Pre-exposure prophylaxis (PrEP) is the pre-emptive use of oral antiretroviral therapy in HIV negative people to reduce the risk of HIV infection.
PrEP is available free of charge through the HSE to those who meet clinical eligibility criteria and are deemed to be at substantial risk of acquiring HIV.
PrEP should be provided as part of a combination HIV (and STI) prevention approach within services that meet national standards.
We have developed guidelines and national standards for PrEP service providers.
Guidelines for PrEP service providers
Guidelines have been developed by the multisectoral HIV PrEP working group in consultation with relevant clinical stakeholders. The guidelines have been approved by the HSE Sexual Health Strategy Implementation Group.
The guidelines include information on:
- current PrEP availability in Ireland
- who is eligible for free 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.
Download the clinical management guidance for individuals taking PrEP within the context of a combination HIV (and STI) prevention approach in Ireland (PDF, 620 KB, 23 pages).
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.
Download the National Standards for the Delivery and Management of Pre-Exposure Prophylaxis (PrEP) for HIV (PDF, 856 MB, 16 pages).
Apply to be a PrEP service
All PrEP services must meet the national standards for the delivery and management of PrEP in Ireland.
From 28 October 2020, there is a temporary pause on all further PrEP service approvals until the Programme Clinical Lead is in place. When this happens, there will be an urgent review of the approval process and an audit of existing services in line with national PrEP standards. It is expected that the Programme Clinical Lead will be starting soon.
To apply for approval as a PrEP service:
- Complete the HIV PrEP service application form (form will be available soon)
- Submit the completed form to HSE Sexual Health & Crisis Pregnancy Programme (SHCPP) for approval
After you apply
If your service is approved to provide PrEP, we will send you a service agreement. You must complete this, sign it and return it to us.
Once we get this, we will inform the HSE Primary Care Reimbursement Service (PCRS) that your service has been approved.
We will send you information on the registration process for authorised PrEP prescribers with PCRS.
PrEP medication will be provided through community pharmacies.
The steps following approval are outlined below.
Monitoring and evaluation framework
All services providing free PrEP must participate in national data collection and reporting.
The monitoring and evaluation framework for PrEP was developed to facilitate consistency of data collection across services. It will ensure that the necessary information is being collected to inform service delivery and planning.
A minimum level of data will be collected from service providers on a quarterly basis. Additional data may be collected through sentinel surveillance or periodic audit.
The HIV PrEP monitoring and evaluation framework is currently being finalised.
The framework will set out the key performance indicators (KPIs) and the data collection and reporting requirements for:
- monitoring PrEP use
- monitoring and evaluating the impact of PrEP
PrEP programme pathway for service providers
1. SHCPP communicates application approval to service. The agreement is signed and returned.
SHCPP links the service clinical lead for PrEP with PCRS so that PrEP prescribers within an approved service can register with PCRS.
2. SHCPP informs PCRS when a service is approved and provides the name of the service clinical lead for PrEP.
3. PCRS registers HIV PrEP prescribers on PCRS and provides user access and log-in details (1).
4. Individual attends services and is confirmed as meeting clinical eligibility criteria.
5. Baseline assessment, PrEP dosing schedule agreed and prescription provided (up to 3 months).
6. Service logs onto PCRS system to register individual and completes mandatory patient registration fields.
7. Individual attends community pharmacy for PrEP dispensing (2).
8. Individual attends service for 1-3 monthly monitoring and re-assessment.
9. Service participates in national PrEP monitoring and evaluation (3).
- Authorised HIV PrEP prescribers can be added to the list as required. Where an authorised PrEP prescriber leaves a service, PCRS should be informed by the service Clinical Lead for PrEP so they can be removed from the list.
- Individual requires a medical card (GMS), long-term illness (LTI) scheme card, or drug payment scheme (DPS) card or personal public service number (PPSN)
- HSE. The HIV PrEP Monitoring & Evaluation Framework is currently being finalised