PrEP in Northern Ireland: How to Actually Get It

PrEP is available free through HSC Northern Ireland. Following a successful pilot, it is now part of routine sexual health care. The honest version: if you are in Belfast, you are well served. Outside Belfast, wait times can be significant and the number of clinics offering PrEP is limited. The workaround is the same as anywhere else in the UK and it is entirely legal.

👤 Who Can Get It

HSC Northern Ireland funds PrEP for anyone at elevated risk of HIV — gay men, bi men, trans people, women with HIV-positive partners, anyone in a serodiscordant relationship. No behavioural gatekeeping. The medication is free; the variable is the wait.

🏥 How to Get It: The HSC Route

You do not need a GP referral. You self-refer directly to your local GUM clinic.

How to start:

1. Find your nearest clinic via sexualhealthni.info.
2. Call the clinic's appointment line and request a PrEP assessment.

The two main hubs are Royal Victoria Hospital in Belfast and Altnagelvin in Derry/Londonderry. Belfast handles the largest volume and is the most efficient. Elsewhere, capacity is more limited.

At your first appointment the clinic runs a baseline HIV test (4th generation), a full STI screen, and kidney function bloods. If everything is clear, you leave with your first supply of PrEP.

Wait times are real. Initial PrEP assessment appointments can carry significant waits outside Belfast. Do not assume the system will move quickly — call early, and use the options below in the meantime.

💊 If You Can't Wait: Buying Privately (IWPN)

If you cannot secure a timely clinic slot, it is completely legal in the UK to import up to a 3-month supply of generic PrEP for personal use. This applies equally in Northern Ireland.

The charity I Want PrEP Now (IWPN) maintains a strictly vetted list of reliable online pharmacies that ship genuine generic PrEP to UK addresses. Do not buy from sources not on that list.

Test before you start. You must confirm you are HIV-negative immediately before taking your first PrEP pill. Starting PrEP with an undetected infection risks drug resistance, making HIV much harder to treat. Use the SH:24 postal testing service (available via sexualhealthni.info) to get an HIV test before you start.

Day one isn't covered. Daily oral PrEP takes 7 full days to build up to protective levels in rectal tissue. Use condoms for that first week. Day 8 onwards, you're covered.

The Hybrid Move: Buy your first 3 months privately via an IWPN-approved seller while simultaneously joining the HSC waitlist. When your clinic appointment comes through, tell them you are already buying privately — they will transition you onto the free HSC supply without any gap. Given the wait times outside Belfast, this is often the sensible approach.

🔄 What Happens After: Monitoring

Miss your quarterly check-up and your prescription lapses. They run an HIV test (4th gen), kidney function bloods, and an STI screen. On the STI screen: ask for a three-site screen — throat, genitals, rectum. A urine-only test misses anything living in your throat or rectum, and three-site is not always offered as the default. The kidney test is there because tenofovir can affect kidney function over time; that is what they are tracking.

Your initiation appointment is also the moment to sort vaccines — Hep A, Hep B, and Mpox are free at sexual health clinics, HPV free for MSM up to 45. Ask at the first visit.

If you are self-sourcing, SH:24's postal testing service (via sexualhealthni.info) covers HIV and STI testing. Kidney function is the gap — for that you need a clinic visit. Your local GUM clinic or GP can run a creatinine blood test even if you are not yet on their PrEP programme; just ask.

💉 Injectable PrEP (CAB-LA)

A jab every two months instead of a daily pill (cabotegravir-LA / Apretude). Ask your clinic directly whether it is available and whether you qualify.

💊 Dosing Options

Daily: One tablet every day. Works for all types of sex.

On-demand (2-1-1): Two tablets 2–24 hours before sex, one 24 hours after, one 48 hours after. Only proven for anal sex with men; not suitable if you have Hepatitis B. Ask for it by name — some clinicians will prescribe daily by default without asking.

📊 Routes Compared

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