🛡️ The Situation

Northern Ireland's health system — Health and Social Care Northern Ireland (HSCNI) — operates distinctly from NHS England, Wales, and Scotland. The free-at-point-of-use principle and the sexual health firewall apply here as they do across the UK.

What differs is that the system requires more active navigation, particularly outside of Belfast, due to funding constraints and geography. Provision is centralized around Belfast, and those in rural or border areas may face delays or need to look towards Dublin as a cross-border alternative.

⚖️ The Golden Rules

1. The Rainbow Project Is Your Community Anchor

The Rainbow Project (rainbow-project.org) is Northern Ireland's primary LGBTQ+ health organization. Based in Belfast, they provide sexual health outreach, mental health support, chemsex support, and critical navigation into the HSC system. Start here.

2. GUM Clinics Provide Free Care, Unlinked to GPs

Routine STI screening, PrEP, HIV care, and PEP are provided completely free via HSC GUM clinics (primarily the Royal Victoria Hospital in Belfast). These services are legally firewalled from your GP. You do not need a referral to book a testing or PrEP appointment.

3. For PEP: Nearest A&E or Clinic, Within 72 Hours

If you need PEP, go to your nearest A&E or HSC sexual health clinic immediately. Say: "I need PEPSE following a high-risk exposure." The medication is free. Do this within 72 hours ( ideally within 24).

⚖️ The Reality of the System

  • Free and Firewalled: Care is completely free at the point of use and strictly firewalled from your GP.
  • Strong Community Anchor: The Rainbow Project offers excellent LGBTQ+ support and health navigation.
  • Centralization: Provision is heavily centralized around Belfast, leaving those in rural or border areas with fewer options.
  • Need for Active Navigation: Accessing care outside of Belfast can require patience, travel, or relying on community resources.

💬 Anonymous Partner Notification

If you test positive for an STI, you can notify your partners completely anonymously. You do not need to face a difficult conversation if you feel unsafe or anxious.

  • Clinic Health Advisers: HSC clinics employ Health Advisers. You can give them your partners' phone numbers, and they will text them anonymously to say they have been exposed to an STI and should get tested. They will never reveal your identity.
  • SH:24: The postal testing portal for Northern Ireland has built-in anonymous notification tools.
  • SXT: A UK-based digital service (sxt.health) that allows you to send anonymous partner notifications via text or email.

🗺️ Guide Map

Testing & Clinics

Prevention

Emergencies & Support

Result Management

Other