Al Borj: listening to the needs of MSM Mohcin HARRI Moroccan Association against AIDS (ALCS)

Al Borj: listening to the needs of MSM

Mohcin HARRIMoroccan Association against AIDS

(ALCS)

Al Borj: ALCS Marrakesh response to adverse environment for MSM

In Morocco, article 482 of the penal code punishes ““Any person who commits unnatural acts with an individual of the same sex ”.

• Prevalence among MSM in Marrakesh: 2,8% for HIV and 10,8% for syphilis• Low access to needed information

High levels of stigma and discrimination

• Since1995, most services are HIV screening and prevention

IAS 2014- Melbourne « Al Borj: listening to the needs of MSM »

Al Borj: adapted services for MSM• Primary objective: Improve access and quality for MSM to services of prevention,

care and support.

• Introduction of the notion of “follow-up care” / “suivi de cas” (codified file)

• Broadening of care services for MSM: • syphilis test, dermatology, proctology, psychosocial consultations, orientation to MSM-

friendly private doctors, social aid with a solidarity fund to face health challenges, therapeutic mediation, cultural and friendly activities, legal advise

• Discussions on good practices and MSM care with the Sexual Health Center “Le 190” in Paris (member of SIS-Réseau).


How does Al Borj work?The center is open 2 days per week.

• Multidisciplinary team: 1 host, 1 doctor, 1 psychologist, 2 advisers, 2 therapeutic mediators, 1 lawyer

Service provision includes: • Assessment of knowledge on the risk of transmission (with the link to HIV/STI and

substance abuse, mental health…)• Anonymous and confidential testing• Individualized care and follow-up plan


Average age 28

Homosexuals 46%

Bisexuals 50%

Engage in risky behavior 55%

present strong substance addiction 46%

Return rate for HIV testing 71%

Living with HIV 10%

Psychological consultations 10 %

Descriptive Info of Al Borj Clients

Reason of visit


Screening tests: 55%Psychological support: 16%STI consultation: 12%Overall checkup: 7%Other: 10%

Mental health status


Anxiety / Depression : 37%Social Isolation: 29%Sexual Abuse / Violence : 28%Family or Social Problem: 3%Interpersonal problem: 3%

Limitations

• Lack of specialized staff (No volunteers)

• Insufficient funds for care of certain high-cost pathologies (hepatitis screening, HBV vaccine…)

• Impossible to carry out small surgeries


Lessons learned• The follow-up system allows an individualized and adapted prevention plan

• Customized approach = taking ownership of their health

• HIV screening is an entrance door that facilitates prevention

• Prevalence among clients is higher than the national averages among MSM

The Center grasps the most-at-risk MSM


The lessons learned (cont.)• The broadening of services at the Center alerted on other MSM problems that were

previously ignored: violence (sexual abuse, incest), mental health

• Mental health should not be dissociated from prevention work

• Individual prevention is more efficient- Change or adaptation according to risk behavior- Integration of new prevention strategies


Conclusions

• Al Borj is identified since more than 4 years by priority populations as a service that listens to their needs

• Al Borj has an efficient method of approaching and retaining MSM through health care

• The need to reinforce the fight against stigma and discrimination against MSM among regular health providers in the healthcare system


Next steps

• Reinforcement of current services

• Assessing the impact of Al Borj on the MSM community

• Duplicate the service in other cities of Morocco – mobilizing funds

• Consortium bringing together other sexual health centers in the MENA region (i.e., Marsa in Lebanon and ATL in Tunisia)


Thank you for your attention

[email protected]


Documents

Al Borj: listening to the needs of MSM Mohcin HARRI Moroccan Association against AIDS (ALCS)