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

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.