The Irish Times view on PrEP and HIV: A matter of urgency

There should be no delay in proceeding with this vital preventive health initiative

The number of people diagnosed with Human Immunodeficiency Virus (HIV) rose by eight per cent last year. There were 531 HIV diagnoses in 2018, up from 492 the previous year. Statistics from the Health Protection Surveillance Centre show the number of people in Ireland diagnosed with HIV has continued to rise in recent years; this contrasts with the EU and European Economic Area where there has been a 20 per cent drop in the rate of new diagnoses among men who have sex with men since 2015.

The increase of HIV rates here is a multifaceted problem that requires diverse solutions. From a preventive health perspective, the HIV prevention drug PrEP (pre-exposure prophylaxis) is safe and highly effective for people at substantial risk of contracting the virus. In this context, the Health Information and Quality Authority’s recommendation to the Government that introducing a PrEP programme here would be cost effective, is an important one.

The Hiqa report estimates that 173 HIV infections could be averted over the course of the first five years of a programme, at a cost of €5.4 million. This cost includes providing the PrEP drug as part of a holistic service that offers frequent monitoring for adherence and side effects, testing for HIV, and advice on safer sex practices.

PrEP is considered cost saving compared with standard care by Hiqa

PrEP is the most recent development in the field of HIV prevention, involving the use of oral antiretroviral therapy in HIV negative people to prevent infection. The Hiqa report estimates that more than 1,700 people would join a PrEP programme in its first year.

With the success of combined anti retroviral therapy in turning HIV infection from a fatal illness to a chronic, manageable condition, the focus has moved from treatment to prevention. When used every day, in combination with condoms, PrEP reduces the risk of HIV infection by up to 99 per cent. With PrEP considered cost saving compared with standard care by Hiqa and pending a short period of public consultation, there should be no delay in proceeding with this vital preventive health initiative.