1. What is PrEP?

PrEP is a pill that pre­vents you from getting HIV. PrEP stands for Pre-Expos­ure Pro­phy­laxis. The pill (Truvada) con­tains two sub­stances (Teno­fo­vir and Emtri­cit­abine) that prevent HIV infect­ing the body. Truvada was ori­gin­ally designed to treat HIV.

PrEP provides excel­lent pro­tec­tion against HIV, even if you’d forget to use a condom.

2. How is PrEP taken?

Taking PrEP on a daily basis is the most stand­ard. However, PrEP is also effect­ive when taken around the time you have sex. This is known as inter­mit­tent use and may be an option for people who plan their sexual activ­it­ies well.

With inter­mit­tent use, you take a double dosage (two PrEP-pills) 2 to 24 hours BEFORE sex, and two single doses at approx­im­ately 24 hours and 48 hours after the first dose.

If you have sex for more than one day, you con­tinue until you have taken two single doses after the last sex contact. (See sched­ules.)

3. PrEP in the Neth­er­lands?

PrEP is avail­able in the Neth­er­lands since 2016. Any doctor can pre­scribe PrEP but it is not covered by health insurers. However if you can afford it, this is the easiest way to get PrEP: get a pre­scrip­tion for PrEP from your doctor and buy the pills at the phar­macy. (You’ll pay the full price, which is around €550 for 30 pills.)

Free PrEP is only avail­able in the Neth­er­lands in the H-TEAM’s AMPrEP study, conduct by the Public Health Service of Ams­ter­dam (GGD Ams­ter­dam). In total, 376 men who have sex with men (MSM) and trans­gender people are par­ti­cip­at­ing in this study.

4. Can I buy generic PrEP in the Neth­er­lands?

There are some good, reli­able options of getting generic PrEP. ‘Generic’ means pills with the same ingredi­ents but without the brand name Truvada. The price varies from €30 to €100 a month (if taken daily).

IMPORTANT: Inde­pend­ent PrEP-use has to be done respons­ibly. We have developed a pro­tocol for safe use of generic PrEP. In the pro­tocol we explain which tests you need to do when and where you can have them done, among other things.

There are 5 options in the Neth­er­lands at the moment:

5. How does PrEP work?

If you protect your­self with PrEP and you are exposed to HIV, PrEP pre­vents HIV from enter­ing your cells and rep­lic­at­ing. There­fore you will remain HIV neg­at­ive. PrEP is only effect­ive when there is a suf­fi­cient amount of the active sub­stances in your blood before you are exposed to HIV.

6. What are the bene­fits of PrEP?

Sex is fant­astic, but you don’t always make sens­ible decisions once you’re all excited. PrEP pro­tects you against HIV, even when you don’t manage to use a condom, provided that you take your pills as pre­scribed.

When you take PrEP, you will get checked for HIV and STIs at least every three months. PrEP only pro­tects against HIV, in con­trast to condoms that also protect against other STIs. By getting your­self checked for HIV and other STIs reg­u­larly, you can get treat­ment in an early stage if needed.

7. Does PrEP work?

Yes, it really works! Several studies across the world have shown that PrEP is highly effect­ive in pre­vent­ing HIV. To be effect­ive PrEP has to be taken accord­ing the pre­scribed sched­ule. Reg­u­lar­ity and punc­tu­al­ity are crucial.

8. How soon is it effect­ive?

The time it takes for PrEP to be fully pro­tect­ive depends on several factors. Research shows that when used daily, it takes 4 to 7 days before the sub­stances reach suf­fi­cient levels in the blood and the rectum. It takes more time to be effect­ive in the vagina and the uterus. Vaginal pro­tec­tion is mostly reached after 3 weeks. Inter­mit­tent use of PrEP will only be effect­ive in the blood and rectum when taken accord­ing to the pre­scribed sched­ule. Pro­tec­tion in the vagina with inter­mit­tent use has yet to be fully studied.

9. Are there any side effects?

Most people who take PrEP don’t exper­i­ence side effects. 1 in 10 people exper­i­ence mild side effects like nausea, tired­ness, indi­ges­tion and head­ache. They usually go away on their own within a few weeks.

Teno­fo­vir (one of the sub­stances of Truvada) can result in a decrease in both kidney func­tion and bone density and there­fore, PrEP users are reg­u­larly mon­itored. PrEP studies have shown that these side effects are tem­por­ary: your body will recover once you stop taking PrEP.

10. Should I discuss PrEP with my doctor?

If you are con­sid­er­ing to start PrEP, it is highly recom­men­ded that you discuss this with your family doctor or a doctor at the STI clinic. They will be able to help you to decide if PrEP is right for you. They will give you a few tests includ­ing the most suit­able HIV test and a kidney func­tion test.

*It is import­ant to be abso­lutely sure that you DO NOT have HIV before taking PrEP..

11. How can I support PrEPnu?

You can support PrEPnu with a fin­an­cial con­tri­bu­tion. All gifts will be used for making PrEP afford­ably access­ible in The Neth­er­lands.