Morocco makes headway against HIV but stigma remains

645

CASABLANCA, Morocco, Sept 27, 2019 (BSS/AFP) – In Morocco, the struggle
against HIV has been so successful in recent years that campaigners worry
about losing funding for combatting the virus, but for people living with the
disease it remains a heavy stigma.

In Casablanca, a group therapy workshop offers HIV patients a rare
opportunity to speak openly about their disease.

“Here I feel normal, I’m treated like a human being,” said Zineb, a 29-
year-old mother.

Organised by the Association for the Fight Against AIDS (ALCS), on a
recent Thursday the workshop brought 12 HIV patients together with a
psychologist and a therapist.

The ALCS also organises follow-up therapeutic care in hospital, and
prevention and screening campaigns, with funding from the Global Fund to
Fight AIDS, Tuberculosis and Malaria.

These programmes were developed shortly after the first HIV case was
detected in Morocco in 1986.

This early start is partly why UNAIDS, the Joint United Nations Programme
on HIV/AIDS, calls Morocco a “model country” for its HIV response.

Thanks to improved screening, access to treatment and monitoring, new HIV
infections in Morocco declined by 42 percent between 2010 and 2016, compared
to an average reduction of four percent across the rest of the Middle East
and North Africa.

Morocco had 350 deaths from AIDS in 2018, from a population of about 35
million.

But some groups remain vulnerable, with intravenous drug users, men who
have sex with other men, and sex workers accounting for two thirds of
Morocco’s 21,000 identified cases.

And the stigma attached to those infected remains high, even within the
family.

“My mother treated me like a murderer. For a long time I felt alone in the
world,” said Youssef, a 28-year-old who has twice attempted suicide.

Like other HIV patients interviewed by AFP, he asked to be identified by a
pseudonym.

And all of them — save for a 40-year-old considered very lucky by the
group — have either hidden their illness or been rejected by loved ones.

– ‘Don’t tell him anything’ –

In this conservative Muslim society, where sex outside marriage and
homosexuality are illegal, HIV patients seldom talk publicly about the virus.

“The subject is taboo, because the infection is linked to sex, itself a
taboo subject in Morocco,” said Yakoub, a 25-year-old ALCS worker.

“The social rejection is such that some (HIV patients) lose everything:
family, friends, work, home,” he said.

Zineb, like many HIV patients, hides her medication to conceal her
illness.

For 10 years, the former teen mother has told her family that she is being
treated for diabetes. “My 17-year-old son knows nothing, I can’t bring myself
to tell him, I’m too afraid,” she said with a sad smile.

“Once you’re sick, you’re no longer a person,” said Sakina, a mother who
says she never speaks of her illness except with doctors, the ALCS staff and
other HIV patients.

Like 70 percent of HIV positive women in Morocco, Sakina was infected by
her husband. She cannot bring herself to tell her 15-year-old son that he is
also infected.

She has always lied to him but she can “no longer sleep at night”, she
told the group through tears.

“My advice: above all, don’t tell him anything,” said a young man.

“For your sake, let him find out from someone else,” another group
participant suggested.

Then the psychologist interjected to say that private sessions are
available to “reflect on these difficult questions”.

The shame of HIV is so entrenched, it even permeates the medical
establishment.

“For 30 years we’ve been talking about it, the virus is well known but the
discrimination is still there,” said Dr Kamal Marhoum El Filali, head of the
infectious diseases department at Ibn Rochd Hospital in Casablanca, which
hosts an ALCS branch.

“The stigmatisation isn’t just from society but also from medical staff
within the hospital environment.”

Amina, another group therapy participant, experienced this first hand.

“When I went to the hospital to give birth, no one wanted to take care of
me, no one wanted to touch me, I ended up in intensive care,” she recalled
indignantly.

Others in the session though were grateful for the care they had received.
“We are lucky to be under the care of the infectious diseases department: we
are well cared for compared to others, considering the lack of funding and
disrepair in Moroccan hospitals,” said another participant.

– ‘Victim of own success’ –

The emergency room at Ibn Rochd is sometimes overwhelmed with doctors each
seeing up to 40 patients a day.

But the infectious diseases department is always spotlessly clean,
providing personalised support as ALCS staff liaise with the medical teams.

But how much money Morocco will receive to continue its fight against HIV
will be determined at a three-yearly conference for the Global Fund in
October.

With funding declining globally and controversy surrounding the management
of UNAIDS, ALCS president Mehdi Karkouri fears financial cuts.

“We are a victim of our own success: because our results are good, we risk
losing funding,” he said.