Dáil Éireann Debate, Tuesday - 25 July 2023
1381. Deputy Ivana Bacik asked the Minister for Health the projected cost of expanding the free HIV rapid testing and PrEP to college health centres, in order that students can access services on-campus; and if he will make a statement on the matter. [36910/23]
View answerIreland established a national HIV PrEP programme in November 2019, following a HIQA HTA, which concluded that the introduction of HIV PrEP would be safe, effective and cost saving. The HTA also found that significant investment in public STI services was required to implement PrEP and €5.4 million was set aside in Budget 2020 to roll out a national HIV PrEP programme, managed by the HSE Sexual Health and Crisis Pregnancy Programme (SHCPP).
At present, there are 13 public PrEP clinics in Ireland, four of which are located in Dublin, and 16 private/GP providers who are approved to prescribe PrEP, 15 of which are located in Dublin. Dispensing PrEP is free of charge, as are appointments at the public clinics, however, the private providers are subject to consultation charges. Student health facilities, like GPs and family planning centres, are private providers; the same principles would apply to GPs working in these settings.
The HSE SHCPP is working towards increasing the number of GPs approved as PrEP providers, thus giving individuals more choice around who and where they attend for treatment. A PrEP e-learning module is being developed to increase the number of appropriately trained nursing and medical PrEP providers.
However, currently, individuals attending GPs for PrEP would have to pay a consultation fee for attendance and may also have to pay for investigations, treatment and vaccines as recommended by their GP, if not attending a free STI clinic. Needless to say, it should also be noted that PrEP protects against HIV infection and not other STIs; it would also be necessary for PrEP patients to attend a public STI clinic for treatment of incident STIs, should these be diagnosed.
In terms of free home HIV and STI testing, this was launched nationwide in October, 2022, and is already freely available, including to those who may be resident on campus or in student accommodation. The scheme can be accessed through www.sexualwellbeing.ie.
The Department of Health and the HSE Sexual Health and Crisis Pregnancy Programme have been supporting sexual health on 3rd level campuses through the National Condom Distribution Scheme, which has been supplying free condoms through participating 3rd level campuses since 2019. In 2023, free condoms are also being provided with orders from the home STI testing service.
The free contraception scheme for women, covering prescription contraception, is currently open to women ordinarily resident in Ireland aged 17-26 and will be expanded to those aged 30 and under in September. Student health providers were consulted in preparation for the launch of the scheme and student health clinics are among the approximately 2,400 providers that have signed up to provide services and products under the scheme to date.
It covers the cost of consultations with GPs and family planning centres and prescriptions for the wide range of contraceptive options available on the HSE Re-Imbursement List, including long-acting reversible contraception (LARCs: injections, intra-uterine devices and systems (coils) and implants) and emergency contraception in addition to the contraceptive Pill, patch and ring. LARC fittings, removals, injections and check-ups are also free of charge under the scheme. Approximately €32 million was allocated to support the scheme in 2023.
Sexual health has been a priority for the Department of Health; the National Sexual Health Strategy 2015-2020 (NSHS) was developed as a core policy under the Healthy Ireland Framework and remains a priority under the Healthy Ireland Strategic Action Plan 2021-2025. An NSHS Redrafting Committee has been convened to refresh the Strategy and supports for sexual health in higher education settings will be considered as part of the Strategy redevelopment process. The new Strategy is currently scheduled to be completed by the end of 2023.
Any decisions relating to further expansion of services in 2024 will be a matter for the Estimates process in advance of Budget 2024.
