PrEP in Ireland

This page contains information about pre-exposure prophylaxis for HIV, usually referred to as “PrEP”.

Right now PrEP is not available through the public health system in Ireland. Doctors can prescribe Truvada for use as PrEP, and all of the necessary tests can be obtained from a GP or an STI clinic, but users must pay for the medication themselves.

Brand-name Truvada costs €400 for a 30-day supply in Ireland, but a growing number of people here are sourcing more affordable generic versions of the same medications. The website iwantprepnow.co.uk contains information about how to safely obtain and use these generic versions, including a list of reliable and verified suppliers. If you are interested in using PrEP in Ireland we recommend you visit that site.

You may have read about recent efforts by Irish Customs to crack down on imports of generic PrEP by mail. It is currently illegal to import any medication by post or private courier into Ireland so anyone using this method faces the risk that Customs will seize and destroy the shipment. There is no possibility of such packages being released.

Customs and the HPRA have said that they will not prosecute individuals who attempt to have generic PrEP delivered to Ireland, but they may try to get information about the suppliers from buyers. There is no obligation to talk to Customs or the HPRA if your package is intercepted.

The HPRA has offered no evidence that any of the seized packages are anything but genuine medication. We have no reason to doubt that anyone in Ireland who was self-sourced PrEP from a supplier listed at iwantprepnow.co.uk has received anything but the real thing.

If the HPRA and HSE were seriously concerned that people are using counterfeit PrEP, we would hope they would offer therapeutic drug monitoring testing (which measures the level of drug in someone’s blood) to current users. However, such testing has already been conducted at London’s 56 Dean Street clinic and in every case the drugs were confirmed to be genuine. At this time we continue to have full confidence in the legitimacy of the suppliers and the generic products listed at iwantprepnow.co.uk.

We also recommend prepster.info as another source for learning more about PrEP. Their page on how to safely buy PrEP online includes detailed information about what tests you need before you start and while you’re using PrEP.

The participants in the PrEP Facts Facebook group include PrEP advocates and researchers from around the world and it’s a great resource if you have any specific questions about PrEP.

The i-base Guide to PrEP is a comprehensive resource for UK-based PrEP users, but most of the information is of use to users in Ireland as well.

We’ve created a short fact sheet for campaigners with information about the process for PrEP becoming available in Ireland which is available here.

Last year the HSE solicited legal advice around accessing generic PrEP online. The advice may be of interest to current or potential users of PrEP in Ireland and we have made it available here. It was published as part of the “Action plan: Response to the national increase in HIV and STIs in MSM” report from the HSE’s National MSM HIV/STI increase response group  interventions subgroup which was released in June.

The HSE released a report in April offering “PrEP estimates for populations at risk of sexual acquisition of HIV in Ireland.” This document includes discussion of proposed eligibility requirements for accessing PrEP in Ireland and, based on those requirements, estimates about how many people might be eligible for PrEP and how many might actually choose to access it. Much of the data is based on educated guesses, but it’s useful to know how the estimates are arrived at and what kind of numbers the HSE is considering in its planning.

We will be updating this page with new information in the near future. The following list of questions and answers is drawn from our “PrEP: The Basics” pamphlet which can be viewed or downloaded here.

PrEP: The Basics

What is PrEP?
PrEP stands for “Pre-Exposure Prophylaxis”. It’s a safe and effective way for people who are HIV negative to protect themselves against HIV by taking a pill before and after sex. Currently only one medication, called Truvada, has been studied and proven to be effective as PrEP.

Does it really work?
Yes: PrEP is extremely effective. When used as directed, PrEP provides nearly complete protection from HIV. The World Health Organization, the US Centers for Disease Control, and UNAIDS all recommend that PrEP should be available to people at substantial risk for HIV.

How does it work?
Most people choose to use PrEP by taking one pill every day. One dose of Truvada every day keeps enough medication in your body to protect against HIV. You can take the pill at anytime that’s convenient and easy for you. On a daily dosing schedule, PrEP can provide protection even if you occasionally miss a dose. For more information about other some other options for how to take PrEP, see this page.

What else is involved?
To use PrEP safely you should have the support of a medical provider. Before starting PrEP you must have HIV, hepatitis, and kidney tests. You also need regular HIV, STI, and kidney tests for as long as you continuing taking it. Seeing a medical provider regularly also gives you opportunities to ask questions and ask for support if you need it.

Are there side effects?
About one in 10 people experience mild side effects like upset stomach, headaches or tiredness when they start PrEP. These effects usually last only a few days or weeks. A very small number of people experience kidney problems, which clear up when they stop using PrEP. Truvada has very few interactions with other medications and can be safely used during pregnancy.

What about other STIs?
PrEP protects against HIV, but it doesn’t protect against other sexually transmitted infections (STIs). That’s why regular STI testing is part of the PrEP programme: it helps ensure that STIs are diagnosed and treated quickly, limiting the risk of them causing harm or being passed on.

Is it for me?
PrEP is not for everyone, only you can decide if it’s the right choice for you. The WHO recommends it be an option for people “at substantial risk of HIV infection.” That may include people with HIV-positive partners, sexually active gay & bisexual men, trans people who have sex with men, sex workers, or injection drug users and their partners.

Why is it important?
For 30 years condoms have been our main HIV prevention method. While condoms have been extremely successful, they have not been enough to stop HIV alone. In fact, in 2016 the number of new HIV diagnoses in Ireland was the highest ever. New options like PrEP won’t replace condoms and other risk-reduction approaches, but will be additional tools to help meet the wide range of needs in the real world.