Pre-exposure prophylaxis (PrEP) is the pre-emptive use of oral antiretroviral therapy in HIV negative people to reduce the risk of HIV infection.
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.
Guidelines for the Management of PrEP in Ireland (PDF, 1 MB, 27 pages), National Standards for HIV PrEP in Ireland (PDF, 1.1 MB, 17 pages), and a PrEP Monitoring and evaluation framework (PDF, 440 KB, 19 pages) have been developed by the Sexual Health Programme (SHP) in collaboration with the multisectoral PrEP working group.
Guidelines for PrEP service providers
The PrEP 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.
These guidelines replace all previous versions of the PrEP guidelines
PrEP Safe Starting and Stopping Quick Reference Guide (PDF, 88 KB, 3 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.
The standards were revised in 2024.
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 (PDF, 440 KB, 19 pages)
Apply to be a PrEP service
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
- Complete STIF one/two/three within the previous 3 years. Details of upcoming STIF courses (stif.org.uk)
- Complete the HSEland ‘LGBT+ Awareness and Inclusion Training: the basics’ training course
- Agreement to follow the HSE antibiotic prescribing guidelines for management of intercurrent STIs.
Of note, some other providers, working outside consultant led services, may also need to complete these competencies depending on their training, qualifications and experience.
For information on becoming a HSE approved PrEP provider, please contact Sinead Woods at sinead.woods@hse.ie
HSE approval and registration process for GP PrEP providers
- GP submits completed PrEP application form to SHP. SHP communicates application approval and a service agreement is provided, signed and returned.
- 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.
- 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.
- Individual follow up is planned in line with their needs and national guidelines.
- 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.
PrEP proforma first visit assessment (PDF, 610 KB, 4 pages)
PrEP proforma return visit assessment (PDF, 593 KB, 3 pages)