Prevalence and determinants of intercourse without condoms among migrants and refugees in Morocco, 2021: a cross-sectional study

Abstract

With the world's migratory flow, the risk of infection by the human immunodeficiency virus (HIV) among migrants is increasing. The prevalence of intercourse without condoms with a casual or commercial sex partner, a high-risk sexual behavior for HIV infection, is unknown among migrants. The purpose of this study was to determine the prevalence of intercourse without condoms among migrants and the risk factors associated with not using condoms. In Oujda, we conducted a cross-sectional survey of 416 sexually active migrants. We used a multistage sampling method. Face-to-face interviews were conducted with participants to collect socio-demographic information, disease perception, behavioral habits, sexual behavioral habits, and para-clinical parameters. A multivariate logistical regression analysis identified the risk factors associated with high-risk HIV sexual behaviors. The prevalence of intercourse without condoms with a casual or commercial sex partner was 72.8%, with a median age of 25.0 years, and 212 (69.9%) were males. The prevalence of HIV was 0.2%. Being homeless, having difficulty obtaining condoms, and only having a basic education were all risk factors for these sexual behaviors. Migrants with precarious living conditions are at increased risk of having intercourse without condoms. This group must be prioritized by strengthening public health programs targeting the health of migrants as well as the intervention of thematic non-governmental organizations. Vigilant monitoring of the HIV epidemic, with a focus on vulnerable populations, should be a high priority in Morocco.

The prevalence and risk factors for anxiety and depression symptoms among migrants in Morocco

“…Indeed, we know that migrants, whether refugees, asylum seekers, or undocumented migrants, are a vulnerable population whose mental health can suffer. They may have been victims of traumatic events such as war, the loss of a family member, or physical and/or sexual violence before their arrival in the host country 4 , 22 , all of which can lead to anxiety and depressive disorders. Added to this is the negative perception of migrants that the population of the host country has, the cumbersomeness of the administrative procedures, and the length of the regularization procedures 24 Once granted a refugee status, migrants find themselves caught between an ideal discourse on asylum and the reality in the host country.…”

“…Human migration has an impact on both developed and developing countries 2 . With 86,000 migrants in 2014 3 , Morocco, long known as a transit country to Europe, became a host country for migrants from West and Central Africa, as well as Syria 4 . Migration places people in situations that can have an impact on their physical, social, and mental health.…”

Determinants associated with low dietary diversity among migrants to Morocco: a cross sectional study

“…Migrants were classified into three categories: (i) Undocumented migrants i.e. those who do not have a valid Moroccan residence permit; (ii) Asylum seekers, defined as anyone seeking safety from persecution or harm in a country other than their own and awaiting a response on their application for refugee status; and (iii) Refugees, defined as anyone who is recognized by the host country as unable or unwilling to return to their country of origin due to a well-founded fear of persecution on account of their race, religion, nationality, membership in a social group, or political opinions 4 .…”

“…Wars, conflicts, intra-community violence, and repression continue to undermine the ability of people to maintain their day-to-day livelihoods and generate large numbers of asylum seekers and refugees. In 2020, worldwide, 281 million international migrants were registered, including four million asylum seekers and 33.8 million refugees 3 , 4 . Human mobility aggravates the food and nutritional vulnerability and leads to food insecurity.…”

“…Since implementing a new migrant policy characterized by respect for the human rights of people on the move in 2013, Morocco became not only a transit country to Europe but also a host country for people from Syria and West and Central Africa, with 86,000 migrants in 2014 4 . To date, research has identified the determinants of dietary diversity among adolescents, pregnant and lactating women, and children under the age of five, but no epidemiological study in Morocco has investigated dietary diversity among undocumented migrants, asylum seekers, and refugees 10 – 13 .…”