After going through the 4 steps, it is time to take your first dose of PrEP. What an exciting moment!
You can read here how to use PrEP safely and responsibly.
People with a penis

If you use gen­der-affirm­ing hor­mone ther­a­py, please scroll down for more spe­cif­ic advice

    • Take 2 pills the first time and from then on 1 pill every 24 hours. You are pro­tect­ed from HIV start­ing 2 hours after tak­ing the first two pills.


    • If you want to stop tak­ing PrEP, keep tak­ing pills every 24 hours until 48 hours after the last time you had sex. This means that you can also use PrEP peri­od­i­cal­ly or ‘around sex’. It’s also pos­si­ble to take only 1 pill on the first day, but then you are pro­tect­ed from HIV only after using PrEP for 5 days.


    • If you start using PrEP again, use the same sched­ule. (That is: 2 pills on day one and then 1 pill every 24 hours, until 48 hours after the last time you had sex.)


    • Advan­tage of tak­ing PrEP every day:
      the rou­tine helps you to remem­ber tak­ing your pill, and you can have unplanned sex.


    • Advan­tage of tak­ing PrEP ‘around sex’:
      if you do not have a lot of sex, or you know you can plan sex, you’re able to spend less mon­ey and you need to take less pills. Note: PrEP ‘around sex’ is not appro­pri­ate for peo­ple who some­times (when drunk, for exam­ple) have unplanned sex with­out a con­dom.
People with a vagina

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.

If you start using PrEP again, fol­low the same sched­ule. That is, take 1 pill dai­ly for 7 days before sex and then dai­ly until 7 days after the last time you had sex.

If you have a vagi­na but only prac­tise recep­tive anal sex, you can fol­low the same sched­ules pro­vid­ed for peo­ple with a penis.

When using gender-affirming hormones

Using PrEP does not affect the lev­els of gen­der-affirm­ing hor­mones.

The oth­er way around how­ev­er, gen­der-affirm­ing hor­mones used by trans women can slight­ly low­er the lev­els of PrEP. In this case, PrEP is still just as effec­tive when tak­en dai­ly. Using PrEP only around sex is not suit­able for trans women. It is also advised to take 1 pill dai­ly for 7 days before sex. And if you want to stop PrEP, to con­tin­ue tak­ing 1 dai­ly pill for 7 days after the last time you had sex.

Gen­der-affirm­ing hor­mones used by trans men do not affect PrEP lev­els. Many trans men can how­ev­er only opt for dai­ly PrEP for oth­er rea­sons. See for exam­ple the advices for peo­ple with a vagi­na.

Side effects

Most peo­ple do not expe­ri­ence side effects from using PrEP

Some peo­ple expe­ri­ence one or more of the fol­low­ing symp­toms imme­di­ate­ly after start­ing PrEP: nau­sea, diar­rhea, live­ly dreams, headaches, or fatigue.

After a few weeks of using PrEP, these symp­toms dis­ap­pear for part of these peo­ple. This is the case for dai­ly use and also for use around sex. For some peo­ple, the symp­toms per­sist, and this can be a rea­son to stop using PrEP.

Going for check-ups


    • Before start­ing PrEP, and a month after start­ing PrEP, you must get test­ed for:
      · HIV
      · Kid­ney func­tion


    • Before start­ing PrEP, you must also get test­ed for:
      · Chlamy­dia
      · Gon­or­rhea
      · Syphilis
      · Hepati­tis B
      · Hepati­tis C


  • After start­ing PrEP you must get test­ed EVERY THREE MONTHS for:
    · HIV
    · Kid­ney func­tion
    · Chlamy­dia
    · Gon­or­rhea
    · Syphilis
    · Hepati­tis C
To save cost, you can get test­ed for HIV, chlamy­dia, gon­or­rhea, syphilis and hepati­tis B for free at your local GGD STI clin­ic, or you can arrange a test online via Man­tot­Man Test­lab.

Test­ing your kid­ney func­tion and hepati­tis C is usu­al­ly only pos­si­ble via your fam­i­ly doc­tor, and these two tests togeth­er will incur a charge of about €15,- on your deductible excess (“eigen risi­co”) every time you get test­ed.

Of course, it is pos­si­ble to get test­ed at your fam­i­ly doctor’s office, but the cost for STD test­ing is charged on your deductible. All tests togeth­er will cost about €210,- every time. If you have already met your deductible, it does not mat­ter where you get test­ed, since STD tests are then cov­ered under Dutch health insur­ance.

You can read more about the rea­sons for each of the var­i­ous tests under Fre­quent­ly Asked Ques­tions.

IMPORTANT: If you use PrEP, you need to get test­ed for HIV, kid­ney func­tion, chlamy­dia, gon­or­rhea, syphilis, and hepati­tis C EVERY 3 MONTHS.

TIP: Put the appoint­ment in your cal­en­dar, write it on your bath­room mir­ror, stick a note on your fridge. Most doc­tors will not give you a new pre­scrip­tion if you did not get test­ed, so it is impor­tant that you real­ly keep up with the tests and that you make a new appoint­ment with your doc­tor in time.