Colm Burke (Cork North-Central, Fine Gael)
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I propose to take Questions Nos. 355, 356 and 357 together.

Sexual health is a priority for the Department of Health. This Government is committed to enhancing sexual health services in Ireland. As outlined in the Programme for Government, 2025, Securing Ireland's Future, we plan to:

• Publish a new National Sexual Health Strategy.
• Develop an Action Plan to support the elimination of new HIV transmissions by 2030, in line with international targets and provide additional supports for people living with HIV.
• Increase the availability of HIV Pre-Exposure Prophylaxis (PrEP) and reduce waiting times for access to it.

These and additional priorities have been included in the new National Sexual Health Strategy, which is currently in the final stages of formal approval; we hope to launch this shortly.

The HSE are currently working on a Model of Care for sexual health, which will examine equality of access, including geographical access, as part of the programme of work. A list of STI services in Ireland are available at the following link: www.sexualwellbeing.ie/sexual-health/hse-sti-services-in-ireland.html

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.

An additional €600,000 has been allocated for free home STI testing 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 Department of Health and HSE Sexual Health Programme are also working together to expand sexual health services that were funded in Budget 2025. These included an additional 7 WTE to support additional access to PrEP appointments, from July, 2025 and additional support for PrEP medications, totalling €550,000. This brings support for PrEP to €6.45m in 2025. These supports, in addition to further capacity within the free home STI testing service, will increase access to the PrEP scheme, once additional staff are in place.

As the information sought is a service matter, I have asked the HSE to respond directly to the Deputy, as soon as possible.