Pre-exposure prophylaxis (PrEP) is the pre-emptive use of oral antiretroviral therapy in HIV negative people to reduce the risk of HIV infection.
Since 2019, the HSE has made PrEP medication available free of charge through community pharmacies to individuals who meet clinical eligibility criteria and are likely to benefit from the intervention and for whom it is not contraindicated.
At this time, free PrEP care is available through public PrEP clinics. Individuals attending other HSE approved PrEP providers (such as general practice (GP) or private providers) will have to pay for the consultation, investigations, treatment of STIs and vaccines.
PrEP should be provided as part of a combination HIV (and STI) prevention approach within services that meet national standards.
National guidelines and national standards for PrEP service providers, and a monitoring and evaluation framework, have been developed by the Sexual Health Programme (SHP) in collaboration with the multisectoral PrEP working group .
Guidelines for PrEP service providers
The guidelines include information on:
- current PrEP availability in Ireland
- who should be offered PrEP
- determining suitability for PrEP
- baseline assessment and testing
- monitoring individuals on PrEP
The guidelines on assessment and monitoring of people on PrEP are relevant to all people on PrEP, not just those who meet criteria for free PrEP medication.
Download the clinical management guidance for individuals taking PrEP within the context of a combination HIV (and STI) prevention approach in Ireland
These guidelines replace all previous versions of the PrEP guidelines.
Updated December 2024
The National PrEP Guidelines were updated in 2022.
Key changes are in the following areas:
- Eligibility criteria
- A further move towards determining individual suitability versus strict eligibility criteria.
- Specific mention of PrEP for people who inject drugs (PWID)
- Updates to starting and stopping rules for PrEP
- Follow up and monitoring
- Updates to requirements for PEP in people using PrEP
Amendment March 2023
HIV language was updated in line with the People First Charter in March 2023.
Amendment September 2022
An amendment was made to the guidelines in September 2022 around the PrEP dosing schedule for trans men and trans women.
Updated May 2022
The National PrEP Guidelines were updated in 2022.
October 2019
The first set of PrEP guidelines, version 1.1, were published in October 2019.
National standards for PrEP service providers
National standards have been developed for the provision of PrEP as part of combination HIV prevention in Ireland.
Services providing free PrEP to people who meet clinical eligibility criteria must meet these core national standards.
The standards were revised in 2024 and are available to download here:
National Standards for the Delivery and Management of Pre Exposure Prophylaxis (PrEP) for HIV
Standardised PrEP proformas have been developed for services who do not have their own, and are available to download here;
PrEP first visit proforma
PrEP return visit proforma
PrEP monitoring and evaluation framework
A monitoring and evaluation framework is required in order to understand how the PrEP programme is performing.
It is acknowledged that a range of approaches and methodologies are needed to monitor and evaluate the national PrEP programme.
This monitoring and evaluation framework is a working document and is subject to change over time as appropriate.
The framework sets out the key performance indicators (KPIs) and the data collection processes.
PrEP Monitoring and Evaluation Framework
Apply to be a PrEP service
Updated 19th December 2024.
All PrEP services must meet core national standards for the delivery and management of PrEP in Ireland.
In addition, for GP PrEP providers, a number of competencies must be completed prior to becoming a HSE approved PrEP provider:
- Complete the HSEland ‘HIV PrEP e-learning programme’ with exit assessment. Login to HSeLanD here.
- Complete STIF one/two/three within the previous 3 years. Details of upcoming STIF courses are here
- Complete the HSEland ‘LGBT+ Awareness and Inclusion Training: the basics’ training course. Login to HSeLanD here.
- Agreement to follow the HSE antibiotic prescribing guidelines for management of intercurrent STIs. These guidelines can be accessed here.
Of note, some other providers, working outside consultant led services, may also need to complete these competencies depending on their training, qualifications and experience.
The application form to be a PrEP provider is available here. If you have any queries please email caroline.hurley1@hse.ie
HSE approval and registration process for GP PrEP providers
1. GP submits completed PrEP application form to SHP. SHP communicates application approval and a service agreement is provided, signed and returned.
2. SHP informs PCRS when a GP is approved. SHP provides GP with the special drug request (SDR) form to register as a HIV PrEP prescriber with PCRS, the form is completed by the GP and submitted to PCRS. PCRS provides GP with access and log-in details.
3. Individual attends PrEP service and is confirmed as being suitable for PrEP. The individual is registered on the PCRS PrEP system and you need to tick that they are eligible for free PrEP. This approval indicates to community Pharmacist that the individual is eligible and free PrEP medication can be dispensed.
4. Individual follow up is planned in line with their needs and national guidelines.
5. Individual PrEP approval on the PCRS system is valid for 12 months. During this time, only the initial approving provider can re-approve the individual for free PrEP on the PCRS system.
When the approval lapses after the 12 month period, any HSE approved PrEP provider can re-register the individual on the PCRS system, should they still be eligible for free PrEP. This allows PrEP users to move to a different service if they wish.
