Ciarán Ahern (Dublin South West, Labour)
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481. To ask the Minister for Health the number of staff in each public PrEP service in 2024 and to-date in 2025; the number of vacancies in each of those PrEP services, in tabular form; and if she will make a statement on the matter. [22347/25]

Colm Burke (Cork North-Central, Fine Gael)
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It is of vital importance that people living with HIV (PLHIV) are promptly linked to care, for prevention of onward transmission and for clinical benefit. It is also vital that those at risk are encouraged to access regular testing and preventive programmes such as PrEP and post-exposure prophylaxis (PEP). These measures are key elements towards achieving UN and WHO aims of ending the HIV/AIDS epidemic in Europe by 2030 and supporting wider national and international commitments, including the Sustainable Development Goals.

Antiretroviral therapy can be used for HIV prevention by treating those with established infection, known as Treatment as Prevention (TasP); through administration at low doses to those at risk of infection (Pre-exposure prophylaxis, PrEP); or administration to those who may have been exposed to infection (Post exposure prophylaxis, PEP).

A national HIV pre-exposure prophylaxis (PrEP) programme commenced in November 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.

These include public PrEP services, delivered through the public network of STI clinics, and some general practice (GP) services and private providers. There are currently 13 approved public PrEP services, located in public STI clinics, and 17 private or general practitioner (GP) PrEP providers. Appointments at the 13 public PrEP services are free of charge, however, the private providers charge for consultations.

The number of people eligible to access PrEP has been expanding since inception, with the number of individuals re-imbursed for PrEP at least once in a given calendar year expanding from 1763 in 2020 to 4,419 users by the end of Q4, 2024. The population has grown significantly in recent years, and clinical criteria for PrEP eligibility have been widened, increasing the number of people eligible. While the PrEP service continued to grow in 2023, many PrEP services are reaching (or have reached) capacity and service users are reporting challenges accessing appointments. Additional work to understand the extent of the unmet need/demand for PrEP, which has been estimated as circa 30%, is ongoing.

In order to further increase capacity for PrEP, a number of additional measures have been deployed and are being developed, including administrative efficiencies, the use of telephone consultations and use of the free home STI testing scheme for routine tests. In order to 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. We have also been allocated additional funding of €550,000, through Budget 2025, to further support the PrEP scheme, bringing the total allocation to €6.45m this year. This additional funding is comprised of €0.2m for additional PrEP drug costs, and €0.35m for additional staffing in the public STI clinics from July 2025, increasing capacity for in-person appointments.

Furthermore, the home STI testing scheme is being used to support the PrEP programme; an additional €600,000 has been allocated for this in 2025, given increasing demand for the service. This brings funding for home STI testing to €4.82m in 2025. Over 126,000 kits were ordered in 2024, with a return rate of 71% and with just under 10% of returned kits indicating reactive results.

The potential to widen eligibility and access for PrEP and PEP delivery, through the public system, its partnerships and through primary care (analogous to methods of provision in some other jurisdictions), will be considered under the new National Sexual Health Strategy. The new Strategy is at design stage and will be submitted to Government for approval in the first half of 2025. As stated earlier, funding is in place already for expansion of capacity within our network of STI clinics from July, 2025.

The Department of Health and HSE Sexual Health Programme are also working together on plans to fulfil the commitments on HIV supports, including PrEP, included in the Programme for Government, Securing Ireland's future.

As staffing in these services is a service matter, I have asked the HSE to respond directly to the Deputy, as soon as possible.