Written answer
Health Services
PrEP access has expanded, with free medication, increased funding, seven additional staff and more trained providers, but growing demand has caused appointment capacity pressures. The Government plans wider primary-care, community and digital provision under its sexual-health strategy, while the Minister has asked the HSE to address waiting lists.
3678. Deputy Pádraig Rice asked the Minister for Health the steps she is taking to expand equitable access to pre-exposure prophylaxis (PrEP) and eliminate waiting lists; and if she will make a statement on the matter. [57377/26]
Comment on this
Sexual health is a priority for the Department of Health. A national HIV pre-exposure prophylaxis (PrEP) programme commenced in 2019, following a HIQA HTA, which concluded that its introduction would be safe, effective, and cost saving. Free PrEP medication is available to individuals who meet clinical eligibility criteria, attending HSE approved PrEP services.
Public PrEP services are delivered through the public network of STI clinics and through some approved private providers. Contact details for PrEP providers are available on the HSE website: https://www2.hse.ie/conditions/hiv/where-to-get-prep/
Appointments at the 13 public PrEP services are free of charge, however, the private providers charge for consultations. PrEP medications are free of charge.
The population has grown significantly in recent years, and clinical criteria for PrEP eligibility have been widened, increasing the number of people eligible for PrEP. This number has been expanding since inception, with the number of individuals reimbursed for PrEP at least once expanding from 1763 in 2020 to 7,437 users by the end of 2025, a year in which a further additional 2,196 new PrEP users were added.
While the PrEP service continues to grow, many PrEP services had reached capacity and service users are reporting challenges accessing appointments. In order to expand PrEP services and provide additional supports to our rapidly growing population, we were allocated additional funding of €550,000, through Budget 2025, and an additional €100,000 in 2026, to further support delivery of the PrEP scheme. The total allocation for PrEP has therefore increased to €6.55m in 2026. The 2025 allocation included funding for 7 WTE to increase capacity for in-person appointments within the PrEP clinics, with all staff in place by October, 2025.
In order to further increase the number of providers, a PrEP competency framework and eLearning platform has been developed; these can be accessed by GPs with an interest in providing PrEP. Following the introduction of training, provider numbers have increased substantially in recent years, with numbers increasing from 17 in late 2023 to 45 currently, with more in training (please see the above weblink for contact details).
Further supports for capacity include use of the free home STI testing service for some routine testing. The PrEPtimise Study, a HRB funded Evidence for Policy grant, led by researchers and clinicians based in TCD and in St James’s Hospital GUIDE clinic, is looking at the use of a hybrid model for an integrated digital-hybrid clinical service to deliver PrEP, as a way to increase functional capacity. Interim findings indicate that the research is going well.
The National Sexual Health Strategy, 2025-2035 (NSHS) and National Sexual Health Action Plan, 2025-2038 (NSHAP), commit to developing Models of Care for sexual health and for HIV, to develop an HIV Action Plan and to expand community options for the delivery of PrEP, including widening access through primary care and exploring digital options. The Models of Care and HIV Action Plan will examine geographic equity, also taking into account the new HSE regional structure. The NSHS and NSHAP (included in one document) can be accessed at the following link: https://www.gov.ie/en/healthy-ireland/policy-information/national-sexual-health-strategy-2025-2035/.
Governance arrangements for the Strategy are laid out in its final chapter; the Implementation Group and various sub-groups and working groups have commenced work. Significant progress has been made in implementing its Actions already. Further consideration of more options for delivering improved access to PrEP will be included in the forthcoming Models of Care and HIV Action Plan. However, it should be noted that measures requiring additional funding are a matter for the Estimates process preceding the Budget each year.
With regard to addressing waiting lists, as this is also a service matter, I have asked the HSE to provide a response to the Deputy as soon as possible.