There is “inequitable access” to public services for sexually-transmitted infections (STIs), as clinics work at capacity and are “struggling to cater for increasing demand”, a new strategy has found.
On Wednesday, the Department of Health published its new National Sexual Health Strategy for 2025 to 2030. It highlighted priorities in terms of increasing access to free contraception and expanding capacity for STIs, including the home STI testing service.
According to the strategy, staff resources are insufficient, as is clinic time, resulting in increased waiting times at public STI clinics.
“The challenges posed by emerging STIs, including mpox, have put further pressure on existing constrained services, highlighting the need for additional capacity in our STI clinics to support greater service resilience and surge capacity,” the document says.
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However, the introduction of a free home STI testing service is estimated to have increased testing capacity by about 33 per cent.
The report states that access to pre-exposure prophylaxis (PrEP), which prevents HIV/Aids, has increased significantly since it was introduced in 2019. There were 1,763 people accessing PrEP in 2020, which rose to 6,974 by the final quarter of last year.
“While demand for the PrEP service continues to grow, many PrEP services are reaching (or have reached) capacity,” the report added.
The strategy sets out a number of areas it seeks to address in a bid to improve the sexual health of the island.
It is envisaged free contraception, which is currently available to those aged 17 to 35, will be extended to those up to 55-years-old and that STI testing will be increased.
The strategy said a model of care will be developed for sexual health services, focusing on prevention, diagnosis, treatment, information and surveillance for STIs and HIV. Also included is a focus on “improving geographic equity”. Access to vaccines that support sexual health will also be improved.
However, it highlights “potential challenges” to realising the strategic plan due to the country being in a “period of significant and ongoing change”.
These challenges include demographic changes; increased incidence of chronic conditions and the spectrum of disability and neurodiversity and multiple drug-resistant STI variants. Increasing demand for services is also a challenge, both in terms of capacity and diversity of need.
Minister for Health, Jennifer Carroll MacNeill, said the focus is on developing and expanding services “that meet the needs of our population at every stage of life”.
Andras Kolto is a researcher at the Health Promotion Research Centre at University of Galway and co-ordinator of the Irish National Survey of Sexual Health. He said that after the Covid-19 pandemic, there was a rise in STIs as people began to meet again following periods of restrictions.
“The problem we are seeing is there appears to be a consistent rise in some infections. We are seeing this in cohorts that we wouldn’t previously have seen it in,” he said.
“Young women having higher rates of gonorrhoea which we wouldn’t have seen. If untreated, this can have a long-term impact on their reproductive health.”
Speaking in advance of his conference on sexual health promotion on Thursday, he said there is a concerning trend among sexually active 15-year-olds – a decrease in the use of condoms.
“Porn is changing. Things which were widespread – such as using condoms – are not there anymore. And we know that many young people use porn as education, so if they’re not seeing that, it will have an impact,” he said.
Mr Kolto said there has also been a rise in the use of IUDs (intrauterine devices) and other methods of contraception. However, he stressed the importance of “not putting all the burden of contraception on girls”.
