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
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 consultation with PrEP Service Leads and relevant clinical and community stakeholders. The guidelines were reviewed by the HSE Chief Clinical Officer (CCO) Clinical Forum prior to publication.
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
These guidelines replace the first set of PrEP guidelines, version 1.1 published in October 2019.
Key changes are in the following areas:
1. Eligibility criteria
- addition of likely to engage in condomless anal sex in the next three months
2. Follow up and monitoring
- Incorporation of the 45 day window period for HIV testing
- Renal monitoring
- Frequency of follow up determined by potential exposure
- Online STI/HIV testing option for stable patients
3. New section on when PEPSE is needed in people taking PrEP
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
Apply to be a PrEP service
Updated 11th April 2022.
All PrEP services must meet the national standards for the delivery and management of PrEP in Ireland.
The assessment and approval process for new PrEP providers is currently under review. The Programme has made contact with providers who have previously expressed an interest. Updates to the assessment and approval process will be posted here as they are finalised. In the meantime, if you have any queries please email caroline.hurley1@hse.ie
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 was developed by the SHP in collaboration with the multisectoral PrEP working group. This 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
PrEP programme pathway for service providers
1. SHP communicates application approval to service. The agreement is signed and returned.
SHP links the service clinical lead for PrEP with PCRS so that PrEP prescribers within an approved service can register with PCRS.
2. SHP 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).
References
- 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 available to download above.
