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IntroductionHIV and syphilis are major public health problems in Morocco. The region of Souss-Massa, south-west of the country, hold more than 24% of HIV seropositive cases registered in Morocco during 2009. The aim of this study is to evaluate the seroprevalence of syphilis among HIV seropositive patients in the region of Souss-Massa, south-west of Morocco.MethodsTo evaluate the seroprevalence of syphilis and neurosyphilis among HIV seropositive patients, we retrospectively investigated the medical records of HIV-infected patients attending the regional hospital located in the city of Agadir, during the period comprised between 2011 and 2016.ResultsThe population studied involved 1381 males (49.18%) and 1427 females (50.82%) HIV seropositive patients. Among them, 481 patients were seropositive for syphilis and three cases were diagnosed with neurosyphilis. The sex ratio distribution was 243 male (52.71%) and 218 female (47.29%). The prevalence of syphilis among the studied population was estimated to 16.42% with a slight dominance in male (17.63%) compared to female (15.28%). By contrast, neurosyphilis was only detected in male patients, with a prevalence estimated to 0.11%.ConclusionEven if the prevalence of HIV and syphilis is stable in the region of Souss-Massa, the prevalence of syphilis among HIV seropositive patients remained high and correlated positively with that of HIV infection. We did not find a significant difference between the genders, in relation to the prevalence of HIV and syphilis. We concluded that it was essential to continue monitoring the population, in order to improve the prevention and the access to the medical care in the south-west of Morocco.

Background In Morocco, of the estimated 29,000 people living with HIV in 2011, only 20% were aware of their HIV status. More than half of diagnoses were at the AIDS stage. We assumed that people who were unaware of their infection had contacts with the healthcare system for HIV indicators that might prompt the healthcare provider to offer a test. The aim was to assess missed opportunities for HIV testing in patients newly diagnosed with HIV who accessed care in Morocco. Methods A cross-sectional study was conducted in 2012–2013 in six Moroccan HIV centers. Participants were aged ≥18, and had sought care within 6 months after their HIV diagnosis. A standardized questionnaire administered during a face-to-face interview collected the patient’s characteristics at HIV diagnosis, HIV testing and medical history. Contacts with care and the occurrence of clinical conditions were assessed during the 3 years prior to HIV diagnosis. Over this period, we assessed whether healthcare providers had offered HIV testing to patients with HIV-related clinical or behavioral conditions. Results We enrolled 650 newly HIV-diagnosed patients (median age: 35, women: 55%, heterosexuals: 81%, diagnosed with AIDS or CD4 < 200 cells/mm3: 63%). During the 3 years prior to the HIV diagnosis, 71% (n = 463) of participants had ≥1 contact with the healthcare system. Of 323 people with HIV-related clinical conditions, 22% did not seek care for them and 9% sought care and were offered an HIV test by a healthcare provider. The remaining 69% were not offered a test and were considered as missed opportunities for HIV testing. Of men who have sex with men, 83% did not address their sexual behavior with their healthcare provider, 11% were not offered HIV testing, while 6% were offered HIV testing after reporting their sexual behavior to their provider. Conclusions Among people who actually sought care during the period of probable infection, many opportunities for HIV testing, based on at-risk behaviors or clinical signs, were missed. This highlights the need to improve the recognition of HIV clinical indicators by physicians, further expand community-based HIV testing by lay providers, and implement self-testing to increase accessibility and privacy.

patients still get transient side-effects especially at the beginning of taking this regimen due to efavirenz as such, regular monitoring and thorough counselling of all patients on the side effects of tenofovir-based regimen and transient nature of side effects is needed. A large scale study to be done to obtain data on longterm side-effects of tenofovir-based regimen most possibly renal impairment due to tenofovir or efavirenz-induced gynecomastia. The findings and conclusions in this report are those of the authors and do not necessarily represent views of the Centres for Disease Control and Prevention. Background Incident syphilis among HIV-infected persons indicates ongoing behavioural risk for HIV transmission. Detectable viral loads among co-infected cases may amplify this risk. Methods Primary and secondary (P&S) cases reported during 2009-2010 from four US sites were cross-matched to local HIV surveillance registries to identify syphilis case-persons infected with HIV prior to or shortly after the syphilis diagnosis. We examined HIV viral load and CD4 results collected within 6 months before or after syphilis diagnosis for the co-infected cases identified. Independent correlates of detectable viral loads ( ‡200 copies/mL) were determined. Results We identified 1675 cases of incident primary or secondary syphilis among persons with HIV. Median age was 37 years, 99.5% were male, 41.1% were African American, 24.5% Hispanic, and 79.9% of the HIV diagnoses were made at least one year prior to syphilis diagnosis. Among those co-infected, there were no viral load results reported for 188 (11.2%); of the 1487 (88.8%) with reported viral load results, 809 (54.4%) had a detectable viral load (median 25,101 copies/mL, range 206-3,590,000 copies/mL). Detectable viral loads were independently correlated with syphilis diagnosed at younger age, at an STD clinic, and closer in time to HIV diagnosis. Conclusion More than half of syphilis case-persons identified with HIV had a detectable viral load collected within 6 months of the syphilis diagnosis. This suggests virologic as well as active behavioural risk for transmitting HIV. Despite the increase of HIV patient throughput in Morocco, follow up testing (HIV Viral load VL) is still centralised in the National referral laboratory (NRL) as the activity required trained staff and specialised infrastructure. P17.26Patients were often lost due to great distances between testing centre and home as well as delays in returning results.To follow the dynamic of decentralising HIV treatment and care in Morocco, the NRLH launched a process of strengthening regional laboratory capacities.In this framework, we assessed factors associated with lab capacities to offer HIV viral load testing, and followed their performance after implementation.On site visits were performed to the laboratory of the regional laboratory of the Hassan II hospital of Agadir in southern Morocco; this region that accounts the greatest number of HIV positive cases. Using Laboratory assessment tool, the labora...

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