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 25 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.

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 €25 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?

YES.
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?

NO.
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?

NO.
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?

NO.
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.