PrEP can protect you from getting HIV.
Other methods of protection against HIV are:
· never fuck
· only fuck people when you are 100% sure they do not have HIV
· only fuck people with HIV who have an undetectable viral load (= less than 200 virus particles per milliliter blood)
· always use a condom when fucking
The question you need to ask yourself is: am I at risk for contracting HIV? Be honest with yourself.
Is PrEP for me?
PrEP is for everybody. For straight, gay, and bi+, for men and women, cis, trans, and non-binary. There however are differences in how to use PrEP:
- Men and other people who have a penis take 2 pills on the first day and then 1 pill every 24 hours. You are protected against HIV starting two hours after the first dose. If you want to stop using PrEP, you should keep taking your pills until 48 hours after the last time you had sex without a condom. It’s also possible to take only 1 pill on the first day; if you do that, then you are protected against HIV after using PrEP for 5 days.
- Women and other people who have a vagina take 1 pill on day one and then 1 pill every 24 hours. Because PrEP takes a longer time to penetrate the vaginal tissue lining, you are protected against HIV after 7 days. If you want to stop using PrEP, you should keep taking pills for 7 days after the last time you had sex without a condom. If you only have anal sex, the longer waiting periods do not apply and you can use the schemes provided for people who have a penis.
The advantages of PrEP
- No more fear for HIV
- No feelings of guilt if you do not use a condom time to time
- A more enjoyable sexual experience
- More confidence in your own actions
- Never dependent on someone else’s condom use
- Provided you get tested for STD’s every 3 months: if you contract an STD you will be treated right away
Whether you should use PrEP is a personal choice. It is a good idea to be well-informed when you make this choice. There are many different considerations, but two important ones are: how important is it to stay HIV-negative? And, what are the odds that I would contract HIV?
Why avoid getting HIV?
Nowadays there are very good treatments for HIV available, and usually you only need to take one pill per day. Most people do not experience side effects from this medication, and they will live roughly as long as someone who does not have HIV. HIV-positive people who have an undetectable viral load (less than 200 virus particles per milliliter blood) cannot transmit HIV to others.
Still, it is better to avoid contracting HIV, because:
- You HAVE to take pills every day for the rest of your life. With PrEP, you can stop whenever you want.
- A lot of people with HIV experience stigma.
- If you do not start in time with HIV treatment, you could get AIDS.
- Your health at a later age can be worse if you have an HIV infection that remains untreated for a long time.
- You can transmit HIV to your sexual partners, which can cause harm to your partners’ health.
Risk of contracting HIV through ‘gay sex’
In 2017, 7 out of 10 recent HIV infections were found in men who have sex with men, and trans women who have sex with men.
In The Netherlands, around 1 out of 10 men who have sex with men have HIV.
If you are a man or trans woman who has sex with men, you are at high risk of contracting HIV.
As a man who has sex with men it is a good idea to use PrEP, unless:
- You ALWAYS use a condom when fucking, including with your regular partner
- You do not always use a condom but you are 100% sure that your sexual partner is HIV-negative and is not at risk of contracting HIV from another sexual partner
- You do not always use a condom but you know that your sexual partner has HIV with undetectable viral load. Someone who has an undetectable viral load (= less than 200 virus particles per milliliter blood) cannot transmit the virus.
Risk of contracting HIV through ‘straight sex’
3 out of 10 HIV diagnoses in the Netherlands are given to women and men who only have straight sex. Since there are many more women and straight men than men who have sex with men, the risk of contracting HIV in the Netherlands as a woman or straight man is very low.
As a woman or man who only has sex with women, you do not need to use PrEP, unless for example:
- You are a woman who has sex with a man who also has sex with men.
- You have sex with people in or from a country where HIV is very prevalent (for example in parts of southern Africa or South-East Asia).
- You are a sex worker and you do not always use condoms.
- Your partner has HIV with a detectable viral load. Someone who has an undetectable viral load (= less than 200 virus particles per milliliter blood) cannot transmit the virus.
Risk of contracting HIV as trans
Unfortunately, there is little information available about the risk of contracting HIV as a trans woman or trans man in the Netherlands. In other parts of the world (such as in the United States) this chance is considered to be high.
It all comes down to who you have sex with. Our advice is to read the last few chapters about ‘gay sex’ and ‘straight sex’ and to follow your own judgement. Also when it comes down to taking PrEP or not. For this read “How do I take PrEP?”
For the sake of clarity in the chapters ‘gay sex’ and ‘straight sex’ we chose not to use inclusive language, for which we offer our sincerest apologies.
Talking to people who already use PrEP
On Facebook you can become a member of the Facebook group #PrEPNu. This is a closed group: only members can see who else is a member of the group, and only members can read and participate in the conversations.