In the framework of the CORE EU project, we filmed at two community-based centers run by GAT Portugal in Lisbon. They are excellent examples of building effective HIV responses on peer work! Check it out!
At the CORE – COmmunity Response to End Inequalities EU project meeting, we had the chance to visit two of the several community-based centers of GAT, the Portuguese Activist Group on Treatments. GAT, which was founded in 2001, is a structure of individual membership and cooperation between people from different communities and organizations affected by HIV and AIDS, sexually transmitted infections, viral hepatitis, and tuberculosis.
They started as an advocacy organization, working for legal and policy changes that positively affect the health, rights, and quality of life of people living with HIV or at risk of becoming infected. They soon realized that vulnerable groups that are most affected by HIV, such as men having sex with men (MSM), sex workers, trans people, people who use drugs, and migrants, need tailored HIV services, and they started to build these programs for them. Today, GAT has one of the biggest reaches of key populations in Portugal, with 100 thousand HIV tests conducted annually.
“GAT has several testing sites, all adapted more or less for key populations. All the sites are open to everyone but are built and offer services more tailored to key populations.” Said Mariana Vicente, general director of services and projects at GAT.
Moreover, these services employ peers, people with lived experiences, as their key staff. “Peers are people who share something in common with the people we support, either because they live with the infection or belong to a vulnerable group we support. It is often the peers who bring people to the interventions and can also be the link between people and different services.” Explained to us by Joana Assunção, a peer social worker at GAT.
At GAT Checkpoint LX, which is a free, confidential testing service for HIV and other STIs among men who have sex with men, all the staff are MSM. “For me, it’s really important to know that I’m contributing to the health of my community. Community-based centers are as good and as efficient as health services with doctors and nurses. Peer work is really important for us, and it really works because people come back.” Said João Caldas, one of the peer workers of GAT Checkpoint LX.
Peers at GAT Checkpoint LX indeed provide a very broad range of services: condoms and water-based lubricating gel; peer counseling; rapid, anonymous, confidential, and free peer-to-peer testing in the center and saunas; confidential and free medical appointments and counseling about Pre-exposure prophylaxis (PrEP); administration of vaccines and injectable antibiotics; anonymous partner notification; referral and follow-up to healthcare services; and self-support group sessions (facilitated by people living with HIV).
These community-based services are essential to the success of Portugal’s fight against HIV/AIDS: “The Portuguese state is counting on these [testing] numbers. They count on GAT and other organizations in Portugal to do the rapid tests to have these community-based centers, ” said Luis Veríssimo, coordinator at GAT Checkpoint LX.
“The community also wants to define the rules and how the service works,” told Maria Luísa Salazar, co-coordinator at GAT IN Mouraria, the second service we visited. GAT IN Mouraria is a community-based harm reduction drop-in center that opened in 2013. They provide anonymous testing of HIV, hepatitis B, hepatitis C, and syphilis; condoms; sterile drug consumption materials (needles and syringes, crack pipes, etc.); peer counseling; health care support by nurses and doctors; referral and escort to various health care and social facilities. On average, 70-80 people enter the drop-in center daily, where they can relax in a stress-free environment, eat, use the internet, charge their phones, and receive their mail, which is also a very important service for those without a home.
GAT IN Mouraria also has a drug consumption room that has operated for years as a semi-legal site. It is now running fully legally and is managed by peers. “Maria do Rosário, our peer, she’s the one who usually leads the injection part. And the injection spot is a very intimate space. We have a curtain here, and people, while they are preparing the substance and injecting, are sharing so many things, and it’s a very special moment of the day. And then the peers and the harm reduction workers who do the community intervention are the ones who take people if they want to, to make the bridge with the social worker, the nurses, or the doctors,” explains Maria.
As the peer co-coordinator at GAT IN Mouraria, João Santamaria summarises it all: “The importance of peers is their life experience of drug use, which, together with the experiences of the team, can make a super intervention.“
This video was produced in the CORE – COmmunity Response to End Inequalities EU project framework. CORE is a 36-month EU Action Grant from January 1st, 2023, to December 31st, 2025, involving 24 partners from 16 EU Member States. The project seeks to reduce inequalities in the responses to HIV, TB, and viral hepatitis by promoting, strengthening, and integrating community responses that have proven essential in reaching communities traditionally underserved by mainstream prevention and healthcare services. Funded by the EU4Health Programme, this project is particularly crucial in countries where these responses remain inadequate compared to the EU average.
Special thanks to Rosa Freitas and Mariana Vicente from GAT for all their great help in producing this work.
Video and text: István Gábor Takács
