectional gender influences on health.

“Findings revealed that males face a double burden of higher prevalence of risk factors and diseases while also experiencing lower access to diagnosis and treatment,” wrote Angela Y. Chang, ScD, University of Southern Denmark, and colleagues.

Examining the Entire Health Pathway

The researchers reviewed published papers that included sex‑disaggregated global data spanning the full “health pathway”—from risk exposure through mortality—across eight high‑burden conditions. However, they located complete three‑step care‑cascade information (diagnosis, treatment, control) for only three illnesses—hypertension, diabetes, and HIV/AIDS—highlighting a persistent evidence gap.

The authors identified sex differences at every step of the pathway for each condition and interpreted the findings through a gender analysis lens.

“By examining the entire health pathway, we can identify the various points at which inequities arise, generate more nuanced hypotheses of the complex network of influences shaping health and mortality outcomes,” the researchers wrote, “and thereby design interventions that are more responsive to the roles that sex and gender are playing in outcome differences and arguably improve the health of all.”

Sex Differences at Every Juncture

Marked sex differences emerged at every juncture of the hypertension, diabetes, and HIV/AIDs pathways, the researchers reported. Globally, males showed significantly higher disease prevalence in 56% of countries for HIV/AIDS, 30% for diabetes, and 4 % for hypertension, while females exceeded males in 14%, 5%, and only India, respectively; male mortality likewise surpassed female mortality in 131 countries (64%) for HIV/AIDS, 107 (53%) for hypertension, and 100 (49%) for diabetes, whereas female‑predominant mortality was limited to 25 countries (12%) for HIV/AIDS, 9 (4%) for diabetes, and only the United Arab Emirates for hypertension. Regarding risk factors, smoking rates were significantly higher for males in 86% of countries. 

Females generally achieved higher rates of diagnosis, treatment, and disease control across all three conditions; however, women bore higher burdens of obesity and reported unsafe sexual behaviors more often in most countries, underscoring the nuanced, bidirectional nature of gender influences on health. 

Data Gaps & Limitations

The study also identified a lack of comprehensive, sex-disaggregated data overall, which impeded precise cross-country comparisons. Although sex-disaggregated data were found for risk factors, disease prevalence, and mortality for 3 of the 8 conditions across 204 countries, sex-disaggregated data for the care cascade analyses were found for only 39 countries for diabetes, 76 countries for HIV/AIDS, and 200 countries for hypertension.

Implications for Policy & Practice

The authors stressed “the increasing need to encourage more male participation in preventive and health care services” and “the importance of sex-disaggregated data in understanding health inequities.”

“Despite limitations in data availability and completeness, this study elucidates the need for more comprehensive and harmonized datasets for these and other conditions to monitor sex differences and implement sex-/gender-responsive interventions along the health pathway,” the researchers concluded.