Sexually transmitted diseases in Morocco: gender influences on prevention and health care seeking behavior

Increased awareness of the medical and social costs of sexually transmitted diseases (STD) has resulted in greater attention to the control of these i llnesses. STDs are responsible for a significant amount of morbidity in Mor occo and have become a key target of the HIV control program. In 1996, the Ministry of Health conducted a qualitative study in order to enhance inform ation, education and communication strategies;in the national STD/HIV progr am. Data on the conceptualization and knowledge of STD, information sources and health-care-seeking behavior were gathered through 70 semidirected, in -depth interviews conducted with men and women in the general population an d health care providers (HCPs). Two commonly applied health behavior theori es in STD/HIV prevention, the Health Belief Model (HBM) and the Theory of R easoned Action (TRA) served as a framework for data analysis. The most common name for STD is berd, which means "the cold" in Moroccan Ar abic. Berd is caused either by cold striking the genital area or sexual int ercourse and most often designates a syndrome of genital discharge. However , the term was also often used to indicate STD in general. The dual causali ty of berd maintains social stability by providing an honorable excuse for individuals who become infected, while warning against unsanctioned sexual behavior. Clear gender differences in understanding STDs and health-care-seeking beha vior emerged through these interviews. STDs in Morocco are viewed as women' s illnesses and men with STD often reported feeling victimized by women. Me n appear to have more extensive informal information sources fdr STD than w omen. Consequences of STD, both physical and psychosocial, were viewed as m ore severe for women than men, and men had greater access to treatment, for both social and economic reasons. (C) 2000 Elsevier Science Ltd. All right s reserved.