HIV among potential outbreaks feared by Gay Men’s Health Service

The closure of Ireland’s only dedicated sexual health clinic for gay men has fuelled concerns of a “massive surge” in sexually transmitted infection outbreaks including HIV.

Dublin’s Gay Men’s Health Service (GMHS) shut its doors on March 19th last year as a consequence of the pandemic and has only recently resumed on a limited basis.

Members of the gay community and healthcare professionals have urged its immediate reopening, particularly to screen for STIs and to expand its PrEP scheme – Pre Exposure Prophylaxis medication taken to reduce the chance of contracting HIV.

According to HSE Community Healthcare East, which runs the GMHS, its clinic was attended by 2,228 patients last year. However, Act Up (Aids Coalition to Unleash Power), a grassroots activist organisation, says the service normally sees about 1,000 people every month.

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In a recent letter pleading for service resumption, the organisation warned of the “disastrous consequences for the sexual health of gay and bisexual men in Dublin and Ireland” of its ongoing closure.

Undiagnosed STIs

“A significant percentage of STIs (including HIV) may be asymptomatic, or symptoms may not be recognised. Given the high rates of STI diagnosis among gay and bisexual men when screening is widely available, it is almost certain that the number of undiagnosed and untreated STIs has grown substantially in the last year,” it said.

“Allowing the proliferation of undiagnosed STIs creates the conditions for a massive surge in infections. The longer this remains unaddressed, the longer it will take, and the more resources will be required, to contain it.”

Dr Derek Freedman, specialist consultant in sexually transmitted infections, said while most people continue to socially distance there remains a group who continue to seek out sex during the pandemic.

“To close the doors completely for a year because of one epidemic may result in the resurgence of easily treatable infections . . . that we may have to live with for a further period of time,” he said.

“With that shut down, it means we are going to see people catching HIV who may have otherwise avoided it. PrEP is [otherwise] working out to be an extremely effective mechanism at stopping infection.”

Gonorrhoea and syphilis

However, he said while there was anecdotal evidence that gonorrhoea and syphilis infections appear to be problematic over the last year, he has not heard of similar issues with HIV.

John Gilmore, an assistant professor of nursing at University College Dublin and a member of Act Up, noted there has always been health inequality in the gay community.

"Men come from all over Ireland to access these services," he said, adding that while existing PrEP recipients are being seen, the service is not being expanded to new users.

Mr Gilmore also noted that post exposure prophylaxis (PEP) was not being administered for those who may have been exposed to HIV.

In a statement, Martina Queally, chief officer at HSE Community Healthcare East, explained that at the onset of the pandemic, GMHS staff were reassigned out of necessity to other HSE services.

“Some staff continue to be redeployed to Covid-19 services, including to the Covid-19 vaccination programme which commenced in recent months,” she said. “Covid-19 has placed increased demands on HSE services which require to be delivered in accordance with current restrictions.”

The service reopened in January on a “phased basis”.