Róisín Garvey (Green Party)
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Cuirim fáilte roimh an Aire Stáit, Teachta Feighan. I thank him for attending.

Jerry Buttimer (Fine Gael)
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Míle Buíochas, a Chathaoirligh Gníomhaigh. I welcome the Minister of State to the House today, World AIDS Day. This is a worldwide health day with the theme of global solidarity and shared responsibility in fighting the stigma of HIV and AIDS in our country and in the world. I tabled this matter and I thank the Cathaoirleach for allowing both myself and Senator Warfield to raised two different Commencement matters on World AIDS Day on sexual health strategy, which for the current five-year period is about to expire. I hope it just does not run out and that the next strategy is consultative because it is important that we renew our focus on tackling HIV through rapid testing, accessibility and collaboration between all the stakeholders involved and the NGOs. In particular, I pay tribute to the sexual health clinic in Cork and HIV Ireland for the work that they are doing. I also want to thank the State agencies under the remit of the Minister of State and to compliment him on the work that he is doing as Minister of State in the time that he has been in this position. I know that he has been very proactive on this particular issue.

The sexual health and crisis pregnancy programme has helped to fund and provide seed capital to meet our aspirations under Healthy Ireland to tackle the stigma of HIV and to reduce the numbers. The rates for this year are on a par with previous years and there is a worry about the trends. Our focus must be on achieving the goals and on maintaining funding. As a country we have signed up to Fast-Track Cities, the global partnership with the 90-90-90 outlook and outcome, and we all must be committed to making testing easier, to know our status while community testing must be made available, awareness raised, and the stigma that still exists in the context of HIV reduced.

In the context of Cork, I pay tribute to the staff and leadership of the Sexual Health Centre who are doing Trojan work during this pandemic with the outreach, support programme and counselling that has been available. Their HIV sexually transmitted infection, STI, clinic has been open throughout the pandemic. It is a facility and service available to people and the clinic must be commended on this.

Our urban centres may not be an issue - Senator Warfield will have a Commencement matter on a particular issue shortly - but visibility in rural settings is one that needs to be addressed as to equity of service, and availability and access to services. I was asked by somebody whether an eircode was the decisive feature in access to service. I certainly hope that it is not.

I also commend HIV Ireland, which has been to the forefront in our battle and response to HIV and AIDS for more than four decades. In reflecting, as many of us do, and remembering our many friends we have lost, we recognise today that we are in a better place as a country because in the furtive early years, a social policy was being led and changed by NGOs and activists. Today, this is now Government-led. That is why the red ribbon, the symbol of HIV-AIDS awareness, is one that we should be proud to wear. I thank the Minister of State for being present and I look forward to his response. Our journey continues and I am very proud to see that he is present to wear the jersey in this battle and quest. I genuinely believe that we are lucky to have him as Minister of State as I know him a long time as a person with a genuine commitment to people.

Frank Feighan (Sligo-Leitrim, Fine Gael)
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I thank the Senator for his remarks. The national AIDS strategy referred to by the Senator was published in 2000. Its most recent successor is the National Sexual Health Strategy 2015-2020, published in 2015. That strategy aims to improve the sexual health and well-being of the population and to reduce negative sexual health outcomes, including unplanned pregnancies and the transmission of STIs, including HIV. These aims are being addressed by the delivery of a programme of work to improve education and prevention supports, sexual health and STI services, and the quality of health information used to inform policy. The vision of the sexual health strategy is "that everyone in Ireland experiences positive sexual health and wellbeing". The strategy has three goals: that everyone living in Ireland will receive comprehensive and age-appropriate sexual health education and/or information and will have access to appropriate prevention and promotion services; that sexual health services, which are equitable, accessible and of high quality, will be available to everyone; and that robust and high-quality sexual health information will be generated to underpin policy, practice, service planning and strategic monitoring.

A mid-term review of the strategy in 2018 found that implementation is going well. There is a great working relationship between voluntary and community groups working in this area, and the HSE's sexual health and crisis pregnancy programme, SHCPP, which manages the health care services covered by the strategy.

Tackling the recent increase in new diagnoses of HIV and other STIs is a key element of the strategy. Last year saw the launch of a number of major actions to combat these rising rates of infection. In June 2019, Ireland formally became a member of the HIV Fast-Track Cities initiative, a major global partnership committed to accelerating local HIV-AIDS responses. Dublin, Cork, Limerick and Galway have joined this network, and €450,000 in funding was provided in 2019 for implementation of local actions, such as increased access to HIV testing. The most significant development in 2019 was the introduction of a national programme of HIV pre-exposure prophylaxis, or PrEP, which involves the pre-emptive use of anti-retroviral medication to prevent HIV infection.

PrEP is provided within a holistic prevention service which includes regular monitoring and testing, as well as advice and counselling on safer sex practices. Funding of €5.4 million was provided in 2020 to provide for a full national roll-out of PrEP and to fund additional staff and other resources required to provide HIV PrEP within a broader sexual health and HIV prevention programme.

Other important actions undertaken by the SHCPP includes support for parents, with a range of booklets having been published recently to enable them to talk to their children about relationships, sexuality and growing up. The SHCPP also provided support for the provision of relationship and sexuality education in schools. The programme plays a vital role in developing research, collaborating with, for example, the ESRI, to produce the evidence-based information that is vital to understanding emerging trends. The future direction of the strategy will be reviewed in 2021.

Jerry Buttimer (Fine Gael)
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I thank the Cathaoirleach Gníomhach and the Minister of State.It is important that we live up to our expectations around fast-track cities, that there is a combined collaborative approach and that we continue to be to the forefront in responding to HIV and AIDS.

The funding of €450,000 announced last summer needs to be matched in future years. I hope that community-based testing, outreach services, public awareness campaigns and the availability of PrEP continue. They are very necessary. The elimination of stigma, increasing education and awareness and the continued promotion of young and not so young people is important.

Frank Feighan (Sligo-Leitrim, Fine Gael)
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Some 23 public STI services nationally provide free STI and HIV testing. HIV testing is also available as part of the national antenatal screening programme, with almost 100% uptake. The HSE sexual health and crisis pregnancy programme funds and collaborates with community partners to expand HIV testing among higher risk population groups such as gay men and migrants in order to identify those living with undiagnosed HIV. The two most important partners are HIV Ireland and the Gay Health Network. I was delighted to meet HIV Ireland yesterday at the launch of another facility in the Mater hospital in Dublin.

HIV Ireland is funded to support a programme called mPower which provides testing and outreach support to gay and bisexual men online and in a face-to-face capacity. Funding is also provided to the Gay Health Network to manage the man2man.iewebsite, communications messaging and campaigns to ensure that gay men have access to the appropriate information on sexual health and available services. Further information and links are also available through sexualwellbeing.ie.

I note the importance of World AIDS Day in raising awareness of this illness which is a key element in keeping infection rates as low as possible. We will continue to work as closely as possible with all of our key partners and stakeholders in this important area in order to make the best use of resources and continue to fight against HIV and, as Senator Buttimer said, stigma.