Prep Programme

Irishgay84

I was reading a report in one of the papers recently that the government plans to roll out a Prep programme later this year. Does anyone know what this will entail and when exactly it’ll be rolled out. Will it be free and will there be additional resources put into sexual health clinics to cope with the additional testing requirements that come with people being on prep.

Ten of Swords

In June this year it was announced that the HSE will roll out a publicly funded PrEP program. It is due to start at the end of this year though no specific dates or requirements have been announced yet.

If it is in line with other PrEP programs across Europe it will be either totally free or heavily subsidized for high risk categories but again, no solid confirmation yet.

PrEP is currently available in Ireland however you must cover the cost yourself.

When taking PrEP you will initially be tested for Hep B and your kidney function will be monitored on an ongoing basis.

https://www.hivireland.ie/hiv/prevention/prep-2/

Irishgay84

Thanks for the info ten of swords. I’m currently on prep and get checked every three months. It costs €60 per month which isn’t too bad but it would obviously be better if the cost was significantly reduced to make it available to more people.

I’m just curious as to whether the hse will properly fund the sexual health clinics as the existing ones are overstretched. And I’d have my doubts as to whether they’ll have the programme up and running this year. I hope they do as I think it’s badly needed.

Ten of Swords

It is needed but we will have to wait and see what it actually delivered. The commitment made by the department of health on June 14th was make available €450,000 to boost HIV testing and local outreach programs in Dublin, Cork, Galway and Limerick. This funding is also to be used to promote the PrEP program but, to my knowledge, the funding is not for PrEP itself.

This thread discussed the HIQA feasibility study for PrEP. The study was accepted by the government. It estimates that the year 1 cost of PrEP will be approximately €1.5 million

https://www.boards.ie/vbulletin/showthread.php?t=2057917325

Ten of Swords

PrEP program due to be rolled out in 2 weeks. HSE have published eligibility criteria

To get PrEP for free through the HSE you need to:

test negative for HIV
be able to attend for a check-up at least once every 3 months
meet at least 1 of the following criteria for free PrEP

1: You are having sex without condoms with HIV-positive partners who:

are not on HIV treatment, or
are on treatment but not virally suppressed (do not have an 'undetectable' viral load)

2: You are a man who has sex with men. This includes transgender men who have sex with men or a transgender woman who has sex with men, who meets any 1 ofthe following:

had anal sex without condoms with more than 1 partner in the last 6 months
had an STI in the last year
used HIV post-exposure prophylaxis (PEP) in the last year
used recreational drugs for sex (also known as chemsex) in the last 6 months

3: You are a heterosexual man or woman who is considered by a specialist STI doctor, to be at a large risk of contracting HIV through sex.

https://www.sexualwellbeing.ie/sexual-health/prep/how-to-get-prep/

Gadgie

Ten of Swords wrote: »

PrEP program due to be rolled out in 2 weeks. HSE have published eligibility criteria



https://www.sexualwellbeing.ie/sexual-health/prep/how-to-get-prep/

How I'm reading this is that to get it for free you have to first engage in risky behaviour that would expose you to HIV. Seems a bit crazy.

Ten of Swords

The purpose of the PrEP program is to ensure it is available to people with the highest risk factors, the behaviours outlined carry the highest risk so it is correct to make it available to them.

Let me put it another way, do you think if PREP were not freely available that people wouldn't engage in high risk behaviours?

Gadgie

Ten of Swords wrote: »

The purpose of the PrEP program is to ensure it is available to people with the highest risk factors, the behaviours outlined carry the highest risk so it is correct to make it available to them.

Let me put it another way, do you think if PREP were not freely available that people wouldn't engage in high risk behaviours?

I agree completely that it should be available, free of charge, to people at high risk of contracting HIV. It just appears from the eligibility criteria that you must have engaged in some high risk activity *before* you are able to get it for free. That's the crazy part.

Ten of Swords

I hear you but people aren't going to engage in high risk activities because there is free PrEP available, they will do it anyway. At least this way they drastically reduce the risk of catching HIV whereas without this program they could potentially catch it and the HSE would spend a lot more in the long run treating them.

It does seem counterintuitive but in the long run it's the most effective solution imo

Gadgie

Ten of Swords wrote: »

I hear you but people aren't going to engage in high risk activities because there is free PrEP available, they will do it anyway. At least this way they drastically reduce the risk of catching HIV whereas without this program they could potentially catch it and the HSE would spend a lot more in the long run treating them.

It does seem counterintuitive but in the long run it's the most effective solution imo

We are in agreement here, but the point I was trying to make is that it is only being given free to people who have already engaged in high risk activities, rather than to all groups who could be at risk of acquiring HIV.

For example, if you are an MSM who consistently uses condoms, you are not eligible for free PrEP according to the published criteria. But I feel this group is not entirely risk free, as the condom could break or you may not wear one for whatever reason, even if you had consistently used them up to now.

I believe that anyone at risk of acquiring HIV should have free access to PrEP without conditions on past behaviour.

Ten of Swords

Gadgie wrote: »

I believe that anyone at risk of acquiring HIV should have free access to PrEP without conditions on past behaviour.

In a perfect world yes, but that means basically everyone having sex with a partner that they are not 100% certain of their STD status. Since that's not practical from a cost perspective they have to attach risk criteria to it and evidence of engaging in previous risky behavior is the most logical way to do this.

Gadgie

Ten of Swords wrote: »

In a perfect world yes, but that means basically everyone having sex with a partner that they are not 100% certain of their STD status. Since that's not practical from a cost perspective they have to attach risk criteria to it and evidence of engaging in previous risky behavior is the most logical way to do this.

HIV disproportionately affects MSM, and I don't think you should need to provide evidence of past risky behaviour in order to get free PrEP. Ultimately it will be more cost effective in the long run by reducing the number of HIV infections and consequential lifelong treatment.