Dáil Éireann Debate, Tuesday - 3 March 2026
815. Deputy Martin Daly asked the Minister for Health whether there is a national HIV strategy or national HIV action plan, separate to the National Sexual Health Action Plan and the Healthy Ireland framework; and if not, whether consideration has been given to developing a dedicated national strategy for HIV. [16391/26]
View answer816. Deputy Martin Daly asked the Minister for Health whether consideration has been given to the introduction of routine or opt-out HIV screening in emergency departments and other large acute hospital settings, in light of advances in treatment and the benefits of early diagnosis. [16392/26]
View answer817. Deputy Martin Daly asked the Minister for Health whether the opt-out HIV screening pilot in Saint James’s Hospital has been evaluated; if so, the findings of that evaluation; and whether consideration has been given to rolling out a similar programme in other acute hospitals. [16393/26]
View answer818. Deputy Martin Daly asked the Minister for Health whether the national HIV pre-exposure prophylaxis (PrEP) programme has been reviewed in terms of accessibility and uptake; and whether consideration has been given to expanding access for groups at increased risk of HIV infection. [16394/26]
View answerI propose to take Questions Nos. 815, 816, 817 and 818 together.
Sexual health is a priority for this Government and for the Department of Health.
The Programme for Government, Securing Ireland’s Future, 2025, commits to developing an HIV Action Plan, increasing the availability of Pre-Exposure Prophylaxis (PrEP) and reduce waiting times for access to it, in addition to the publication of a new Sexual Health Strategy, a process that was completed in 2025.
The new National Sexual Health Strategy, 2025-2035 (NSHS) and National Sexual Health Action Plan, 2025-2038 (NSHAP), commit to developing Models of Care for sexual health and for HIV, to develop an HIV Action Plan, as per the Programme for Government commitment, and to expand HIV prevention, diagnosis and treatment. The Strategy also includesa commitment to explore community options for the delivery of PrEP, including widening access through primary care and exploring digital options.
The NSHS and NSHAP (included in one document) can be accessed at the following link: www.gov.ie/en/healthy-ireland/policy-information/national-sexual-health-strategy-2025-2035/.
Work is commencing on the HIV Action Plan; a subgroup of the NSHS Implementation Group focussing on sexual health services has been convened and will oversee and co-ordinate drafting. A stakeholder consultation request has been shared with clinical, sexual health and public health experts, other relevant divisions of the HSE, community and research partners and representative organisations working with people at risk of and living with HIV.
In terms of PrEP, a national HIV pre-exposure prophylaxis (PrEP) programme commenced in 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.
Public PrEP services are delivered through the public network of STI clinics and through some approved private providers. There are currently 13 approved public PrEP services, located in public STI clinics, and 42 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. PrEP medications are also free of charge.
The population has grown significantly in recent years, and clinical criteria for PrEP eligibility have been widened, increasing the number of people eligible. 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 expanding from 1763 in 2020 to 7,037 users by the end of 2025, a year in which an additional 2,196 new PrEP users were added.
While the PrEP service continues to grow, many PrEP services had reached capacity and service users were reporting challenges accessing appointments. In order to expand PrEP services and provide additional supports to our rapidly growing population, we were allocated additional funding of €550,000, through Budget 2025, and an additional €100,000 in 2026, to further support delivery of the PrEP scheme. The total allocation for PrEP has therefore been increased to €6.55m in 2026.
Some progress has been made already, and further consideration of more options will be included in the Models of Care and HIV Action Plan.
• The 2025 allocation included funding for 7WTE to increase capacity for in-person appointments within the PrEP clinics, with all staff in place, and increasing capacity for PrEP appointments, by October, 2025.
• In order to further increase the number of providers, a PrEP competency framework and eLearning platform were developed; these can be accessed by GPs and other private providers with an interest in providing PrEP.
• Following the introduction of training, provider numbers have increased substantially in 2025, with 42 private services now delivering PrEP and additional services undertaking the training currently.
• Further supports for capacity include use of the free home STI testing service for some routine testing.
• The PrEPtimise Study, an HRB funded Evidence for Policy grant, led by researchers and clinicians based in TCD and in St James’s Hospital GUIDE clinic, is looking at the use of a hybrid model for an integrated digital-hybrid clinical service to deliver PrEP, as a way to increase functional capacity. Interim findings indicate that the research is going well.
The details of the national networks of STI clinics, including those providing PrEP, the HIV treatment centres and SATUs are available in Appendix 4 of the National Sexual Health Strategy, 2025-35. These details are also usually available through the HSE’s www.sexualwellbeing.ie website, however, the HSE advise that this is temporarily offline for maintenance.
Further review of eligibility and access for PrEP is being considered as part of the development of the Models of Care and HIV Action Plan, as laid out in the NSHS and NSHAP.
Routine and opt-out screening for HIV is carried out through our network of maternity units and hospitals; comprehensive data arising from this screening is published and available on the Health Protection Surveillance Centre Website: www.hpsc.ie/a-z/hivandaids/antenatalhivtesting/.
Routine HIV screening is not in place across most Emergency Departments, however, we understand that St. James’s Hospital commenced routine testing for HIV and hepatitis B and C for all emergency department patients at the end of July, 2025.
As development of the Models of Care, HIV screening for Emergency Department patients in general and evaluation of the routine ED HIV screening pilot in St. James’s University Hospital Emergency Department are clinical and service matters, I have also asked the HSE to provide additional information to the Deputy as soon as possible.
