Róisín Shortall (Dublin North West, Social Democrats)
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391. To ask the Minister for Health the steps being taking to increase the availability of pre-exposure prophylaxis, given that existing services are oversubscribed; and if he will make a statement on the matter. [5395/23]

Hildegarde Naughton (Galway West, Fine Gael)
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Ireland established a national HIV PrEP programme in November 2019, following a HIQA Health Technology Assessment (HTA), which concluded that the introduction of HIV PrEP would be safe, effective and cost saving. The HTA also found that significant investment in public STI services was required to implement PrEP and €5.4 million was set aside in Budget 2020 to roll out a national HIV PrEP programme, managed by the HSE Sexual Health and Crisis Pregnancy Programme (SHCPP).

At present, there are 13 public PrEP clinics in Ireland, four of which are located in Dublin, and 16 private/GP providers who are approved to prescribe PrEP, 15 of which are located in Dublin. Services rapidly adapted PrEP service delivery early in the COVID-19 pandemic to ensure continued access to PrEP, despite the impact of the pandemic on every aspect of the health service. 

In 2021, given the ongoing impact of the pandemic on attending clinical services in person, coupled with a national outbreak of early infectious syphilis, the Sláintecare Integration Fund initially supported a pilot programme to provide access to online STI testing, in Dublin, Cork and Kerry. This pilot was very successful and was gradually expanded, receiving €3 million in support in Budget 2022 and an additional €600,000 in Budget 2023. The service was launched on a nationwide basis in October, 2022. 

Since the PrEP programme commenced in November, 2019, the HSE SHCPP advise that over 7,500 individuals have been approved for PrEP, in line with national PrEP eligibility criteria.   Significant progress has been made in PrEP rollout across Ireland. However, this occurred at a time of unprecedented challenges for the health service - the pressures of the Covid-19 pandemic on access to clinical services, coupled with the effects of necessary Covid-19 restrictions on people's social interactions.  This made it difficult to assess whether capacity would meet demand under normal circumstances.

In line with international trends, the eligibility criteria for PrEP have recently been revised to include anticipated risk of HIV infection. This is likely to increase the overall numbers of individuals meeting the criteria for inclusion in the PrEP programme. 

The relaxation of most Covid-19 restrictions, following the successful national vaccination campaign, has permitted a preliminary assessment that additional resources may be required to meet additional demand, build capacity and invest in monitoring, evaluation and research to ensure that the PrEP programme in Ireland is reaching those in need, responsive to changing need and at the cutting edge of international PrEP programme delivery.

The HSE SHCPP have put a number of measures in place to support the PrEP Programme, including updating the clinical PrEP Guidelines and approval processes and providing an e-learning module to enable greater access to the PrEP programme through GPs, allowing stable patients to undertake routine STI testing through the new online service, and working with other areas of the HSE to enable efficient data collection and identify resources to improve capacity.

The HSE SHCPP has identified monitoring and evaluation of the PrEP programme as a priority area of work, building on that which has been undertaken to date.

An independent review of the National Sexual Health Strategy 2015-2020 (NSHS) is in the final stages of preparation and will be published shortly. The Review will inform development of the new NSHS 2023 – 2030. Capacity for PrEP will be examined as part of the policy development process leading to the new NSHS. Allocation of additional resources to support the new Strategy, including resources to support PrEP, is a matter for the Estimates process leading to Budget 2024.

Róisín Shortall (Dublin North West, Social Democrats)
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392. To ask the Minister for Health the number of persons on a waiting list for a pre-exposure prophylaxis appointment, by clinic and wait time. [5396/23]

Hildegarde Naughton (Galway West, Fine Gael)
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As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.