1. 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 d'Ecologie 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.