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While new HIV diagnoses continue<br />
to be at an all-time high for gay and<br />
bisexual men in Ireland, the government<br />
needs to make sure PrEP is fully<br />
accessible, says Andrew Leavitt of<br />
ACT UP Dublin. Image by Will St Leger.<br />
As of January <strong>2018</strong>, preliminary figures released by Ireland’s<br />
Health Service Executive (HSE) show 506 newly reported<br />
HIV diagnoses in Ireland in 2017. These latest figures match<br />
closely with record high figures of 508 in 2016. It’s clear<br />
Ireland has a HIV crisis and one that is disproportionally<br />
affecting gay and bisexual men. The good news is that we<br />
have the best tools that science can offer to prevent HIV and<br />
halt its onward transmission.<br />
PrEP & Clinical Support<br />
Although PrEP has not been widely available or accessible<br />
in Ireland, we know that a considerable number of people<br />
here have been self-sourcing generic versions of PrEP via<br />
online suppliers. With the recent availability of generic PrEP<br />
from Irish pharmacies, we expect the number of people<br />
using PrEP in Ireland to continue to increase. Getting proper<br />
medical support is a crucial part of safely using PrEP, and a<br />
number of medical tests are needed before you start and<br />
while you continue to use it.<br />
The Gay Men’s Health Service on Baggot Street in<br />
Dublin opened the first clinic specifically for people using<br />
PrEP in Ireland in November. This walk-in clinic offers<br />
users information on how to get and use PrEP, along with<br />
a consultation with a supportive doctor who can answer<br />
questions about PrEP and provide a prescription. It runs<br />
every Thursday morning from 10am to noon.<br />
Just a few weeks later, the Mater Hospital announced the<br />
start of its own Prevention Support Clinic for PrEP users.<br />
This clinic is by appointment, and to make one you can email<br />
psc@mater.ie.<br />
Having access to these dedicated clinical services is a big<br />
step forward in meeting the needs of those of us already<br />
using PrEP, and in preparing the health services for<br />
delivering PrEP when the HSE begins to provide it directly.<br />
Generic PrEP in Ireland<br />
Teva Pharmaceuticals began marketing their generic PrEP<br />
product in Irish pharmacies from Monday, December 4, last<br />
year. Although prices will be set by individual pharmacies, it’s<br />
expected that it will cost between €85 and €100 for a bottle<br />
of 30 pills. This is about the same price-range as a similar<br />
product that recently became available in the Netherlands.<br />
Currently there are over 100 pharmacies in 20 counties<br />
stocking generic PrEP. The number of pharmacies stocking<br />
PrEP will likely continue to grow and competition between<br />
pharmacies may mean prices fall a bit further.<br />
Some key points about this development:<br />
• PrEP is not yet available through the HSE. This product is<br />
only available at full retail price. There is no discount for<br />
medical card holders or anyone else.<br />
• It’s vital that any potential prescribing doctors and<br />
dispensing pharmacists are properly informed about what<br />
tests are needed to support PrEP users, and that they<br />
understand the different dosing regimens so that they can<br />
offer informed guidance to users.<br />
• The availability of generic PrEP in community pharmacies<br />
is a result of a private company taking the opportunity to<br />
directly market a product because the health service has<br />
failed to make it available. Taoiseach, Leo Varadkar, the<br />
Department of Health or the HSE did not do anything to<br />
make this happen.<br />
• It’s imperative that we keep the pressure on the<br />
Department of Health and the HSE to make PrEP<br />
available and accessible immediately. Teva’s shown that<br />
generic companies can offer their product at a fraction of<br />
what Gilead asks, removing the biggest obstacle to PrEP<br />
access. It’s time for the Department of Health and HSE<br />
to become proactive and take advantage of this historic<br />
opportunity to deliver PrEP in Ireland.<br />
GetPrep.online<br />
GetPrEP.online is a new website created and launched by<br />
a Dublin-based group of individuals to provide information<br />
specifically for people living in Ireland about getting and<br />
using PrEP. It is entirely volunteer-run and independent of the<br />
HSE or any NGOs. All costs related to creating this site were<br />
paid using their own funds. GetPrEP.online creators want to<br />
ensure that current or potential PrEP users in Ireland can find<br />
clear and up-to-date information to support them in making<br />
informed decisions about their sexual health.<br />
Visit www.getPrEP.online and see if PrEP is right for you<br />
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