The development and implementation of a national programme of Pre- Exposure Prophylaxis (PrEP) was a landmark development in realising the strategic vision of the National Sexual Health Strategy 2015 - 2020, which was to improve sexual health and well-being and reduce negative sexual health outcomes by ensuring that everyone living in Ireland has access to high quality sexual health information, education and services throughout their lives.
Wave 3 of the pandemic has further increased the strain on the health service. The unprecedented surge in Covid-19 infection rates has implications for staffing of all health services in terms of necessary redeployment of staff to urgent pandemic related duties including testing, vaccination, contact tracing and patient treatment.
Virtual clinics are held where possible, with attendance in person limited to appointment only. Service restrictions are predominantly due to social distancing requirements; waiting rooms can now only hold a fraction of patients compared to before the pandemic.
Phone lines, the GMHS website and other resources such as man2man.ie and sexual wellbeing.ie are regularly updated to reflect current service delivery and to signpost users to the HSE list of approved PrEP services.
Although services have been subject to some Covid-19 related restrictions, the national PrEP programme has continued to expand and over 2,000 individuals, mostly gay men, are currently registered on the national PrEP programme.
Routine STI testing, including HIV testing, is available for free through all 23 public STI services in Ireland. HIV testing is also provided to specific populations, such as those who inject drugs, homeless people, migrants and prisoners, and is included as part of the national antenatal screening programme for all pregnant women in Ireland. The latest report (2018) indicates an uptake of almost 100%.
HIV testing is available in all hospitals and conducted where this is clinically indicated. Many emergency departments (EDs) offer HIV and hepatitis screening as part of an ED viral screening programme for anyone having bloods taken when they attend the ED.
The HSE is currently piloting a free home STI/HIV testing service, supported by the Sláintecare Integration Fund, in Dublin, Cork and Kerry. The first phase of tests were made available early January and additional tests will be made available over the coming months. Tests are being made available in a phased manner to ensure there is sufficient capacity in local clinics for service users who may need follow-up treatment or support.
All health services, including STI/HIV services are continuing to face service restrictions due to the current impact of Covid-19 on the hospital system and social distancing requirements. Public STI clinics are prioritising those with symptoms or requiring treatment, and this includes anyone who may be referred for confirmation HIV testing.
Student health services provide STI/HIV testing and STI treatment for their students at a subsidised rate, though some are currently providing testing for free to students, due to the service restrictions elsewhere. Home HIV and STI testing kits are also available to purchase in pharmacies.
In terms of the future direction of services, it is intended to review and refresh the National Sexual Health Strategy in 2021, taking into account the views of stakeholders. Funding remains in place for all current services, including the national PrEP programme; it is hoped that these vital services can return to being delivered to their full potential, and indeed, developed further, once it is possible to reduce the multiple pandemic related constraints on the health service as a whole.
As the topics raised are service matters, for additional operational updates, including the current status of HPV vaccinations, I have also asked the Health Service Executive to respond to the Deputy directly, as soon as possible.