Govt committed to HIV prevention programme

PrEP programme recommended by HIQA
  • Deborah Condon

The Minister for Health has committed to implementing a HIV prevention programme, that has been recommended by the Health Information and Quality Authority (HIQA).

The pre-exposure prophylaxis (PrEP) programme is aimed at people who are considered to be at substantial risk of sexually acquired HIV.

HIQA carried out a health technology assessment to determine whether the introduction of such a programme in Ireland would be beneficial. It found that the successful implementation of a national PrEP programme would be safe, effective and cost-saving.

PrEP is the most recent development in the field of HIV prevention, involving the pre-emptive use of oral antiretroviral therapy in HIV negative people in order to prevent infection.

With PrEP, those at risk are given a fixed dose combination of oral tenofovir/emtricitabine, which has been licensed for use in Ireland since 2016.

A PrEP programme provides PrEP as part of a holistic service that sees participants frequently monitored for adherence and side-effects. It also includes testing for HIV and other STIs, and counselling and advice on safer sex practices.

"HIV infection remains a significant public health concern. There were 492 diagnoses of HIV notified in Ireland in 2017. Just over half of all notifications were in men who have sex with men," explained HIQA's director of health technology assessment and deputy chief executive, Dr Máirín Ryan.

She said that after reviewing the evidence, HIQA has found PrEP to be ‘safe and highly effective at preventing HIV in people at substantial risk'. It is also cost saving when compared with standard care.

"The effectiveness of PrEP is strongly linked with taking the medication correctly, and PrEP must not be taken by individuals with an unrecognised HIV infection as drug resistance mutations may develop. This means that it is important that people taking part in a PrEP programme should receive advice on taking the medication appropriately and undergo frequent HIV testing," Dr Ryan explained.

She noted that the main barriers to introducing a PrEP programme in public STI clinics in Ireland relate to ‘staffing and infrastructural issues'.

"A significant investment in STI services is required for a national PrEP programme to ensure a safe, sustainable and equitable service," Dr Ryan added.

Following this recommendation, the Minister for Health, Simon Harris, and the Minister for Health Promotion, Catherine Byrne, committed to implementing a PrEP programme later this year.

"We want to reduce the number of new HIV diagnoses in Ireland and increasing the availability of PrEP will help us to do so. This report not only confirms that PrEP can help to prevent HIV among those who are high risk, it also shows how a PrEP programme could save money.

"My Department and the HSE will fully consider the advice from the HIQA report as we continue to plan for implementation of a programme later this year,' Minister Harris said.

HIQA's assessment of the PrEP programme can be viewed here.


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