Dáil Éireann Debate, Tuesday - 28 April 2026
1066. Deputy Ken O'Flynn asked the Minister for Health the total number of patients currently accessing State-funded pre-exposure prophylaxis (PrEP) under the national programme; and the annual figures for new commencements in each year from 2019 to 2026. [29871/26]
View answer1067. Deputy Ken O'Flynn asked the Minister for Health the number and geographic distribution of clinics contracted or authorised to provide PrEP services under the public system; and to provide this information by county. [29872/26]
View answer1068. Deputy Ken O'Flynn asked the Minister for Health which PrEP clinics are currently accepting new patient registrations; the number not accepting new patients; and the reasons for any suspension or restriction on new registrations. [29873/26]
View answer1069. Deputy Ken O'Flynn asked the Minister for Health whether a national waiting list, central referral pathway, or prioritisation framework exists for access to PrEP; and if not, the reason such a system has not been established. [29874/26]
View answer1070. Deputy Ken O'Flynn asked the Minister for Health the estimated unmet demand for PrEP services within the State; the methodology used to assess this demand; and any capacity planning undertaken to address identified shortfalls. [29875/26]
View answer1071. Deputy Ken O'Flynn asked the Minister for Health the average waiting time from referral to initiation of PrEP treatment, where applicable; and the longest recorded waiting time in the most recent year for which data is available. [29876/26]
View answer1072. Deputy Ken O'Flynn asked the Minister for Health the funding allocated annually to the PrEP programme since its establishment; the proportion of this funding utilised each year; and whether any underspend or capacity constraints have been identified. [29877/26]
View answer1073. Deputy Ken O'Flynn asked the Minister for Health the policy and clinical governance arrangements in place for individuals who are eligible for PrEP but are unable to access the public programme and instead source medication privately or online; and whether interim access or bridging mechanisms are provided. [29878/26]
View answer1074. Deputy Ken O'Flynn asked the Minister for Health whether her Department or the Health Service Executive has conducted any review of service accessibility, regional disparities, or barriers to entry within the PrEP programme since 2019; and to provide details of any findings and resulting actions. [29879/26]
View answer1075. Deputy Ken O'Flynn asked the Minister for Health the measures planned to expand capacity, ensure equitable geographic access, and guarantee timely entry into the PrEP programme; and the timeline for implementation of such measures. [29880/26]
View answerI propose to take Questions Nos. 1066 to 1075 together.
Sexual health is a priority for the Department of Health. 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. Contact details for PrEP providers are available on the HSE website: [https://www2.hse.ie/conditions/hiv/where-to-get-prep/] Appointments at the 13 public PrEP services are free of charge, however, the private providers charge for consultations. PrEP medications are 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 for PrEP. This number 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 are 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 increased to €6.55m in 2026.
The 2025 allocation included funding for 7WTE to increase capacity for in-person appointments within the PrEP clinics, with all staff in place by October, 2025. In order to further 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. Following the introduction of training, provider numbers have increased substantially in 2025 (please see the above weblink for contact details).
Further supports for capacity include use of the free home STI testing service for some routine testing. The PrEPtimise Study, a 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 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 and to expand community options for the delivery of PrEP, including widening access through primary care and exploring digital options. The Models of Care and HIV Action Plan will examine geographic equity, also taking into account the new HSE regional structure. The NSHS and NSHAP (included in one document) can be accessed at the following link: [https://www.gov.ie/en/healthy-ireland/policy-information/national-sexual-health-strategy-2025-2035/] .
Governance arrangements for the Strategy are laid out in its final chapter; the Implementation Group and various sub-groups and working groups have commenced work. Significant progress has been made in implementing its Actions already. Further consideration of more options for delivering improved access to PrEP will be included in the forthcoming Models of Care and HIV Action Plan.
As the following are service matters:
• total number of patients currently accessing State-funded PrEP;
• the number and geographic distribution of public clinics;
• which PrEP clinics are currently accepting new patient registrations;
• the number not accepting new patients;
• waiting lists, referral pathways, and prioritisation frameworks for PrEP;
• estimated unmet demand for PrEP;
• the methodology used to assess demand for PrEP;
• average waiting time from referral to initiation of PrEP treatment;
• longest recorded waiting times for PrEP;
• annual funding for the PrEP programme since inception;
• clinical governance arrangements in place for individuals who are eligible for PrEP but are unable to access the public programme and instead source medication privately or online;
• whether interim access or bridging mechanisms for PrEP are provided;
• the findings of any reviews of service accessibility, regional disparities, or barriers to entry within the PrEP programme since 2019 and any resulting actions,
I have asked the HSE to provide this information to the Deputy as soon as possible.
