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.