HIV Pre-Exposure Profylaxis (PrEP)

Frequently Asked Questions about PrEP

• Who is eligible for PrEP?

  PrEP is recommended for individuals who are at substantial risk of HIV infection:

  • men who have sex with men
  • transgender individuals who have sex with men
  • sex workers who have sex with men who have sex with men

• What is PrEP?

  PrEP is a pill, consisting of a combination of antiviral drugs (tenofovir with or without emtricitabine), which significantly reduce the risk of an HIV infection.

• What are the costs of PrEP?

  PrEP is not yet reimbursed by health insurers in the Netherlands. You have to pay for the pills yourself. PrEP is only available in the Netherlands with a doctor's prescription. The costs vary per pharmacy (approximately 40 euros for a box of 30 pills).

• Which check-ups do I need?

  If you take PrEP, it is important to have regular check-ups.

  Testing for an (acute) HIV infection

  Before you start using PrEP, we must be sure that you do not have an HIV infection. That is why we take a blood test and ask you about any symptoms. These symptoms may include: a rash, fever, sore throat, severe headache, diarrhea, night sweats and weight loss.

  It is necessary to rule out HIV, because if you start PrEP during an HIV infection, there is an increased risk of resistance developing.

  Checking your kidney function

  Sometimes it is necessary to monitor your kidney function while using PrEP. We test your urine for glucose and protein. We check the kidney function because there is a small risk of temporarily developing reduced kidney function when using PrEP.

  Hepatitis B virus

  It is important that you are protected against hepatitis B (through a vaccination or if you have recovered from a hepatitis B infection). If you have not yet received a vaccination, this is available through the GGD at no additional cost.

  If it turns out that you have an active hepatitis B infection, you can only use PrEP daily. You will also receive a referral to the internist-infectiologist for PrEP care.

  Hepatitis C virus

  It is important to know if you have had hepatitis C. An old infection can reactivate while using PrEP. We regularly test for hepatitis C while using PrEP.

  STI testing

  We test for chlamydia and gonorrhea during all PrEP consultations. We also test your blood for syphilis and HIV.

• How do you use PrEP?

  PrEP can be used in 2 ways; daily or irregularly (around sexual contacts)

  Daily use

  • One pill every day at the same time
  • People with a hepatitis B infection can only use PrEP daily
  • If you have a vagina you can only use PrEP daily

  Irregular use

  • start with 2 pills, 24 to 2 hours before possible exposure to HIV
  • next, take 2 more pills:
    • one pill 24 hours after first intake and
    • one pill 48 hours after first intake

  It is important to take at least 4 pills. If you have sex more often, you may need to increase the number of pills taken. You must ALWAYS take 2 tablets (24 hours apart) AFTER the last possible exposure.

  If you do not have sex after taking the first 2 tablets, it is of course no longer necessary to take the next 2 tablets.

• What are the side effects?

  Serious side effects are extremely rare. Most side effects experienced are mild and may include the following:

  • Headaches
  • Nausea
  • Stomach problems
  • Sleep problems

  These side effects usually last no longer than 2 weeks. In rare occasions, the side effects may be more serious. If you wish to receive more information, please ask about these side effects during your PrEP appointment.

• I forgot to take PrEP, what should I do?

  This depends on the time and your intake schedule.

  You use PrEP daily

  • If it is less than 12 hours after you usually take PrEP, you should take a pill as soon as possible.
  • If you are more than 12 hours late, skip the dose you missed and take the next scheduled dose as normal. You don’t need to take 2 pills. Forgetting 1 pill in your daily intake schedule will not have an effect on your protection.
  • If you forget to take more than 1 pill, you may not be adequately protected against HIV. In this case, we advise you to contact your doctor.

  If you use PrEP before and after sex

  • Forgot to take your pills before sex:
    • If you forgot to take one or two pills before sex, you will not be protected against HIV.
    • If you did take two pills, but had sex less than two hours after taking the pills, you will not be protected against HIV.
  • - Forgot to take your pills after sex:
    • If it is less than 12 hours after you usually take PrEP, you should take a pill as soon as possible.
    • If you are more than 12 hours too late, or you forgot to take your PrEP on both days, you will not be protected against HIV.

  Did you have sex without PrEP? Or did you take PrEP incorrectly? If you are not protected against HIV and you had anal sex without a condom with someone whose HIV status you don’t know, or with someone who is HIV positive and is not receiving treatment, contact us as soon as possible. You may need to be treated with PEP. This is a four-week course that you need to start within 72 hours of having unprotected sex. For additional information on PEP, please visit our PEP page.

• More information?

  • mantotman.nl
  • factsheet PrEP
  • aidsfonds.nl
  • PrEP richtlijn
  • Soaaids.nl