PrEP HIV Prevention Programme in the Autumn

Minister for Health Simon Harris has committed to implementing a PrEP HIV prevention programme in 2019, following formal advice from HIQA that such a programme would be safe, effective and cost saving.

Welcoming the advice from HIQA , Minister Harris said: “We want to reduce the number of new HIV diagnoses in Ireland. Increasing the availability of PrEP will help us to do so. 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.

“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.

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This follows a HIQA health technology assessment recommending the introduction of a pre-exposure prophylaxis (PrEP) programme for populations at substantial risk of sexual acquisition of HIV. HIQA advised the Minister for Health that the HTA found that the successful implementation of a national PrEP programme in Ireland would be safe, effective and cost-saving.

HIQA’s Director of Health Technology Assessment and Deputy Chief Executive, Dr Máirín Ryan, said, “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.”

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 to prevent infection. PrEP consists of a fixed dose combination of oral tenofovir/emtricitabine and has been licensed for use in Ireland since 2016. A ‘PrEP programme’ provides PrEP as part of a holistic service that includes frequent monitoring for adherence and side effects, testing for HIV and other STIs, and counselling and advice on safer sex practices.

Dr Ryan said, “From reviewing the evidence, HIQA has found that PrEP is safe and highly effective at preventing HIV in people at substantial risk. Additionally, implementing a PrEP programme would be considered cost saving 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 said the primary barriers to introducing a PrEP programme in public STI clinics in Ireland related to staffing and infrastructural issues. A significant investment in STI services was required for a national PrEP programme to ensure a safe, sustainable and equitable service.”

The HTA is available on www.hiqa.ie