The Situation

Ireland's sexual health system is free, specialist, and genuinely LGBTQ+-competent — but almost entirely concentrated in Dublin. The Gay Men's Health Service (GMHS) and the GUIDE Clinic at St James's Hospital set a high standard; the challenge outside Dublin is significantly different.

The system has evolved around two parallel infrastructure pieces:

  • The clinic: GMHS and GUIDE handle complex cases, PrEP initiation, treatment, and anything that needs a clinician.
  • The post: SH:24 (sh24.ie) postal testing covers the entire country and is now the standard for routine quarterly screening — nationwide, free, delivered in a plain white box.

🗺️ The Ireland Guide Map

The Clinics

- SH:24 postal kits (nationwide, free), the GMHS at Baggot Street, and the GUIDE Clinic at St James's — what each is for and when to use which.
- Cork, Galway, Limerick, regional services, and what to do if you're rural. SH:24 works everywhere; PrEP and specialist care are where geography matters.

Prevention

- Free since 2019. You need a DPS card + prescription. Public waitlists exist; private GP route is often faster. Full monitoring cycle explained.
- Free Mpox and Hep A/B at GMHS. HPV free to age 25 (check current catch-up criteria). What's available where.
- Not officially recommended; the GUIDE Clinic is the most progressive route for an off-label conversation.

Emergencies

- Go to A&E at a large hospital. The fee situation. What to say. GUIDE Clinic for follow-up.

Support

- LGBTQ+ Ireland, Switchboard Ireland, BeLonG To, Samaritans, Pieta House, HSE access, finding an affirming therapist in Ireland, Ireland-specific cultural context.
- GUIDE Clinic, GMHS, HIV Ireland, harm reduction basics, when to seek support.

Language

- GMHS, GUIDE, DPS card, Medical Card, SH:24, three-site panel, reactive result — all the terminology you need.

The Golden Rules

Rule 1: Apply for the DPS Card Now

If you're going to use PrEP, the Drugs Payment Scheme card is what makes it free. It takes a few weeks to process. Apply at hse.ie before you need it.

Rule 2: SH:24 for Routine Testing — Not Your GP

Your GP's standard STI test is a urine sample. It misses most gonorrhoea and chlamydia in gay men (which is rectal and pharyngeal). Use SH:24 (sh24.ie) for quarterly testing — it includes the three-site panel. Save clinic appointments for symptoms and treatment.

Rule 3: A&E for PEP, Not Your GP

If you need PEP out of hours, go to the A&E at the nearest large hospital. GP out-of-hours services do not stock HIV medication. Do not wait for a GP appointment — the 72-hour window is absolute.

Rule 4: The GUIDE Clinic vs GMHS

Think of the GMHS as your sexual health GP and the GUIDE Clinic as your specialist. GMHS handles PrEP, routine care, vaccinations, and most STI treatment. GUIDE handles HIV management, complex cases, PEP follow-up, and anything that needs infectious disease expertise.

General Education

The clinical and educational content lives in the general section:

Bottom line: Order kits from SH:24. Get PrEP via GMHS or a private GP with your DPS card. Go to St James's A&E for PEP. Outside Dublin — SH:24 still works, your regional hospital A&E handles emergencies, and your GP can prescribe PrEP.