David Cullinane (Waterford, Sinn Fein)
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1666. To ask the Minister for Health if preparations for a successor to the National Sexual Health Strategy are underway; if a successor strategy will be published; if the strategy will have a focus on HIV addressing the 90:90:90 ambition; and if he will make a statement on the matter. [18599/21]

Frank Feighan (Sligo-Leitrim, Fine Gael)
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The National Sexual Health Strategy, 2015-2020 was launched in October 2015, and has been extended to the end of 2021 to allow for the effects of pandemic related delays on implementation. It takes a life course approach, acknowledging the importance of developing a healthy attitude to sexuality in young people and of building on that foundation for positive sexual health and wellbeing into adulthood and older age.

It also recognises the importance of challenging stigma and discrimination and creating positive cultural change to promote open communication about relationships, sexuality, and sexual health and wellbeing.

The goals of the Strategy are:

- Everyone in Ireland to receive comprehensive and age-appropriate sexual health education/information and to have access to appropriate prevention and promotion services;

- Equitable, accessible and high-quality sexual health services, which are targeted and tailored to need, to be available to everyone; and

- Robust and high-quality sexual health information to be generated to underpin policy, practice, service planning and strategic monitoring.

Since its publication in 2015, very significant progress has been made in implementing the objectives of the Strategy. Key achievements to date include:

1. The rollout of a national treatment programme of Pre – Exposure Prophylaxis (PrEP);

2. Ireland’s membership of the Fast-Track Cities HIV global partnership project which is driving the response to HIV/Aids across 300 cities;

3. Establishment of the National Condom Distribution Service which distributes free condoms and lubricant sachets to high-risk groups;

4. A wide range of educational and promotional work with the education system, parents, children and young people to ensure that they receive the information and resources they need to support their needs in terms of relationship and sexuality education

5. An ongoing programme of research to provide the evidence base needed to ensure robust policy development.

6. Responding to the challenges posed by the Covid 19 pandemic in the maintenance of vital HIV/STI services. All health services, including STI/HIV services are continuing to face service restrictions due to the current impact of Covid-19 on the hospital system and social distancing requirements. Public STI clinics are prioritising those with symptoms or requiring treatment, and this includes anyone who may be referred for confirmation HIV testing.

7. The HSE SHCPP is currently piloting a free home STI/HIV testing service, supported by the Sláintecare Integration Fund, in Dublin, Cork and Kerry. The first phase of tests were made available in early January. Tests are being made available in a phased manner to ensure there is sufficient capacity in local clinics for service users who may need follow-up treatment or support. The results of the pilot programme will be used to inform future planning.

As detailed above, HIV prevention, prompt diagnosis and treatment are key priorities under the Strategy. The “90-90-90” targets for HIV diagnosis, treatment and viral suppression and the U=U principle; ‘Undetectable equals untransmissible’ (patients taking daily antiretroviral therapy for HIV, and who can achieve and maintain an undetectable viral load, cannot sexually transmit the virus to an HIV-negative partner) are key elements in terms of controlling HIV transmission at population level.

The current National Sexual Health Strategy will remain relevant beyond its original timeframe; the progress made as part of its implementation will continue to be funded and maintained. Moreover, it is intended to review and refresh the Strategy; work was postponed due to the onset of the pandemic but work on this is getting underway.

It is envisaged that, as part of the review process, focus group meetings with key stakeholders, including clinical and public health staff, the SHCPP team, those working in the STI clinics, the Education sector, the Department of Health and Women’s Health Taskforce, the research and academic sector and organisations representing the LGBTI+ community will be held to inform the future direction of the next iteration of the strategy. Planning for this is currently underway.

HIV prevention, diagnosis and treatment will remain core elements of future sexual health service provision and will be included in future policy.