Abstract number: WEPE427 Do women disclose their HIV-status more than men? Results from a community-‐based research among PLHIV in Morocco A. Abadie1, M.K. Hilali2, M. Loukid2, E. Henry3, J. Otis4, M. Karkouri5, N. Rafif1,O. Mellouk1, H. Himmich5, L. Ouarsas6, M. Préau7 1Association de Lutte Contre le SIDA, Marrakech, Morocco, 2University Cadi Ayyad, Laboratoire dEcologie Humaine, Marrakech, Morocco, 3Coalition Plus SIDA, Paris, France, 4Université de Québec à Montréal, CREcES, Montréal, Canada, 5Association de Lutte Contre le SIDA, Casablanca, Morocco, 6Association de Lutte Contre le SIDA, Agadir, Morocco, 7Université de Nantes, LABECD, Nantes, France Background DISCLOSURE MOROCCO E 75,8% have disclosed their status, essenLally with their o Low prevalence Muslim country (< 0,1%) regular sexual partner Figure 1: Percentage of disclosure with regular sexual partner by gender o Concentrated epidemic among MARPS (Agadir : 5,6% of prevalence among MSM -‐ 5,1% among FSW) 100 90 80 o HIV infecLon is a socio-‐cultural taboo 70 60 no si 50 o High rates of sLgma against PLHIV 40 30 20 -‐> Diﬃculty to disclose one’s HIV-‐status 10 0 Women Men Disclosure: E Men have disclosed with the partner sexual more than o Seems parLcularly diﬃcult for women women but not signiﬁcantly o No scienLﬁc data on this issue available to date E Women were more likely to disclose with female family members: mother (51,2%), sister (44,6%) versus father Methods (15,38%), brother (15,8%). Figure 2 : Pecentage of disclosure with family members by gender AN INTERNATIONAL STUDY PARTAGES’ 60 50 • InternaLonal research consorLum engaging academics and NGOs from Mali, DemocraLc Republic of Congo, Ecuador, 40 Romania, Morocco, France, Canada in a community-‐based 30 Women research Men 20 -‐> Development of a research program to study serostatus 10 disclosure in order to inform policies and propose suitable 0 intervenLons father mother sister brother • A standardized quesLonnaire was developed ASSISTANCE TO DISCLOSURE • Eligibility criteria for parLcipaLon: PLHIV aged 18 or older E Few PLHIV have already asked for assistance to disclose and knowing its for at least six months (10,4%) • Data collecLon between May and October 2011 E More women have asked for assistance to disclose than men (W: 12,4%; M: 7,6%; p < 0.18) IN MOROCCO DISCLOSURE PERCEPTION AND CONCEALMENT • Mixed team: ALCS (AssociaLon de Lu^e Contre le Sida)/ Cadi E Both men and women (89%) considered disclosure risky Ayyad University (Human Ecology Laboratory) of Marrakesh E More women would have asked their relaLves to keep • 300 PLHIV in contact with ALCS interviewed in 5 ciLes: Agadir, their HIV-‐status secrete (W: 82,5%; M: 60,2%; p < 0.001) Casablanca, Marrakesh, Rabat, Fes E More women felt the "need to hide” it (W: 90,6%; M: • Preliminary descripLve analysis using SPSS 10 84%; p < 0.09) E 46,5% of women who disclosed considered it was a Results mistake (M: 28% ; p < 0.004) Figure 3: Disclosure percepUon by gender (in percent) 100 SOCIO-‐DEMOGRAPHIC CHARACTERISTICS 90 80 70 E 56,7% female, 39,7% male and 3,7% transgender. 60 50 women Transgender people are not integrated in this analysis. 40 men 30 20 Variables Men (%) Women (%) 10 0 is risky ask their relaLves to keep it feel the "need to hide" is a mistake* Marital status: secrete Married Ø 45.4 32.9 Conclusion * among those who disclosed their status Ø Concubinage 3.4 7.6 q Women are less likely to disclose their HIV-‐status and feel Ø Divorced/ separated 8.4 30.6 more vulnerable aber disclosure. Educa-on The socio-‐cultural and religious context may explain this Ø No educaLon 16.1 45.9 situaLon. Ø Primary/ Secondary level 73.7 50.6 q Disclosure of HIV-‐status is crucial regarding prevenLon Ø Post secondary level 10.2 1.2 and treatment adherence and may inﬂuence PLHIV behaviors and aftudes. Main ﬁnancial ressources for living q The results of this study need to be used to develop a Ø Self-‐income 55.5 19.4 comprehensive and gender-‐oriented approach of disclosure Ø Family network 26.9 54.7 programs.