title: HIV, syphilis and sexual risk behaviours among men who have sex with men in Agadir and Marrakesh, Morocco.
abstract: 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
  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.
authors.affiliation: University of California, San Francisco, Global Health Sciences, , San Francisco, USA.
authors.forename: Lisa Grazina
authors.initials: LG
authors.lastname: Johnston
authors.forename: Kamal
authors.initials: K
authors.lastname: Alami
authors.forename: M Houssine
authors.initials: MH
authors.lastname: El Rhilani
authors.forename: Mehdi
authors.initials: M
authors.lastname: Karkouri
authors.forename: Othoman
authors.initials: O
authors.lastname: Mellouk
authors.forename: Alise
authors.initials: A
authors.lastname: Abadie
authors.forename: Nadia
authors.initials: N
authors.lastname: Rafif
authors.forename: Lahoucine
authors.initials: L
authors.lastname: Ouarsas
authors.forename: Aziza
authors.initials: A
authors.lastname: Bennani
authors.forename: Boutaina
authors.initials: B
authors.lastname: El Omari
mesh_terms: D000328:Adult; D001727:Bisexuality / Q000706:statistics & numerical data*; D003415:Crime; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission; D018451:Homosexuality, Male / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009018:Morocco / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D040242:Risk Reduction Behavior; D012309:Risk-Taking; D018571:Sentinel Surveillance; D012725:Sexual Behavior; D012747:Sexual Partners; D057545:Social Stigma; D011795:Surveys and Questionnaires; D013587:Syphilis / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission
keywords: Hiv; Homosexuality; Sexual Behaviour; Surveillance