ISPUP; GAT;
ENDA-SANTÉ,
AGUIBEF; RENAP.
HIV/AIDS remains a pressing public health challenge in Guinea-Bissau, with a national prevalence of 2.3% among adults aged 15 to 49. An estimated 34,000 people are living with HIV, yet only 77% know their status—far below the 95% target set by UNAIDS for 2025. Key populations, such as female sex workers, men who have sex with men, transgender individuals, and people who inject drugs are disproportionately affected, with HIV prevalence as high as 17% among sex workers. This is aggravated by the fact that only 64% of adults and children living with HIV have access to antiretroviral treatment, leaving significant gaps in care.
The situation is further complicated by overlapping health challenges, including a high incidence of tuberculosis (361 cases per 100,000 people in 2021) and a TB-related mortality rate of 58% among people living with HIV. Viral hepatitis is also a growing concern, with a 12.3% prevalence of chronic hepatitis B and 0.75% for hepatitis C. These epidemics are exacerbated by a fragile healthcare system, limited access to services, and a lack of robust data collection and surveillance systems. Women face additional vulnerabilities due to poverty, gender-based violence, and limited access to sexual and reproductive health services, making them a key population in need of targeted interventions.
To address these challenges, the SafeSpace Point-of-Care Community Hubs project was launched. This initiative aims to strengthen community-based responses to HIV, viral hepatitis, TB, and malaria by establishing accessible testing hubs operated by and for the community. The project is led by four community-based organizations (CBOs) in Guinea-Bissau—ADPP-GB, ENDA, AGUIBEF, and RENAP+GB—with technical support from the Grupo de Ativistas em Tratamentos (GAT) and scientific partnership from the Institute of Public Health of the University of Porto (ISPUP).
The SafeSpace Hubs will be strategically located in regions with the highest disease burdens, including the Autonomous Sector of Bissau, Gabú, Bafatá, Tombali, Oio, and Farim. These hubs will offer integrated services, including point-of-care testing for HIV, viral hepatitis and syphilis, as well as symptoms screening for TB and malaria, health education and (re)linkage to treatment. Health activists from the CBOs will be trained to conduct testing, administer questionnaires, and collect epidemiological data, ensuring that services are tailored to the needs of key populations. The data gathered will not only improve local surveillance but also inform national and international policymakers, helping to shape more effective public health strategies.
The Institute of Public Health of the University of Porto (ISPUP) integrates this project as the scientific partner, leading the development of a cohort to study disease dynamics, supporting the implementation of a community-based epidemiological surveillance system, and providing training for health activists.
The project aims to reduce barriers to early diagnosis and treatment, particularly for marginalized groups, by equipping and operationalizing community-driven health services. It also seeks to strengthen the capacity of CBOs to collect, analyze, and disseminate data, contributing to a more integrated and evidence-based approach to public health in Guinea-Bissau.
