The Health Service Executive (HSE) has introduced a new online assessment pathway to improve access to post-exposure prophylaxis (PEP) for people who may have had a recent exposure to HIV and cannot get to a sexual health clinic within 72 hours.

PEP is a 28-day course of HIV medication that can help prevent the virus after a significant exposure. It should be started as soon as possible and must be started within 72 hours (three days) of a potential exposure to HIV.

The new HSE-funded online assessment is available free of charge to people aged 17 and over living in Ireland. It is designed for those who may have had a recent exposure to HIV and are concerned they may need PEP but cannot access a sexual health clinic within the recommended timeframe.

Through feedback from the National gbMSM Sexual Health Working Group, it was identified that accessing the medication outside normal clinic hours could be challenging. The Emergency Department attendance fee was also a barrier for some people seeking PEP when sexual health services were closed.

 

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The online pathway aims to address both issues by providing an assessment that is reviewed by a sexual health clinician. If PEP is recommended, users receive a referral letter for Emergency Department assessment and treatment. The referral letter means residents of the EU will not be charged the standard Emergency Department attendance fee, while non-EU residents will have the fee reduced by €100.

The online assessment does not provide the medication; instead, it determines whether a referral to an Emergency Department is appropriate. If a referral letter is issued, a healthcare professional in the Emergency Department will assess the individual and provide a five-day starter pack of PEP if appropriate. Follow-up care for the remainder of the 28-day course will then be arranged through a public sexual health service.

The HSE advises that if a public sexual health clinic is open within 72 hours of a possible exposure, people should attend the clinic directly. If this is not possible, the online assessment should ideally be completed within 48 hours of exposure. Those whose exposure occurred between 48 and 72 hours should contact their local sexual health clinic or attend an Emergency Department.

The assessment recognises that not everyone who seeks PEP will require treatment. Factors such as the type of exposure, whether PrEP has been taken correctly, condom use and a partner’s HIV treatment status are all considered.

Following treatment, patients are referred for follow-up care, which may include HIV and STI testing, vaccinations, treatment review and ongoing support. More information about PEP and the online assessment pathway is available at man2man.ie/hivpep.