While new HIV diagnoses in Ireland remain at historic highs, there is some good news on the horizon with the Government recently announcing plans to inally make a HIV prevention drug available through the public health system. Andrew Leavitt of ACT UP explains.

PrEP, or Pre-Exposure Prophylaxis, is a safe and highly effective way for HIV-negative people to prevent HIV by taking medication before and after sex.

Generic versions of PrEP are already available for purchase in community pharmacies across Ireland, however the medication’s relatively high cost of €60 to €90 for a 30 day supply keeps it out of reach of many who could benefit. For that reason amongst others, ACT UP Dublin and other advocates have been calling for the HSE to provide PrEP. Last June, Taoiseach Leo Varadkar said he expected a PrEP programme to be in place by June of 2019. This was followed by a statement from Minister for Health, Simon Harris, that the Government’s plan was to roll out PrEP from early 2019.

In September, Minister Harris reaffirmed to members of ACT UP Dublin and ACT UP Cork the Government’s commitment to this programme, although he could not provide a specific start date. He asserted that the PrEP programme will be a priority for the HSE, and that their budget would include funding for the programme.

In October, we saw another important step forward when the Health Information Quality Authority (HIQA) announced that it is to carry out a Health Technology Assessment for the PrEP programme. The assessment will examine clinical and costeffectiveness data, as well as assessing the budget impact and organisational implications of the programme. HIQA has put together an expert panel to provide advice during the process and a report is due early in 2019. It is expected that the Minister for Health will act quickly when he receives the final report.

Of particular note, HIQA’s Director of Health Technology Assessment, Dr Máirín Ryan, made explicit that the HSE programme will provide PrEP, along with the regular HIV and STI testing that PrEP users need, free of charge. We were happy to finally see this stated clearly. It is vital that cost not be a barrier to accessing PrEP, that it be easily and freely accessible.

In July, ACT UP Dublin hosted an open forum called ‘Preparing for PrEP’ at Outhouse. At the packed meeting, guest speakers Paddy Mallon and Pierre-Cédric Crouch talked about the effectiveness of PrEP and its value as an additional HIV prevention tool. Members of the community spoke about the barriers to getting PrEP along with limited access to PrEP monitoring services in Ireland.

Crouch provided real-world examples from his work in San Francisco’s Magnet sexual health clinic and emphasised the importance of making it as easy as possible for people to be able to get PrEP. Reducing barriers and increasing the convenience and user-friendliness of services are important for the success of any PrEP programme.

We are encouraged by Minister Harris’ public commitment to tackling Ireland’s HIV crisis and will be watching to make sure those promises are backed up by action. ACT UP Dublin, along with new chapters ACT UP Cork and ACT UP Belfast, recognise that the HIV epidemic is a political crisis. We will continue to challenge indifference and neglect on the part of government, state agencies, non-governmental organisations, community institutions, and the public at large.

For more information about PrEP, how to use it, and where to get it in Ireland, visit www.getPrEP.online