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            Using ICT solutions to
           reach MSM in Morocco
         M. Karkouri, M. Harri, O. Mellouk, H. Himmich
         Association de Lutte Contre le Sida, Morocco
The Context

• Low HIV overall prevalence but concentrated
  epidemic among Key Populations (MSM)
• Homosexuality is illegal in Morocco by Law 489 (6m
  to 3y prison and/or 12 to 120 $ fine)
• Homophobia and high level of
  stigma, violence, police harassment
• Development and diffusion of ICT (mobile
  phones, internet)  lesser recourse to cruising areas


                                                      2
The MSM Program of ALCS
                         • ALCS : Community-based
                           organization (1988) with extensive
                           experience working with MSM in
                           Morocco
• MSM Outreach Prevention Program (since 1993)
  (Gov't approved):
   –   Prevention sessions on cruising areas and in-house
   –   Condom/lube access
   –   Information on HIV, AIDS and STIs
   –   Self-esteem improvement
   –   Psychosocial support and income-generating activities

• Coverage limited to major urban centers
                                                                3
The Data
• BBSS Study, MSM, 2010-2011, Agadir & Marrakesh
   – HIV prevalence among MSM:
      • Agadir : 5.6% and Marrakech : 2.8%
   – Internet at least once a week : 56% (daily : 19-31%)
   – Gay sites at least once a week : 33% (daily : 18%)
   – Peferred way to get information about HIV and STIs:
       • TV           45.5%
       • CBOs         26.3%
       • Internet     15.8%
       • Press        4.5%
       • Brochures 3.9%
       • Radio        3.8%
                                                            4
The Intervention

• Creation of a profile "Pleasure & Health" on the most
  popular gay sites (Gayromeo, NRJChat)
• A standard message is sent to users explaining the
  purpose of our presence and offering to further chat
• Interested persons are invited to switch to "msn"
  instant messaging
• Conversations are recorded and FAQ are noted in a
  database allowing very quick answers ("Copy and
  paste")


                                                      5
6
The Services

• Education and information about HIV, AIDS and STIs
• Tailored counseling sessions on sexual practices
• Discussion about safer sex practices
• Reference to HIV Testing and Couseling sites
• Promotion of the HIV Hotline
• Information on psychological support and other
  services offered to PLHIV
• Safe space to talk about homosexuality


                                                       7
The Sexual and Reproductive Health
            SMS Platform

• "Bilaharaje" ("Be comfortable to ask") program
• Partnership : ALCS – OneWorld UK – Butterfly Works
   SMS Plateform (started 2011) hosted by ALCS
   "On t’écoute" ("We are listening to you") live free
    talk show airing weekly for two hours with a
    sexologist answering questions from young people
    (telephone calls, e-mail, Facebook)

                                                       8
9
The Results
                     Jan-June   July-Dec   Jan – June
                       2011       2011        2012
Sessions               86         89         102
New contacts           432       562         583
Follow up contacts     120       482         489
Decline                88         89          85




                                                        10
The Results

 Most popular topics                   Referrals and orientation
     Living with                       Marrakesh Men's
         HIV              Prevention   Health Clinic
Family                                                            Hotline
& Society                 Sexual
                          Practices     ALCS'                     HTC
             Prevention
  Religion                Stigma & D    website         Hotline
                                                                  ALCS'websi
   Stigma Sexual
                          Religion        HIV Testing             te
   & Discr. practices
                                          & Couns.                Health
                          Family                                  Clinic




                                                                            11
The Results

 Most popular topics                   Referrals and orientation
     Living with                       Marrakesh Men's
         HIV              Prevention   Health Clinic
Family                                                            Hotline
& Society                 Sexual
                          Practices     ALCS'                     HTC
             Prevention
  Religion                Stigma & D    website         Hotline
                                                                  ALCS'websi
   Stigma Sexual
                          Religion        HIV Testing             te
   & Discr. practices
                                          & Couns.                Health
                          Family                                  Clinic




                                                                            12
The Lessons learned

• High acceptability (low rate of decline)
• Low cost of operations
• Safety (for service providers and clients)
• Safe space to talk freely about sexual practices (no
  face-to-face bias)
• Opportunity to scale up service provision
• Referral to services more effective



                                                         13
The way forward

• Formal evaluation of the program needed (change of
  behaviors)
• Scale up of the service provision
• More extensive research to harness the potential of
  ICT solutions for targeting MSM




                                                    14

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Using ict solutions to reach msm in morocco def

  • 1. THSY10 Using ICT solutions to reach MSM in Morocco M. Karkouri, M. Harri, O. Mellouk, H. Himmich Association de Lutte Contre le Sida, Morocco
  • 2. The Context • Low HIV overall prevalence but concentrated epidemic among Key Populations (MSM) • Homosexuality is illegal in Morocco by Law 489 (6m to 3y prison and/or 12 to 120 $ fine) • Homophobia and high level of stigma, violence, police harassment • Development and diffusion of ICT (mobile phones, internet)  lesser recourse to cruising areas 2
  • 3. The MSM Program of ALCS • ALCS : Community-based organization (1988) with extensive experience working with MSM in Morocco • MSM Outreach Prevention Program (since 1993) (Gov't approved): – Prevention sessions on cruising areas and in-house – Condom/lube access – Information on HIV, AIDS and STIs – Self-esteem improvement – Psychosocial support and income-generating activities • Coverage limited to major urban centers 3
  • 4. The Data • BBSS Study, MSM, 2010-2011, Agadir & Marrakesh – HIV prevalence among MSM: • Agadir : 5.6% and Marrakech : 2.8% – Internet at least once a week : 56% (daily : 19-31%) – Gay sites at least once a week : 33% (daily : 18%) – Peferred way to get information about HIV and STIs: • TV 45.5% • CBOs 26.3% • Internet 15.8% • Press 4.5% • Brochures 3.9% • Radio 3.8% 4
  • 5. The Intervention • Creation of a profile "Pleasure & Health" on the most popular gay sites (Gayromeo, NRJChat) • A standard message is sent to users explaining the purpose of our presence and offering to further chat • Interested persons are invited to switch to "msn" instant messaging • Conversations are recorded and FAQ are noted in a database allowing very quick answers ("Copy and paste") 5
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  • 7. The Services • Education and information about HIV, AIDS and STIs • Tailored counseling sessions on sexual practices • Discussion about safer sex practices • Reference to HIV Testing and Couseling sites • Promotion of the HIV Hotline • Information on psychological support and other services offered to PLHIV • Safe space to talk about homosexuality 7
  • 8. The Sexual and Reproductive Health SMS Platform • "Bilaharaje" ("Be comfortable to ask") program • Partnership : ALCS – OneWorld UK – Butterfly Works SMS Plateform (started 2011) hosted by ALCS "On t’écoute" ("We are listening to you") live free talk show airing weekly for two hours with a sexologist answering questions from young people (telephone calls, e-mail, Facebook) 8
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  • 10. The Results Jan-June July-Dec Jan – June 2011 2011 2012 Sessions 86 89 102 New contacts 432 562 583 Follow up contacts 120 482 489 Decline 88 89 85 10
  • 11. The Results Most popular topics Referrals and orientation Living with Marrakesh Men's HIV Prevention Health Clinic Family Hotline & Society Sexual Practices ALCS' HTC Prevention Religion Stigma & D website Hotline ALCS'websi Stigma Sexual Religion HIV Testing te & Discr. practices & Couns. Health Family Clinic 11
  • 12. The Results Most popular topics Referrals and orientation Living with Marrakesh Men's HIV Prevention Health Clinic Family Hotline & Society Sexual Practices ALCS' HTC Prevention Religion Stigma & D website Hotline ALCS'websi Stigma Sexual Religion HIV Testing te & Discr. practices & Couns. Health Family Clinic 12
  • 13. The Lessons learned • High acceptability (low rate of decline) • Low cost of operations • Safety (for service providers and clients) • Safe space to talk freely about sexual practices (no face-to-face bias) • Opportunity to scale up service provision • Referral to services more effective 13
  • 14. The way forward • Formal evaluation of the program needed (change of behaviors) • Scale up of the service provision • More extensive research to harness the potential of ICT solutions for targeting MSM 14