Guinea: Access to HIV/AIDS treatment, including support provided by public and private sectors, as well as international organizations; treatment by society of persons living with HIV/AIDS (PLHIV), particularly when they attempt to seek treatment (2017–January 2020)
1. HIV/AIDS in Guinea
According to the results of a test administered during the 2018 Demographic and Health Survey (Enquête démographique et de santé [EDS V] 2018) conducted by Guinea’s national statistics institute (Institut national de la statistique de la Guinée) in collaboration with the ICF, the organization responsible for the international program of the Demographic and Health Surveys (DHS), on behalf of the US Agency for International Development (USAID), the prevalence of HIV in the total Guinean population aged 15 to 49 is estimated at 1.5 percent (Guinea and ICF July 2019, ii, 293). The Joint UN Programme on HIV/AIDS (UNAIDS) estimates that prevalence to be 1.4 percent (UN 2018a). According to UNAIDS, approximately 120,000 people were living with HIV in Guinea in 2016 (UN 2018b).
1.1 Access to HIV/AIDS Treatment
In its 2015-2024 National Plan for Health Development (Plan national de développement sanitaire), the Guinean government provides the following overview of its health system:
[translation]
With regard to the country’s overall provision of care, there are 1,383 public structures in total, allocated as follows: 925 health positions, 410 health centres, 5 improved health centres, 33 communal medical centres and prefectural hospitals, 7 regional hospitals and 3 national hospitals. Out of the total number of public infrastructures, 51 percent are considered unsuitable in terms of their functionality and physical state according to defined standards (258 health positions, 201 health centres, 12 prefectural hospitals, 5 communal health centres, 4 regional hospitals and 2 national hospitals). The majority of the country’s health infrastructures no longer meet standards. (Guinea Mar. 2015, 24)
The government of Guinea reports in its National Strategic Framework to Combat AIDS 2018-2022 (Cadre stratégique national de lutte contre le sida 2018-2022) that screening services increased from 101 sites in 2013 to 126 sites in 2016, and that the number of HIV mother-to-child transmission prevention sites increased from 131 in 2013, to 323 in 2016, but that [translation] “their degree of utility is not optimal, particularly in the Kankan, Mamou and N’Zérékoré areas” (Guinea Aug. 2018, 21, 24). With respect to treatment centres, the report indicates that, in 2017, [translation] “only 142 sites have integrated treatment and only 86 sites are functional. The active stream of PLHIV undergoing ARV [antiretroviral] has only increased, rising from 27,792 in 2013 to 51,406 in late 2017, that is, coverage of 42%” (Guinea Aug. 2018, 26). The report also indicates that the [translation] “weak performances” of treatment centres are due to, among other things, “the geographical inaccessibility of the treatment sites and the low income of patients and/or households affected by HIV” (Guinea Aug. 2018, 27-28).
In a report published in April 2016 on the treatment of HIV/AIDS in Western and Central Africa, Doctors Without Borders (Médecins sans frontières, MSF) states that the Guinean health system [translation] “places the financial burden of health care on patients and families” (MSF Apr. 2016, 21). In its National Plan for Health Development of March 2015, the Guinean government states that the increase in costs to fund the health care system has rendered the delivery of care inaccessible for a [translation] “relatively large part of the population” (Guinea Mar. 2015, 37). Sources report that ARV treatments are available without cost in Guinea (Africaguinee.com 12 Apr. 2019; OSAR 12 Oct. 2018, 6). However, sources consulted by the Swiss Refugee Council (Organisation suisse d’aide aux réfugiés, OSAR) indicate that other fees might hinder access to treatment, such as those related to travel, diagnoses, lab work, records, the treatment of opportunistic diseases, and so on (OSAR 12 Oct. 2018, 6).
The MSF association reports [translation] “frequent out-of-stocks” of ARV (MSF n.d.). Other sources questioned by OSAR also state that out-of-stocks are frequent for first and second-line ARV medications (OSAR 12 Oct. 2018, 7, 8). OSAR also reports that, according to the sources it consulted, thirdline ARV medications are not available in Guinea (OSAR 12 Oct. 2018, 8).
According to MSF, in 2016, 28 percent of PLHIV had access to ARV treatments (MSF 30 Nov. 2018). The organization reports that it alone supported nearly 11,000 HIV-positive people in 2017 in Guinea (MSF [2017], 43). UNAIDS reports that approximately 40 percent of PLHIV, that is, 49,000 patients, received ARV treatment in 2018 (UN 2018a), and approximately 35 percent in 2016 (UN 2018b). The government of Guinea reported in May 2019 that [translation] “with regard to infected persons, 30,040 accessed ARV treatments, that is, an access rate of 59.1 percent” (Guinea 16 May 2019, para. 259).
Based on the 2011 data from the Guinean department of public health and hygiene (Ministère de la Santé et de l’Hygiène publique), MSF reports that it is more difficult to access treatment for HIV/AIDS in rural areas than in urban areas:
[translation]
The inequality between urban and rural areas means unequal access to health care: 63% of the population lives in the country, while only 17% of medical staff work there. At the Matam health centre in the capital, 25% of patients come from areas located outside Conakry, despite long distances to travel and transportation barriers. The scarcity of health services in rural areas is compounded by considerable stigmatization. (MSF Apr. 2016, 74)
In a report submitted in 2018 to the UN Committee on the Rights of the Child, the government reports that 80 percent of pregnant women living with HIV received ARVs (Guinea 7 Aug. 2018, para. 94).
According to a doctor who specializes in infectious diseases at the University Hospital of Bern who was questioned by OSAR, ARV treatments are more difficult to access for Guinean children, particularly because there are few specialized paediatricians and the medication is often unavailable (OSAR 12 Oct. 2018, 7). In its report to the UN Committee on Economic, Social and Cultural Rights, the government of Guinea indicates that 21 percent of children receive ARV treatment (Guinea 16 May 2019, para. 260).
Based on the data gathered from stakeholders in the field, including MSF, OSAR reports that access to care is [translation] “limited” for people who have reached the AIDS stage of the disease (OSAR 12 Oct. 2018, 8). The MSF association reports a mortality rate among HIVpositive individuals that might reach 40 percent in the hospitals that it supports in Guinea (MSF n.d.). UNAIDS estimates that the number of deaths caused by AIDS in one year was 4,300 in 2018 (UN 2018a) and 5,800 in 2016 (UN 2018b).
1.1.1 Public Support
The EDS V states that 2 percent of the Guinean population aged 15 to 49 has health insurance (Guinea and ICF July 2019, 39).
The Guinean National Committee to Fight Against AIDS (Comité national de lutte contre le sida, CNLS) was created by decree in 2002 (Guinea n.d.). Its website describes the CNLS as follows:
[translation]
The CNLS is the only organization coordinating all interventions against the HIV epidemic in Guinea. Basically, it is responsible for promoting and coordinating multisectoral activities, including national assessment and control systems. It must, among other things, oversee the creation of a legal environment favourable to compliance with the duties and the protection of the rights of persons living with HIV (PLHIV). It must also seek the funding and supports needed for the activities to fight AIDS for both the public and private sectors. (Guinea n.d.)
The CNLS has developed four national strategic frameworks for fighting AIDS; the framework for the 2018-2022 period reports that the expected budget is US$246,935,749, but that 79 percent of this amount is unavailable and must be obtained through mobilization [translation] “of traditional funding partners … through international and regional advocacy missions and funding requests” (Guinea Aug. 2018, 5, 44, 45).
1.1.2 Associations and NGOs
Sources state that the Afrique Arc-en-ciel (AAEC) association is working in the fight against HIV in Guinea (Belgium 28 Nov. 2017, 14; Afrique Arc-en-ciel n.d.). Information on the organizational abilities or activities of this association was scarce among the sources consulted by the Research Directorate within the time constraints of this Response. AAEC reported to Belgium’s Office of the Commissioner General for Refugees and Stateless Persons (Commissariat général aux réfugiés et aux apatrides, CGRA) in 2017 that it was [translation] “still the only LGBTI association with official approval in Guinea” and that its main activities consisted of “awareness and/or prevention, screening, and the fight against discrimination and stigmatization relating to HIV/AIDS” (Belgium 28 Nov. 2017, 14).
The French NGO Therapeutic Solidarity and Initiatives for Health (Solidarité thérapeutique et initiatives pour la santé, Solthis), which combats HIV/AIDS around the world, reports on its website that it is working in Guinea in the areas of diagnosis, monitoring, therapeutic treatment and research, and that it has a permanent office there (Solthis n.d.). According to its 2018 activity report, Solthis is coordinating three projects in Guinea:
- The OPP-ERA project, which seeks to improve care for PLHIV through access to viral load testing [which makes it possible to monitor the effectiveness of treatment], that, [Solthis English version] “for the first time brought access to viral load testing to the Guinean public health system” and that completed over 26,000 viral load tests between 2014 and 2018 at the National Institute for Public Health (Institut national de santé publique, INSP) and at the Donka national hospital in Conakry (Solthis June 2019, 20, 21);
- The DIAVINA research project, which seeks to prevent mothertoinfant transmission of HIV at birth through the diagnosis of the infection and systematic ARV treatment at birth at the Ignace Deen Hospital, which means that: [Solthis English version] “screening for HIV in the labour ward has increased from 65% in 2016 to 95% in 2018 and in paediatric services: a threefold increase in screening for HIV and children infected with HIV who have received antiretroviral treatment” (Solthis June 2019, 22); and
- The PACTES project, which seeks to maximize the efficiency of treatment by training caregivers and supporting associations for PLHIV (Solthis June 2019, 23).
The Fighting Together Against AIDS in Africa Platform (Plateforme Ensemble luttons contre le sida en Afrique, Plateforme ELSA), [translation] “a consortium of French associations active in the fight against HIV/AIDS in Africa” (Plateforme ELSA n.d.a), reports on its website that the Association of Guinean Women Fighting Against Sexually Transmitted Infections and AIDS (Association des femmes de Guinée pour la lutte contre les IST [infections sexuellement transmissibles] et le sida, ASFEGMASSI) is the [translation] “first NGO fighting against AIDS in Guinea” and that it is working to prevent and treat HIV in this country where it manages two associative outpatient treatment centres in Conakry and in Coyah, and that PLHIV “receive various services there at no cost” (Plateforme ELSA n.d.b). An academic article about the monitoring of patients undergoing ARV treatment in the ASFEGMASSI HIV outpatient treatment centre in Conakry states:
[translation]
It [ASFEGMASSI] helps reduce the spread of STI/HIV in the country through public education, staff training and the social protection of women and PLHIV. Through the support of the National Program to Fight and Prevent STI/AIDS (Programme national de lutte et de prévention des IST/sida), the National Committee to Fight Against AIDS (Comité national de lutte contre le sida) and the Global Fund to Fight AIDS, Tuberculosis and Malaria, ASFEGMASSI is treating nearly 1,000 PLHIV. (Touré, et al. May 2018, 2)
Without providing further information, sources note at least one association for PLHIV in Guinea (MSF 30 Nov. 2018; BBC 24 July 2018).
1.1.3 International Organizations
The MSF private international association reports that it has been participating in the fight against HIV/AIDS in Guinea since 1984 and has been providing ARV treatments there since 2003 (MSF Apr. 2016, 81). Its teams work with the Guinean Ministry of Health to provide support to PLHIV in six health centres in Conakry (MSF n.d.) and in one outpatient clinic in the Matam district (MSF 20 May 2016). The MSF association provides treatment and diagnostic services (MSF 20 May 2016), as well as [translation] “psychosocial support, treatment of opportunistic infections, practical training and support for health care staff in particular” (MSF n.d.). The MSF association also reports that [translation] “since December 2016, [it] also supports a specialized care unit with 31 beds for persons living with AIDS” at the Donka hospital (MSF [2017], 43). The association confirms that it provided care to nearly 11,000 PLHIV in 2017 in Guinea (MSF [2017], 43).
OSAR reports that, according to a doctor specializing in the treatment and monitoring of patients living with HIV/AIDS, the mutual aid Christian community of Sant’Egidio operates three Dream centres in Conakry that [translation] “provide treatment to persons infected with HIV” and depend on the government to supply medication (OSAR 12 Oct. 2018, 6). An article that appears on the Guinea Health Info (Guinée info santé) blog, a website created by 10 journalists following training to [translation] “better understand the issues and responsibilities relating to health information,” provided with the support of the French Department of Foreign Affairs and International Development (Ministère français des Affaires étrangères et du Développement international) (Guinée info santé n.d.), reports the following:
[translation]
The Dream centre, supported by the Community of Sant’Egidio and "persons of good will," opened its doors in Guinea in 2006. Currently, "nearly 4,000 people living with HIV/AIDS are undergoing antiretroviral treatment, 70 percent of whom are women." Treatment is free. (Guinée info santé 15 Oct. 2016)
2. Treatment of PLHIV by Society
Sources report that there is stigmatization of PLHIV in Guinea (UN 7 Dec. 2018, para. 17; Guinea and ICF July 2019, 262). According to sources, [translation] “discriminatory attitudes” are “very widespread” (Guinea and ICF July 2019, 262) or [translation] “strong” (OSAR 12 Oct. 2018, 8). The MSF association explains, while introducing a screening project in Conakry in 2016, that [MSF English version] “[t]he low prevalence of HIV in Guinea … means that very few people know about the disease and that people living with HIV face stifling stigmatization” (MSF 20 May 2016). In a report on Guinea published in December 2018, the UN Committee on Human Rights emphasizes, without providing further information, [UN English version] “acts of discrimination, stigmatization and violence against … persons living with HIV/AIDS” (UN 7 Dec. 2018, para. 17).
According to the EDS V, [translation] “63 percent of women and 63 percent of men believe that HIVpositive children should not go to school with HIV-negative children; similarly, 76 percent of women and 75 percent of men would not purchase fresh vegetables from a seller who has HIV” (Guinea and ICF July 2019, 259). According to data from the same source, the overall percentage of Guineans who [translation] “have expressed discriminatory opinions” against persons infected with HIV/AIDS is 80 percent of women and 79 percent of men (Guinea and ICF July 2019, 263). The same source reports that rates of stigmatization vary based on area, that they are higher in rural areas than in urban areas and that they decrease based on level of education: [translation] “the level of stigmatization is the highest among women in the Mamou area (90 percent) and the lowest in the Kankan area (68 percent). Among men, the level of stigmatization varies from a maximum of 90 percent in Kindia to a minimum of 60 percent in Mamou” (Guinea and ICF July 2019, 262, 263). According to the data of another study conducted by the CNLS and Population Services International (PSI) [1], the Behavioural and Biological Monitoring Study on STI, HIV/AIDS and Syphilis Among Key Populations and Vulnerable Groups in Guinea (Étude de surveillance comportementale et biologique [ESCOMB] sur les IST, le VIH/SIDA et la syphilis auprès des populations clés et groupes vulnérables en Guinée) that was published in March 2018, the percentages of individuals among target groups (youth, fishers, miners and detainees) [translation] “reporting discriminatory attitudes toward persons living with HIV” is between 44.3 percent and 61.1 percent (PSI and Guinea Mar. 2018, 21).
Sources emphasize that discrimination and stigmatization affect women living with HIV/AIDS in particular (US 13 Mar. 2019, 21; OSAR 12 Oct. 2018, 8). The doctor specializing in the treatment and monitoring of patients living with HIV/AIDS informed OSAR that it is a [translation] “frequent” occurrence that women living with HIV/AIDS “are ostracized and rejected by their husbands” (OSAR 12 Oct. 2018, 6, 8). According to the US Department of State’s Country Reports on Human Rights Practices for 2018: “[m]ost victims of stigmatization were women whose families abandoned them after their husbands died of AIDS” (US 13 Mar. 2019, 21).
Information on the accessibility of housing and employment for PLHIV could not be found among the sources consulted by the Research Directorate within the time constraints of this Response.
2.1 Treatment When Seeking Care
Information on the treatment of PLHIV when seeking care was scarce among the sources consulted by the Research Directorate within the time constraints of this Response. According to the Behavioural and Biological Monitoring Study on STI, HIV/AIDS and Syphilis Among Key Populations and Vulnerable Groups in Guinea, [translation] “the persistence of social stereotypes, the weakness of political and programming engagement, and the unfavourable legal environment … make men who have sexual relations with other men [MSM] a difficult population to access and a population that is most often missed in terms of prevention programs and appropriate treatment” (PSI and Guinea Mar. 2018, 20). For information on the treatment of sexual minorities in Guinea, see Response GIN105987 of September 2017.
Sources report that some PLHIV in Guinea fail to seek care or look for treatment for fear of being rejected by society (Africaguinee.com 12 Apr. 2019; Guinée info santé 15 Oct. 2016). The authors of the EDS V indicate that [translation] “a high level of stigmatization and discrimination in a population may have a negative impact on the willingness of individuals to undergo tests and adhere to antiretroviral therapies (ART) in ART programs” (Guinea and ICF July 2019, 262). The information website Africaguinee.com reported in April 2019 that, [translation] “[a]ccording to the coordinator of the HIV/AIDS project of MSF Belgium in Guinea, among the 120,000 people infected by the virus in Guinea, 42 percent were not screened because of community stigmatization and selfstigmatization” (Africaguinee.com 12 Apr. 2019). Corroborating information could not be found among the sources consulted by the Research Directorate within the time constraints of this Response.
2.2 Legislation to Protect PLHIV from Discrimination
US Country Reports 2018 indicates that legislation to protect PLHIV from stigmatization exists in Guinea (US 13 Mar. 2019, 21).
Order No. 056/2009/PRG/SGG Amending Legislation L/2005/025/AN of 22 November 2005 Relating to the Prevention, Treatment and Control of HIV/AIDS in the Republic of Guinea (Ordonnance n°056/2009/PRG/SGG portant amendement de la loi L/2005/025/AN du 22 novembre 2005 relative à la prévention, la prise en charge et le contrôle du VIH/sida en République de Guinée) provides the following:
[translation]
Article 3: All government employees, security and defence forces, and service providers from private sectors (including informal), must undergo basic standardized training on HIV and AIDS focusing on the nature of HIV and AIDS, means of transmission, prevention methods, course of action in the event of exposure and behaviours to adopt toward PLHIV, with particular emphasis on the duty to exercise confidentiality and the prohibition of any form of discrimination and stigmatization.
The National Committee to Fight Against AIDS (Comité national de lutte contre le sida, CNLS) is responsible for implementing the provisions set out in this article.
Article 4: At the time of hiring, all public, private and mixed sector employers are prohibited from requesting that a candidate undergo an HIV screening test or from refusing to hire a candidate on the ground that he or she has not undergone an HIV screening test or has refused to submit the result of his or her most recent test to them. An HIV screening test cannot, in any case, constitute a condition of hiring or a ground for dismissal, regardless of the candidate’s gender.
It is considered abusive to dismiss an employee solely for being HIVpositive. (Guinea 2009)
The order also sets out the following punishments:
[translation]
Article 42: Employers who fail to comply with the provisions of Article 4 of this order shall receive a fine of 2,000,000 [C$274] to 5,000,000 Guinean Francs without prejudice to any damages and interests that may be awarded to the candidate who was discriminated against.
Article 43: The following persons are found guilty of willingly abandoning a dependent PLHIV and shall therefore receive a term of imprisonment of 6 months to 2 years and a fine of 1,000,000 to 3,000,000 Guinean Francs, or only one of these two punishments:
- persons who willingly abandon their legal wife or husband because of their HIVpositive status;
- a father or mother who willingly abandons their child because of their HIVpositive status;
- an adult child who willingly abandons their father or mother because of their HIVpositive status. (Guinea 2009)
Information on whether the preceding provisions have been applied could not be found among the sources consulted by the Research Directorate within the time constraints of this Response.
US Country Reports 2018 states that the government relied on donor efforts to combat discrimination against these people and that they were “limited to paying salaries for healthservice providers” (US 13 Mar. 2019, 21). Corroborating information could not be found among the sources consulted by the Research Directorate within the time constraints of this Response.
This Response was prepared after researching publicly accessible information currently available to the Research Directorate within time constraints. This Response is not, and does not purport to be, conclusive as to the merit of any particular claim for refugee protection. Please find below the list of sources consulted in researching this Information Request.
Note
[1] Population Services International (PSI) is an NGO based in Washington that works with approximately 50 countries to improve [translation] “good health practices and access to affordable medication” (PSI n.d.).
References
Africaguinee.com. 12 April 2019. “Conakry : MSF s’implique dans la lutte contre la stigmatisation des personnes vivant avec le VIH/Sida.” [Accessed 6 Dec. 2019]
Afrique Arc-en-ciel. N.d. “Afrique Arc-en-ciel.” [Accessed 14 Jan. 2020]
Belgium. 28 November 2017. Commissariat général aux réfugiés et aux apatrides (CGRA). Guinée : L’homosexualité. [Accessed 8 Jan. 2020]
British Broadcasting Corporation (BBC). 24 July 2018. “En Guinée les personnes vivant avec le VIH sida manquent d’antirétroviraux.” [Accessed 13 Jan. 2020]
Guinea. 16 May 2019. Rapport initial soumis par la Guinée en application des articles 16 et 17 du Pacte, attendu en 1990. (E/C.12/GIN/1) [Accessed 10 Dec. 2019]
Guinea. 7 August 2018. Rapport valant troisième à sixième rapports périodiques soumis par la Guinée en application de l’article 44 de la Convention, attendus en 2017. (CRC/C/GIN/3-6*) [Accessed 11 Dec. 2019]
Guinea. August 2018. Comité national de lutte contre le sida (CNLS). Cadre stratégique national de lutte contre le sida 2018-2022. [Accessed 14 Jan. 2020]
Guinea. March 2015. Ministère de la Santé. Plan national de développement sanitaire (PNDS) 2015-2024. [Accessed 13 Jan. 2020]
Guinea. 2009. Ordonnance n°056/2009/PRG/SGG portant amendement de la loi L/2005/025/AN du 22 novembre 2005 relative à la prévention, la prise en charge et le contrôle du VIH/sida en République de Guinée. [Accessed 18 Dec. 2019]
Guinea. N.d. Comité national de lutte contre le sida (CNLS). “Le Comité national de lutte contre le sida en Guinée (CNLS).” [Accessed 18 Dec. 2019]
Guinea, Institut national de la statistique (INS) and ICF. July 2019. Enquête démographique et de santé en Guinée (EDS V) 2018. [Accessed 10 Dec. 2019]
Guinée info santé. 15 October 2016. Amadou Touré. “La pauvreté, un frein au traitement des femmes vivant avec le VIH.” [Accessed 6 Dec. 2019]
Guinée info santé. N.d. “À propos.” [Accessed 6 Dec. 2019]
Médecins sans frontières (MSF). 30 November 2018. “Journée mondiale de lutte contre le VIH : Rencontrez les associations communautaires, des acteurs clés pour la lutte contre le VIH.” [Accessed 6 Dec. 2019]
Médecins sans frontières (MSF). [2017]. Rapport international d’activités 2017. [Accessed 16 Dec. 2019]
Médecins sans frontières (MSF). 20 May 2016. “MSF’s First HIV Testing Campaign in Conakry.” [Accessed 6 Dec. 2019]
Médecins sans frontières (MSF). April 2016. Le prix de l’oubli - Des millions de personnes en Afrique occidentale et centrale restent en marge de la lutte mondiale contre le VIH. [Accessed 13 Jan. 2020]
Médecins sans frontières (MSF). N.d. “Guinée : prise en charge des personnes affectées par le VIH/sida.” [Accessed 9 Dec. 2019]
Organisation suisse d'aide aux réfugiés (OSAR). 12 October 2018. Guinée : traitement du VIH/SIDA. [Accessed 8 Jan. 2020]
Plateforme Ensemble luttons contre le sida en Afrique (Plateforme ELSA). N.d.a. “Qui sommes-nous?” [Accessed 13 Jan. 2020]
Plateforme Ensemble luttons contre le sida en Afrique (Plateforme ELSA). N.d.b. “ASFEGMASSI.” [Accessed 14 Jan. 2020]
Population Services International (PSI) and Guinea, Comité national de lutte contre le sida (CNLS). March 2018. Étude de surveillance comportementale et biologique (ESCOMB) sur les IST, le VIH/SIDA et la syphilis auprès des populations clés et groupes vulnérables en Guinée, 2017. [Accessed 11 Dec. 2019]
Population Services International (PSI). N.d. “PSI at a Glance.” [Accessed 13 Jan. 2020]
Therapeutic Solidarity and Initiatives for Health (Solthis). June 2019. Rapport d’activités 2018. [Accessed 15 Jan. 2020]
Therapeutic Solidarity and Initiatives for Health (Solthis). N.d. “Nos pays d’intervention.” [Accessed 13 Jan. 2020]
Touré, Abdoulaye, et al. May 2018. “Facteurs associés aux perdus de vue des patients sous traitement antirétroviral dans un centre de traitement ambulatoire du VIH à Conakry, Guinée.” Revue d’épidémiologie et de santé publique. [Accessed 15 Jan. 2020]
United Nations (UN). 7 December 2018. Human Rights Committee. Observations finales concernant le troisième rapport périodique de la Guinée. (CCPR/C/GIN/CO/3) [Accessed 11 Dec. 2019]
United Nations (UN). 2018a. Joint United Nations Programme on HIV/AIDS (UNAIDS). “Guinea 2018.” Country Factsheets. [Accessed 16 Dec. 2019]
United Nations (UN). 2018b. Joint United Nations Programme on HIV/AIDS (UNAIDS). “Pays : Guinée.” [Accessed 9 Dec. 2019]
United States (US). 13 March 2019. Department of State. “Guinea.” Country Reports on Human Rights Practices for 2018. [Accessed 11 Dec. 2019]
Additional Sources Consulted
Oral sources: Fidesco; Médecins sans frontières; Plateforme Ensemble luttons contre le sida en Afrique; Therapeutic Solidarity and Initiatives for Health; UN – UNAIDS, World Health Organization.
Internet sites, including: Amnesty International; Factiva; France – Office français de protection des réfugiés et apatrides; Freedom House; Global Guinée; Human Rights Watch; International Lesbian, Gay, Bisexual, Trans and Intersex Association; International Committee of the Red Cross; United Nations – Refworld, UN Population Fund.