EIGHT HUNDRED AND sixty two individuals remain on public waiting lists to access HIV pre-exposure prophylaxis (PrEP), according to the latest figures from the HSE.

PrEP is an HIV medicine taken by people who do not have HIV. Taken correctly, it reduces the risk of getting HIV from sex by about 99% and from injection drug use by at least 74%.

The government launched a national HIV PrEP scheme in 2019, and the medicine is available for free for individuals who would benefit from taking it.

That includes people who are HIV negative, people who do not always use condoms, people who are having sex without a condom with HIV positive partners or individuals who inject drugs.

To avail of the PrEP scheme, an individual must be HIV negative, over the age of 17 and must be tested for kidney function and sexually transmitted infections every three months. 

PrEP can be taken either daily or on an event-based dosage, which is where an individual will take two tablets at least two hours but no more than 24 hours before sex.

This ensures that the medicine levels are high enough to be protective when you have sex. The individual must then take a single dose both 24 hours and 48 hours after sex. 

The government earlier this year pledged to intensify its efforts to develop an action plan to eliminate new HIV transmissions in Ireland by 2030.

It plans to increase the availability of HIV PrEP and reduce waiting times for access to the medicine. 

However, due to the backlog in public clinics, many have turned to private GPs around the country to get prescriptions for the drug. 

Difficulties in getting appointments

Eoin Walsh is from Carlow and has attended a private clinic to access a prescription to the drug since 2022.

He originally availed of HIV PrEP through the GUIDE clinic in St. James’ hospital when the rollout of the free scheme began in 2019. 

However, he stopped taking PrEP during the pandemic as he felt he no longer needed it, and has not been able to access a public clinic since he resumed taking the medicine.

Despite his prescription for PrEP being free, Walsh must pay €150 every three months to a GP for a check-up.

Speaking to The Journal, he said: “Going private is great as there is flexibility and you can attend appointments at the weekends, but some of the PrEP clinics are not open at weekends. If you live in rural Ireland, it is very hard to take a full day off work to go in for a 10-to-15-minute appointment.”

The closest clinic to him is either in Portlaoise or Waterford as the clinic in Carlow never reopened after the pandemic. “You can do the STI testing at home, but I still need to go to the GP to check my kidneys and that’s difficult when you need to travel,” he said. 

Walsh hopes that more public services are made available for people who wish to avail of PrEP services, as people “are waiting and waiting for appointments”. 

“I know someone that was waiting almost six months, and in the end, they just went private. I know it’s just €50 a month, but why should you pay for appointments when you should be able to access it for free?”

Many patients are finding it difficult to access PrEP through the public healthcare system in Ireland. Alamy Stock Photo Alamy Stock Photo

Stephen Guilfoyle works and lives in Dublin. He travels to a PrEP clinic in Limerick every three months, where he attended University, to receive his subscription for the drug.

While he attends this clinic for free, he says that the journey is inconvenient as he “has to book a day off work to go as the clinic only runs on Tuesdays and Thursdays”. 

“I emailed St. James and three other approved public clinics for PrEP and all of them advised me that I couldn’t be added on to a waiting list because of demand for the services,” he explained. 

Guilfoyle believes that access to PrEP should be more accessible, as “people who would like to explore the option of PrEP shouldn’t be left on waiting lists for years to start”.

“My own doctor in Dublin prescribes PrEP, so I think I will start getting my prescription here but it’s €150 per appointment, which is frustrating considering it’s free for me in Limerick,” he said.

He has also heard stories about people sharing PrEP with their friends because “it is like gold dust in Dublin”. 

“People are giving PrEP to their friends if they have extra or it’s going out of date, which is dangerous because it can cause kidney dysfunction without the appropriate monitoring,” he explained. 

“People might not even know how to take it properly, whether they should be taking it event-based or daily, and they won’t know these things unless they’re given the proper information by their medical professional in a PrEP clinic,” he said. 

Improved administration in the HSE

The HSE has acknowledged that “several PrEP clinics are experiencing challenges in meeting demand for new PrEP appointments within current service capacity and resource allocation.”

A spokesperson for the HSE said: “Despite these challenges, all services continue to see new PrEP patients.”

“It is important to interpret information on PrEP waiting lists with caution. Services report that in some instances when they contact individuals on their waiting list to offer them an appointment a proportion are already engaged with a different PrEP service.”

The HSE is currently working on expanding administrative efficiencies, including telephone consultations, making the approval process for individuals to access PrEP more efficient.

It also secured funding through Budget 2025 for an additional seven whole time equivalent staff posts for the Dublin public PrEP services to improve capacity within the public PrEP service.

To date, five out of seven of these posts have been filled.