The Crossing Countries, Crossing Communities (4C) project was a collaborative initiative funded by the EU4Health Programme of the European Union that aims to empower community-based organisations in Greece, Spain, and the Netherlands to prevent HIV, sexually transmitted infections (STIs), and viral hepatitis among highly marginalised populations. Groups, such as migrants, LGBTQ transgender people, and sex workers, often face substantial barriers to accessing healthcare, which are further exacerbated by social and legal discrimination. Five consortium partners – Doctors of the World Greece (DotW GR), Positive Voice (Greece), Projecte dels NOMS-Hispanosida (Spain), Doctors of the World Netherlands (DotW NL), and Aidsfonds – Soa Aids Nederland (SANL; consortium lead) – implemented the project between January 2023 and December 2024. The 4C project expanded community-based testing, diagnosis, counselling, referral, and linkage-to-care services for HIV, STIs, and viral hepatitis, reaching an additional 14% of key populations in the participating countries. It also scaled up best practices through e-learning and toolkits, reaching 84 organisations and training around 6,400 healthcare professionals across the EU.
The final evaluation of the project followed a mixed-methods approach, combining desk research, key informant interviews with main stakeholders, field observations (including visits to healthcare facilities, refugee camps, and community outreach checkpoints), and secondary quantitative analysis of key service delivery indicators, such as testing uptake, vaccination coverage, and outreach performance.