New data from the HSE shows the ongoing need for sexual health services and suggests we can expect a surge of new diagnoses of sexually transmitted infections (STIs) when testing and treatment services resume. ACT UP Dublin urgently calls on Minister for Health Stephen Donnelly to act swiftly to reopen sexual health services across the country to address the ongoing need.

The group released the following statement, this morning, July 16.

Since March, as a result of the COVID-19 emergency, public sexual health clinics across Ireland have been operating at significantly reduced capacity, with many closed entirely. Although treatment for people living with HIV and hepatitis has continued, access to PEP (“Post-Exposure Prophylaxis”—an emergency HIV prevention method) has been restricted and routine HIV and STI screening is nearly impossible to access, with most clinics seeing only people with obvious symptoms.

Many people who contract a sexually transmitted infection (STI) don’t experience symptoms and are diagnosed only through routine “asymptomatic” screening. In the case of the most commonly-diagnosed STI, chlamydia, the HSE’s Health Protection Surveillance Centre (HPSC) has noted that: “Most people who have chlamydia do not know they are infected.”

Even with clinics seeing only a fraction of their usual numbers, the latest figures from the HPSC indicate that diagnoses of the major STIs are down only by about 25% compared to this time last year. This strongly suggests the possibility that many STIs currently remain undiagnosed and untreated—presenting a health risk to those with an undiagnosed STI and contributing to onward transmission.

In June 2019, Stephen Donnelly—then Fianna Fáil’s Health Spokesperson—highlighted the key role of regular testing and access to sexual health services, saying:

“If we are to truly stem the rise in STIs in this country, no one should be turned away from a testing service… The cost, in terms of finance and health, of not testing is clear for all to see.”

Before the COVID-19 emergency, access to sexual health services in Ireland was badly inadequate. The majority of clinics had long waiting times for appointments, while walk-in clinics regularly turned people away due to lack of capacity. Ten counties had no public services at all, in others services were available only twice a month.

Yet now nearly everyone is turned away from testing services—and there is no specific plan to ensure that such services reopen. Ireland’s Roadmap for Reopening Society and Business mentions the word ‘sex’ exactly zero times.

As COVID-19 lockdown restrictions are eased and we return to more familiar social lives, we can expect transmission rates to rise. It is also clear that under lockdown many people still had sex, despite mandates regarding social distancing. All of which underlines the urgent need to reopen clinics that specialise in sexual health services.

With the launch of a national PrEP programme in November of last year, Ireland joined a small group of countries taking the lead in HIV prevention. PrEP—short for “Pre-Exposure Prophylaxis”—is the use of anti-HIV medication by HIV-negative people to prevent HIV. It is safe and highly effective, and it is hoped that it will play a key role in bringing down Ireland’s record-high levels of HIV diagnosis.

Under the new programme, the medication and clinical support—including STI screening every 3 months—is provided free of cost. The HSE received €5.4 million in 2020 funding to support rollout of the programme—much of which is intended to provide badly-needed improvements and to increase capacity of Ireland’s long-neglected public sexual health services. Although the COVID-19 emergency has created delays, this historic opportunity to improve sexual health services must not be squandered.

Today, the new Government must continue to fight multiple epidemics: COVID-19, alongside the skyrocketing rates of STI and HIV diagnoses that Ireland has recorded over the last few years. Indeed, Minister Donnelly presciently connected services, PrEP, testing, and treatment last year in the Irish Times:

Fianna Fáil health spokesman Stephen Donnelly said on Sunday that the future roll-out of PrEP will be undermined by the HSE’s unwillingness to invest in STI screening programmes in Dublin and across the State.

Now that he is in a position to make a difference, it’s time for Minister Donnelly to show that these were more than just words to score political points.

Minister Donnelly: put your words into action and restore sexual health services in Ireland now!

You can find out more about ACT UP Dublin here.