HIV/AIDS among migrants in Morocco: a cross-sectional biobehavioral study.

Background: Morocco has become a transit and destination country for thousands of migrants, primarily from sub-Saharan African countries. Migrant groups in Morocco are recognized as key populations vulnerable to HIV/AIDS in the national strategic plans on HIV. This study aims to describe the HIV status, knowledge, attitudes, and risk behaviors among a sample of migrants in northeastern Morocco, as well as their access to HIV prevention, testing and counseling services.

Methods: This cross-sectional biobehavioral survey described the prevalence of HIV, HIV/AIDS knowledge, attitudes, and risk behaviors among migrant populations in Oujda, northeastern Morocco. Using respondent-driven sampling (RDS), adult migrants aged > 18 years, residing in the study area for more than 3 months, and fluent in French or English were included in the study. Data collection was conducted using a questionnaire covering demographics, HIV/AIDS knowledge, attitudes, risk behaviors, and HIV testing. HIV testing included initial rapid tests and confirmatory tests for reactive specimens and polymerase chain reaction (PCR) for discordant or indeterminate results.

Results: Among the 290 respondents, HIV prevalence was 1.7%. About 82% had heard of HIV, half of whom were aware of protective measures such as abstinence (50.4%), condom use (50.8%), and monogamy (47.5%). Awareness of HIV mother-to-child transmission was less than 40%. Regarding attitudes, 77.9% would care for an HIV-positive person at home, 82.8% would keep their HIV status confidential, and over 40% supported HIV-positive students and teachers continuing education. Significant differences in knowledge and attitudes scores were found across age, gender and marital status. Half of the participants (50.7%) reported having ever been tested for HIV, of whom 97.9% received HIV test results, and 61.6% received counseling after the test.

Conclusions: The results of this study show that the prevalence of HIV infection among migrants is greater than that among the general population (less than 0.1% in the general population) and that some challenges remain, such as stigmatizing attitudes, suboptimal understanding of HIV prevention, and substandard access to post-test counseling. Based on these findings, it is crucial to highlight the importance of strengthening HIV prevention efforts among migrants and addressing the social, behavioral and environmental factors that contribute to the spread of HIV.