IMPORTANT: NEVER USE PrEP IF YOU ARE NOT 100% SURE THAT YOU ARE HIV NEGATIVE
NOTE: there is a financial cost for using PrEP in the Netherlands. Depending on where you do your tests, expect around 30 euro’s per month minimum if you take PrEP on a daily basis
Step 1: Choose your doctor
If you want to take PrEP, you need a doctor to monitor your test results and give you a prescription. In the Netherlands, there are 3 options:
- Family doctor
While most doctors see the benefit of PrEP, we know from experience that some (family) doctors are not too excited to prescribe PrEP. There can be several reasons for this. For one thing, you could be the first person in your doctor’s practice who asks for PrEP. If so, your doctor will need to do some homework. But there are also cases where doctors simply do not want to give you a prescription. The most often heard argument is a fear for an increase in STIs. Which is strange, of course, as you don’t ask for PrEP without good reason. You may want to print out these professional PrEP guidelines (in Dutch) and bring them to your doctor. These guidelines describe in detail how your doctor can assist you with using PrEP.Rule of thumb: if it requires a lot of effort to convince your (family) doctor to give you a prescription for PrEP, look for a different doctor.PrEPnu has a list of family doctors who are willing to prescribe PrEP. If you cannot find a family doctor near you try one of the alternatives below.
- GGD STI clinic
Ask the STI clinic (“soapoli”) at the GGD (public health service) if they can help you get on PrEP. Some of the GGD STI clinics are able to assist you. Here is a list of available GGD STI clinics.
- HIV-treatment centre
Contact your nearest HIV-treatment centre. The HIV-specialists can prescribe PrEP for you. Since the HIV-specialist is expensive this will cost you your deductible excess (‘eigen risico’). You also need a referral from your family doctor. Ask the HIV-specialist for help if your family doctor is not cooperating.
Step 2: Get tested
Before starting PrEP, you need to get tested for a number of things. These tests need to be repeated on a regular basis.
- HIV (before starting PrEP, a month after starting PrEP, and every 3 months from then on)
- Kidney function (before starting PrEP, a month after starting PrEP, and every 3 to 6 months from then on)
- Chlamydia, gonorrhea, syphilis, and hepatitis C (every 3 months)
- Hepatitis B (only before starting PrEP)
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 be 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 all tests done 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 (‘basisverzekering’).
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. Put it in your calendar, write it on your bathroom mirror, stick a note on your fridge.
Your doctor 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.
Step 3: Get your prescription
Once you’ve gotten all the tests done, and your doctor does not find any obstructions for prescribing PrEP, it is time for your prescription.
Ask your doctor to prescribe generic Emtricitabine-Tenofovir disoproxil. These are the two medications that together make PrEP. There should not be a brand name on the prescription.
IMPORTANT: do you use other medications besides PrEP? Be sure to tell your doctor. Certain medications do not go well together with PrEP. Your pharmacy can also check this for you.
Tip: once you get your prescription, make your next doctor’s appointment right away!
Step 4: Buy your PrEP
You can buy PrEP at the pharmacy. You will need to bring your prescription to the pharmacy.
Unfortunately, PrEP is not covered by Dutch health insurance, so you will have to pay for it yourself. PrEP costs at least €27,50 per 30 pills.
PrEP is produced by several different pharmaceutical companies, with different brand names and price tags.
Despite the different brand names, all of the options work equally well. The only exception is Centrafarm, which possibly has a limited expiration date. This is only a problem if you do not use PrEP every day. In that case, ask for one of the other brands.
PrEPnu has made a list of pharmacies which sell PrEP in the 6 biggest Dutch cities. We looked at the cheapest option at each of these pharmacies.
This is only a small selection of pharmacies. Every pharmacy should be able to provide you with PrEP for a low price. Ask if there is a cheap PrEP option at your local pharmacy.
If this does not work for you, or your pharmacy does not cooperate, please contact PrEPnu here. We will help you.