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 this is the eas­i­est way to get PrEP: get a pre­scrip­tion for PrEP (‘tenofovir/emtricitabine van Cen­tra­farm’) from your doc­tor and buy the pills at the phar­ma­cy. (You’ll pay the full price, which is around €54 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. What do I need to know about generic PrEP?

Gener­ic PrEP has the exact same com­po­si­tion as the orig­i­nal med­i­cine Tru­va­da. It is just much cheap­er. Since 1st Jan­u­ary 2018, gener­ic PrEP is avail­able in all phar­ma­cies for a lit­tle more than €50 for 30 pills. Of course you need a med­ical pre­scrip­tion.

IMPORTANT: There is more to inde­pen­dent PrEP-use than just tak­ing a dai­ly pill. It has to be done respon­si­bly. That is why we have devel­oped a pro­to­col for safe use of gener­ic PrEP. This pro­to­col explains which tests you need to do when and where you can have them done, among oth­er things. We also organ­ise PrEP Work­shops in Ams­ter­dam to help you make safe deci­sions regard­ing your sex­u­al health.

Some peo­ple still can­not afford €50 a month for PrEP. For them PrEP­nu has devel­oped Project PrEP Shop Boys. Through this project peo­ple can obtain gener­ic PrEP for a vari­able price, depen­dent on income.

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.