How the pandemic has impacted the response to HIV/AIDS in Morocco

The Association for the Fight Against AIDS (ALCS) is launching the 9th edition of Sidaction Maroc. This awareness and fundraising campaign, entitled “ AIDS is still there… Let’s make a donation! », will take place throughout the national territory from 1er as of December 31, 2022.

The launch of the 9th edition of Sidaction Maroc coincides with World AIDS Day, celebrated on 1er December of each year. For its new awareness and fundraising campaign, ALCS warns of the worrying consequences of the health crisis linked to Covid-19 on the response to HIV/AIDS in Morocco as well as the drastic decline in funding for the fight against this virus.

Requested by MoroccoLatestNews UKNaoual Laaziz, Director General of the Association for the Fight Against AIDS (ALCS), explains the repercussions of Covid-19 on the actions of the association and the support and follow-up of people with AIDS.

MoroccoLatestNews UK: In your press release announcing the launch of the 9th edition of Sidaction Maroc, you warn against the consequences of the health crisis linked to Covid-19 on the response to HIV/AIDS in Morocco. How did you experience this pandemic period, as an association?

Naoual Laaziz: The global health crisis linked to Covid-19 has got the better of health systems, which have seen their capacities to receive and care for patients exceeded, in particular during the first global epidemic peak. Human, material and financial resources being directed towards the fight against the Covid-19 pandemic, all other diseases – communicable or not – had taken a back seat.

The ALCS, was aware of the seriousness of the situation and the fact that vulnerability to HIV infection is extremely increased by the addition of vulnerability to Covid-19 and that the addition of vulnerabilities would only increase the risk of infections and reduce the impact of years of tireless efforts by the country in the response to HIV.

The ALCS therefore firmly believed that in addition to its main mission of preventing STIs and HIV/AIDS, it had to actively deploy its network among the populations it covers to reduce the risks associated with Covid-19 and respond to the most urgent needs, in particular by providing essential services and emergency food and social assistance. ALCS, as a community association responsive to the needs expressed by the key populations served, could not ignore these very urgent needs.

Thus, measures were taken during and after confinement for the continuity of the usual services related to the prevention of STIs/HIV/AIDS and viral hepatitis and the response, as far as possible, to the new needs generated by the health crisis linked to Covid-19, while respecting the barrier measures to fight against Covid-19.

The ALCS maintained communication through its social networks, its remote assistance relationship system for survivors of gender-based violence (SMS – WhatsApp platform) and the networks of field workers and peer educators. The messages have been tailored to reassure PLHIV and the key populations she serves that they will not be left behind and that essential services will be provided to them. Also, Covid-19 prevention messages have been prepared and disseminated through social networks and the networks of key populations. In addition to intramural services, stakeholders and peer educators have been mobilized, in agreement with the Ministry of Health, to ensure the home dispensation of antiretrovirals (ARVs) for people living with HIV (PLHIV) and methadone for people who use drugs (PUDI).

Despite all the efforts made, the 2020 national targets in terms of coverage of key populations were only reached at 70% with a notable underperformance in HIV testing which did not exceed 25% of the targets. fixed.

The ALCS has greatly contributed to these achievements by:

  • Coverage of 63,462 people from key populations
  • Offered HIV testing to 21,615 people and hepatitis C virus (HCV) testing to 602 people of which 380 were HIV positive and 26 reactive to HCV.
  • The distribution of 2.8 million condoms
  • The distribution of 4,500 food baskets during confinement for 1,400 poor people.
  • Medical support and psychosocial care for 6,904 PLHIV followed in the deferent centers including 370 children
  • Dispensing of ARVs for 2,793 people (including 35 foreigners and 23 prisoners) and methadone for 15 PUDI.

MoroccoLatestNews UK : How important is AIDS testing for HIV prevention in Morocco?

Naoual Laaziz: HIV screening is the only way to know if you are an HIV carrier before the appearance of symptoms suggestive of AIDS, which occur at a late stage of the infection when the body’s defenses are overwhelmed. Thus, screening at an early stage, where the person living with HIV appears to be in good health, is essential to quickly start treatment with antiretrovirals and avoid complications and the deterioration of the health status of the person. nobody.

Similarly, a person on treatment with an undetectable viral load in the blood can lead a normal life, has a life expectancy equivalent to a person of his age and no longer transmits HIV. Thus, the fact of treating PLHIV very early generates a considerable gain in productivity and a reduction in the economic burden of the disease on health systems and society.

According to estimates by the Global Fund to Fight AIDS in Morocco, for every dollar invested in HIV prevention and testing, there is a return on investment of 7 dollars.

In Morocco, nearly 18% of the estimated 23,000 HIV-positive people would not know their serological status at the end of 2021. Thus, efforts will have to be multiplied to make screening even more accessible by diversifying screening offers and adapting them to the most vulnerable populations. at risk of HIV infection.

Community screening, carried out by non-physician community agents trained for this purpose, set up by the ALCS in partnership with the Ministry of Health since 2015, has given very convincing results insofar as this system screens more of the two sets of cases detected by the ALCS. Similarly, HIV self-tests, the pilot of which was conducted by the ALCS was very convincing, are an efficient strategy for reaching people far from screening centers or people reluctant to be screened by a health worker or a community.

MoroccoLatestNews UK : We know that AIDS is not a virus like the others. Individuals in Morocco still refuse to be screened or monitored because of the impact on them and their families and the gaze of society in particular. How do you interact with these people during your awareness campaigns?

Naoual Laaziz: The Association for the Fight Against AIDS provided, during the year 2021, social and medical support services to nearly 7,000 people, of whom 94.2% had no stable income and 55% were not covered. no social welfare scheme.

According to the study on the stigmatization index of people living with HIV (PLHIV) carried out in 2016 by the Ministry of Health and Social Protection, nearly 50.2% were victims of discriminatory attitudes and nearly 41.2% had been refused care. The preliminary results of a similar study conducted in 2022 showed that nearly 19% of PLHIV had experienced stigma in healthcare settings and nearly 58% self-stigmatized.

Beyond these figures, the therapeutic and social mediators of the ALCS, who take care of PLHIV by providing them with psychological and social support as well as therapeutic mediation, regularly bring up very painful experiences of stigmatization and discrimination experienced by PLHIV. These experiences include HIV-positive pregnant women who were denied care, people whose status was disclosed against their will and forced to quit their jobs, change their children’s school, or even to move and change location. Given the stigma and discrimination to which they are subject, given the uncertainty of winning their case through legal litigation and given the fear that their HIV status will be revealed even more, these PLHIV do not even dare to use the systems remedies available to them in the event of a violation of their human rights.

The ALCS has made respect for human rights and the fight against all forms of stigmatization and discrimination a main focus of its action. It fights to reduce stigma and discrimination, particularly in healthcare settings, to guarantee dignified access to healthcare for key populations and PLHIV.

It advocates the decentralization of services, the delegation of tasks related to the dispensing of antiretroviral treatments and the monitoring of PLHIV by community actors, as well as the establishment of differentiated services, taking into account the particularities of key populations, to improve the daily lives of key populations and PLHIV.

It campaigns for the establishment of an appropriate and effective administrative and legal recourse system that could be used in the event of violations of the human rights of key populations and PLHIV.

It pleads with all stakeholders, in particular parliamentarians, judges, magistrates and law enforcers, for laws and a legal environment in line with the recommendations of the roadmap emanating from Morocco’s political commitment during the United Nations assembly in June 2021.

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