Gender differences in audience participation at infectious disease and microbiology conferences: a prospective observational study

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OBJECTIVES: In medicine, women constitute a large proportion of the workforce but remain underrepresented in senior positions. Scientific conferences, critical for career advancement, reflect these inequities, with prior studies documenting gender gaps in invited speakers. However, less attention has been given to audience engagement, such as asking questions or making comments, which also enhances professional visibility. This study investigates gender differences in audience participation at infectious disease and clinical microbiology conferences, examining their prevalence, contextual variation, and potential structural drivers. METHODS: This prospective observational study recorded audience participations during national and international infectious disease and clinical microbiology conferences (October 2023-October 2024). Consortium members documented eligible sessions with traditional presentation-discussion formats, noting gender, role, and type of participation. Statistical analyses compared observed gender proportions with attendee distributions and examined factors associated with women's participation. RESULTS: A total of 298 sessions from 24 conferences were analysed, comprising 1873 audience participations. Women delivered 47.8% of presentations (n = 487/1018; 95% CI, 44.8-50.9%) but accounted for only 36.4% of participations (n = 681/1873; 95% CI, 34.2-38.5%), significantly fewer than men both in absolute terms and relative to their representation among attendees (p < 0.001). Multivariable analysis showed women were more likely to intervene when at least one moderator was female (OR = 1.44; 95% CI, 1.02-2.04%; p 0.037), with a stronger effect when all moderators were women (OR = 2.12; 95% CI, 1.40-3.24%; p < 0.001), and when the first question was asked by a woman (OR = 1.35; 95% CI, 1.00-1.81%; p 0.046). CONCLUSION: Our findings highlight actionable levers to advance equity. Addressing participation gaps and raising awareness of gender disparities are essential to foster inclusive visibility, empower women, and strengthen scientific innovation.

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