What is PrEP?
PrEP is a pill that prevents you from catching HIV. PrEP is both safe to use and effective. This has been scientifically proven. PrEP has been available to the public in the United States since 2012, and became available in the Netherlands in 2016. PrEP is not covered by Dutch health insurance, but you can get a month’s worth of PrEP for as little as 20 euros. PrEP can only be bought if you have a doctor’s prescription. Read our Step-by-step Guide to find out how to get PrEP in the Netherlands.
What about PrEP and the coronavirus?
There is no evidence that PrEP protects you in any way against the coronavirus (COVID-19). A good overview of information on sex, PrEP, and the coronavirus can be found at Man tot Man.
Concerning COVID vaccination, no interactions are expected with PrEP. The Dutch HIV Association (Hiv Vereniging) has compiled an FAQ covering, among other things, the question of interactions between COVID vaccination and HIV medication (in Dutch). This information is relevant for PrEP users as well as the medication used as PrEP is used for treatment of HIV as well.
How can I get PrEP as cheap as possible?
GGD STI clinics offer PrEP for €7,50 per 30 pills as part of the national PrEP programme. All associated care is free of charge at the GGD. However, the national PrEP programme has a limited capacity. Many GGD clinics have waiting lists, and it could be that the GGD in your region has run out of spots altogether. Your local GGD can give you all information on the possibilites. If you can’t or don’t want to wait, ask your GP to prescribe PrEP. Prices differ between pharmacies (see our price list), starting at about €20 a month.
What if I forgot a pill?
When using daily:
Don’t panic! If you use PrEP daily, you can take your pill up to 12 hours after you should have taken it. If more than 12 hours have passed, it is better to skip the pill. Even if you forget your pill once or twice a week, PrEP remains a very reliable protection against HIV.
When using around risk:
If you only use PrEP around sex, it is more important to take your pills on time. The same rule as above applies: take your pill up to 12 hours after you should have taken it. You then take the next pill according to the original schedule (that is, 24 and 48 hours after taking the first two pills).
If you forgot the pills before sex or you forgot multiple pills, you are NOT SUFFICIENTLY PROTECTED against HIV.
In this case, you should contact your GGD or hospital, and discuss if you need a PEP treatment. Click here for more information about PEP.
Do I always need to take PrEP at the exact same time?
YES, you should take PrEP at approximately the same time every day.
But the exact time is not so important. You can also take your PrEP a few hours earlier or later than planned, and it will still be very effective. There are many apps available to remind you to take your PrEP (via push notifications), you can make good use of these!
Can I use PrEP I got from someone else or a dealer at a (sex) party?
Bad idea, don’t do it!
We advise to only use PrEP with a prescription, through a doctor and pharmacy. The most important reason is that you need to be sure that you do not have HIV. If you have HIV and use PrEP, then your HIV virus can become resistant against the medication in PrEP. This makes your HIV harder to treat. Also, you need to use PrEP for at least two days after sex; this is the only way you are protected against HIV infection. Those pills are usually not available at a (sex) party. Be smart and arrange your PrEP ahead of time, through a doctor.
If my sexual partner takes PrEP, am I also protected against HIV?
If your partner has tested HIV-negative and uses PrEP correctly, the odds are very low that he can infect you with HIV. We still do not recommend using this as a method of protection against HIV, because it requires you to trust your sexual partner completely. A better strategy is to protect yourself by also getting on PrEP yourself!
What is the difference between PrEP and PEP?
PrEP are pills you take BEFORE being at risk for HIV. PEP is a treatment for AFTER being at risk for HIV. For example, if you had sex without condoms or PrEP with a partner whose HIV status you do not know, you are at risk for HIV. If so, you can get a PEP treatment for the first 72 hours after the sex through your GGD clinic or hospital, to prevent you from getting HIV. Click here for more information about PEP.
What does PrEP do to your bones?
In some people who use PrEP for a long time, bone strength can decrease. In theory, this can put you at a slightly higher risk for bone fractures, but this hasn’t been definitively proven. Since this is a side effect that only causes a problem after using PrEP for years, it is not tested for initially. Also, the effect is limited: by comparison, smoking cigarettes would probably have a larger effect. If you already have osteoporosis, discuss with your doctor if PrEP is appropriate for you.
My anus started bleeding during sex, does PrEP still work sufficiently?
PrEP works on the cells deep inside your body. Even if you get skin lesions during sex or experience anal blood loss, PrEP still works equally well.
Is an HIV test less reliable if you are on PrEP?
HIV tests that are performed in a laboratory are equally reliable for people who use PrEP compared to people who do not use PrEP. With rapid HIV-tests it can take longer to detect a potential ongoing HIV infection. We recommend you to get a regular HIV test, and not just a rapid HIV-test.
Swallowing cum, how big it the chance of getting HIV?
The chances of getting HIV from swallowing cum are very low. When HIV gets to your stomach it is killed instantly by the acids in your stomach. If you only have oral sex it is not necessary to use PrEP.
Does it make a difference if you have anal or vaginal sex?
PrEP takes a longer time to penetrate the vaginal wall. If you’re having receptive vaginal sex, you are therefore advised to take 1 pill per day for 7 days before sex, and then continue taking 1 pill every day.
If you want to stop using PrEP, make sure to take the last pill 7 days after the last time you had sex.
Is PrEP less effective if you have an STI?
In several research trials that tested PrEP, people who used PrEP regularly had STD’s. PrEP also worked remarkably well for these people.
Is PrEP 100% reliable?
NO, BUT ALMOST!
Out of tens of thousands of people who use PrEP worldwide, less than 10 people are known to have contracted HIV while using PrEP correctly. There is a very small chance that PrEP does not protect you well. This is also why you need to get tested for HIV regularly when you are on PrEP. If you contract HIV, this can be treated quickly and well. HIV infections did occur in the PrEP research trials with people who did not use their PrEP correctly, or forgot to use it. PrEP only works if you actually take the pills in the correct way!
Do drugs, alcohol or Viagra change the effectiveness of PrEP?
Using alcohol, drugs or Viagra does not change the effectiveness of PrEP. It is possible that XTC has an increased effect at the doses you were used to before using PrEP. If you combine PrEP and XTC, use a smaller dose of XTC the first time, to see how it goes.
Other medications (from the pharmacy or drugstore) sometimes cannot be used together with PrEP. Always discuss with your doctor if you use other medications, to see if it goes together with PrEP.
I am an asylum seeker and I can not get PrEP, can you help me?
Send us a message here and we will see if we can help you.
Why test for HIV when using PrEP?
IMPORTANT: NEVER USE PrEP IF YOU ARE NOT 100% CERTAIN THAT YOU ARE HIV NEGATIVE
It is enormously important that you do not have HIV when you start PrEP. The medications in PrEP are used in combination with other medications to treat HIV. If you use PrEP but already have HIV, then your HIV is only treated partly, and you are at risk that your HIV becomes resistant against the medication in PrEP. This makes your HIV treatment more difficult and may lead to you transmitting HIV to someone else, even someone who uses PrEP. Get tested for HIV every 3 months. Read more about HIV here.
Why test the kidney function when using PrEP?
In rare cases, PrEP can lead to a decrease in kidney function. You won’t notice that your kidney function is deteriorating until it is too late. This is why you need to get your kidney function checked, both before and during use of PrEP. If your kidney function gets worse because of PrEP, stop using PrEP, and your kidney function will recover. Get your kidney function tested every 3 months.
Why test for chlamydia, gonorrhea, syphilis when using PrEP?
PrEP only protects against HIV, so you can still contract other STDs, sometimes without noticing it. By treating these STDs promptly, you ensure that they are not transmitted to other sexual partners. If everyone gets tested for STDs every 3 months, then fewer STDs will go around, and the risk of getting an STD will decrease for everyone. Read more about STD’s here.
Why test for Hepatitis C when using PrEP?
Hepatitis C occurs more often with people who use PrEP. There is no vaccination against Hepatitis C, but there is a treatment. If a test shows that you have Hepatitis C, make sure you get treated quickly. This is good for your own health, and prevents you from transmitting the virus to your partners. Read everything about Hepatitis C here, including how to make the risk of infection as low as possible.
Why test for Hepatitis B before starting PrEP?
Most men are vaccinated against Hepatitis B, or have acquired immunity because they had the virus and their own immune system has killed it. In rare cases, the virus stays in the body: this is called chronic Hepatitis B. In this case, you can only use PrEP daily. PrEP is also a treatment for Hepatitis B, and you should ask your doctor before you stop taking PrEP. Before starting PrEP, you need to get tested for Hepatitis B once. If you have not been vaccinated yet, make sure to get this done as soon as possible. This is free at a GGD STD clinic. Read more about Hepatitis B here.