HIV prevention programme to be rolled out by end of year

A programme for preventing HIV infection through the administration of pre-emptive anti-retroviral drugs is to be introduced later this year.

The PrEP HIV prevention programme is being implemented by the Government following advice from the State’s health watchdog that it would be safe and cost-effective.

Minister for Health Simon Harris said on Friday the Government wanted to ensure the number of HIV diagnoses was reduced.

“This report not only confirms that PrEP can help to prevent HIV amongst those who are high risk, it also shows how a PrEP programme could save money.”

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A PrEP programme (pre-exposure prophylaxis) involves the pre-emptive use of antiretroviral medication to prevent HIV infection, regular monitoring and testing, as well as advice and counselling on safer sex practices. Similar programmes have recently been introduced in other countries.

The health technology assessment report from the Health Information and Quality Authority found PrEP is safe and highly effective at preventing HIV in people at substantial risk, and also found the introduction of a PrEP programme would be cost-saving.

Significant threat

HIV infection remains a significant public health threat in Ireland, with 492 diagnoses in 2017. Male-to-male sexual transmission accounts for more than half of cases. An estimated 7,000 people are living with HIV in Ireland.

The programme is expected to cost about €1.5 million in the first year and €5.4 million over five years. However, after about eight years, the HSE would be expected to spend less money on the PrEP programme than it would have to spend on treating the extra HIV cases if no programme were available, according to the report.

Hiqa said the largest barriers to introducing a programme were staffing and infrastructural issues in sexual health clinics, many of which suffer from staff shortages.

Some experts have warned PrEP could lead to an increase in risky behaviours such as sex without condoms due to the diminished likelihood of acquiring HIV.

The report says the risks of increasing rates of sexually transmitted infections and drug-resistant mutations can be mitigated by careful screening for HIV, frequent testing for other STIs and advice on safer sex.