Dublin Struggles with High Demand for HIV PrEP Amid Long Waits

A significant backlog in accessing HIV pre-exposure prophylaxis (PrEP) persists in Dublin, with **862 individuals** currently on public waiting lists, according to the latest figures from the **Health Service Executive (HSE)**. PrEP is a preventative medication for people who are HIV negative, effectively reducing the risk of contracting HIV through sexual activity by approximately **99%** and by at least **74%** for those who inject drugs.

The national HIV PrEP scheme was launched in **2019**, allowing eligible individuals to access this medication at no cost. Eligibility includes individuals who do not consistently use condoms, those having unprotected sex with HIV-positive partners, and individuals who inject drugs. To qualify for the program, participants must be over **17 years old**, HIV negative, and undergo regular testing for kidney function and sexually transmitted infections every three months.

Challenges in Accessing PrEP Services

Despite the government’s commitment to eliminate new HIV transmissions in **Ireland** by **2030**, the waiting times for PrEP remain a pressing issue. Many individuals have resorted to private general practitioners (GPs) for prescriptions due to the backlog at public clinics. Eoin Walsh, a resident of **Carlow**, began attending a private clinic for PrEP prescriptions in **2022** after initially using the service through the GUIDE clinic at **St. James’ Hospital**.

Although his prescription is free, Walsh faces costs of **€150** every three months for necessary check-ups. He expressed frustration over the limited availability of public services, particularly for those living in rural areas. “Going private is great as there is flexibility, but some of the PrEP clinics do not open on weekends,” he said. “If you live in rural Ireland, it is very hard to take a full day off work to go in for a 10-to-15-minute appointment.” The nearest clinics for Walsh are in **Portlaoise** or **Waterford**, as the local clinic never reopened following the pandemic.

Stephen Guilfoyle, who resides and works in **Dublin**, shares similar concerns. He travels to a clinic in **Limerick** every three months for his PrEP prescription. While the clinic provides the service for free, Guilfoyle faces the inconvenience of taking a day off work due to the clinic’s limited operating days. He has encountered difficulties securing a spot at public clinics, stating, “I emailed St. James and three other approved public clinics for PrEP, and all of them advised me that I couldn’t be added to a waiting list because of demand.”

Guilfoyle has also heard of individuals sharing their PrEP medications with friends, dubbing it “gold dust in Dublin.” He cautions that such practices are dangerous, highlighting the importance of professional guidance in administering the medication correctly.

HSE’s Response and Future Plans

The HSE has acknowledged the challenges faced by several PrEP clinics in meeting the high demand for new appointments. A spokesperson for the HSE stated, “Despite these challenges, all services continue to see new PrEP patients.” They emphasized the need to interpret waiting list information cautiously, as some individuals may already be receiving services elsewhere when contacted.

To address the backlog, the HSE is implementing measures to enhance administrative efficiency, including the introduction of telephone consultations and streamlining the approval process for accessing PrEP. Furthermore, funding secured through **Budget 2025** will facilitate the addition of **seven** full-time staff members to Dublin’s public PrEP services, with **five** of those positions already filled.

As the demand for PrEP continues to grow, the government remains focused on expanding access and reducing waiting times. For those currently navigating the healthcare system, the hope is that more public services will become available, allowing individuals to obtain vital preventative care without lengthy delays.