HIV, syphilis and sexual risk behaviours among men who have sex with men in Agadir and Marrakesh, Morocco
- Lisa Grazina Johnston1,
- Kamal Alami2,
- M Houssine El Rhilani2,
- Mehdi Karkouri3,4,
- Othoman Mellouk5,
- Alise Abadie4,
- Nadia Rafif4,
- Lahoucine Ouarsas4,
- Aziza Bennani6,
- Boutaina El Omari7
- 1University of California, San Francisco, Global Health Sciences, San Francisco, USA
- 2UNAIDS, Rabat, Morocco
- 3Faculté de Médecine et de Pharmacie/Centre Hospitalier Universitaire Ibn Roche, Casablanca, Morocco
- 4Association de Lutte contre le sida, Marrakesh, Morocco
- 5International Treatment Preparedness Coalition, North Africa, Marrakesh, Morocco
- 6Ministère de la Santé, Programme National de Lutte contre le SIDA, Rabat, Morocco
- 7Unité de Gestion du Fonds Mondial, Ministère de la Santé, Rabat, Morocco
- Correspondence to Dr Lisa Johnston, Nieuwezijds Voorburgwal 64F, 1012 SC, Amsterdam 94105, Netherlands; , http://www.lisagjohnston.com
- Received 13 November 2012
- Revised 13 March 2013
- Accepted 1 April 2013
- Published Online First 25 April 2013
Objective To collect baseline measurements of HIV and syphilis prevalence and sexual risk behaviours among men who have sex with men (MSM) in Agadir and Marrakech, Morocco, and provide strategic information to improve outreach programmes.
Methods and Design Respondent-driven sampling was used to recruit men who reported having anal sex with another man in the last 6 months, aged 18 years and older and living in either Agadir or Marrakech for the past 6 months, regardless of nationality. Data were analysed with the multiplicity estimator using respondent-driven sampling analysis tool V.6.0.
Results 323 MSM in Agadir and 346 in Marrakech were recruited into the survey. Most MSM in both cities reported being < 25 years, being unemployed, bisexual and in a couple with both a man and a woman. Most reported selling sex and having sex with women. HIV prevalence was 5.6% in Agadir and 2.8% in Marrakesh; syphilis was 7.0% in Agadir and 10.8% in Marrakesh. Among MSM who tested positive for HIV, 31.6% in Agadir and 56.4% in Marrakesh were co-infected with syphilis.
Conclusions HIV and syphilis findings coupled with high risk activities indicate the need for expanding programmes targeting MSM throughout Morocco. Selling sex and sex with women may be a strategy to cope with extreme stigma towards MSM. Criminalisation and discrimination of MSM in Morocco underscores the urgent need for long-term and sustainable risk reduction through legal reforms and promotion and protection of human rights.
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