Mapping of new HIV infections in Morocco and impact of select interventions

Abstract Objectives The aim of this study was to assess HIV modes of exposure in Morocco at the national level and also for Souss-Massa-Drâa, the region most affected by HIV. Another aim was to assess the impact of different scenarios of select intervention packages. Methods The Modes of Transmission Model was adapted and used, and was parameterized using quality bio-behavioral surveillance data among key populations, routine data sources, and literature reviews. Results Nationally in 2013, the largest number of new infections occurred among clients of female sex workers (FSWs) (25%; 95% confidence interval (CI) 14–37%), followed by men who have sex with men (MSM) (22%; 95% CI 12–35%), HIV serodiscordant couples (22%; 95% CI 12–34%), FSWs (11%; 95% CI 6–18%), and people who inject drugs (5%; 95% CI 2–9%). A similar pattern of results was observed in Souss-Massa-Drâa, but the HIV incidence rate was four-fold that at the national level. Different scenarios of feasible intervention packages reduced HIV incidence by 8–44%. Conclusions Commercial heterosexual sex networks continue as the leading driver of the epidemic, with half of HIV incidence. A quarter of new infections occurred among MSM, a third of which in Souss-Massa-Drâa. Feasible expanded coverage of interventions could lead to large reductions in incidence.