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

  • 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

Because PrEP takes a longer time to pen­e­trate the vagi­nal wall, you are advised to take 1 pill per 24 hours for 7 days before sex, and then take 1 pill per 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 for 7 days before sex and then dai­ly until 7 days after the last time you had sex.)
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

IMPORTANT: NEVER USE PrEP IF YOU ARE NOT 100% SURE THAT YOU ARE HIV NEGATIVE

  • 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
Cost
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.