Users FAQ

PrEP is a pill that can prevent you from contracting HIV. PrEP is safe and effective, as scientifically proven. Since 2012, PrEP has been available to everyone in the US, and since 2016 in the Netherlands. PrEP is not covered by health insurance, but you can get 30 PrEP pills for as little as 20 euros. PrEP can only be purchased with a prescription. Read the PrEPnu Step-by-Step Guide on how to access PrEP in the Netherlands.

PrEP is available through a national scheme at the Public Health Services (GGD) with a contribution of €7.50 for 30 pills. The associated healthcare provided by the GGD is free. However, the number of spots for this scheme is limited. Many GGDs have waiting lists, and it’s possible that the spots in your region are already filled. Your local GGD can provide you with more information on this. Can’t or don’t want to wait? Obtain PrEP through your general practitioner or your regional HIV treatment center. The costs then vary per pharmacy (see our price list), but it can be as little as about 20 euros per month.

For daily use:
No need to panic! If you use PrEP daily, you can still take the pill up to 12 hours after the scheduled time. If it’s been more than 12 hours, it’s better to skip the pill. Even if you forget to take the pill 1 or 2 times a week, PrEP remains a highly reliable protection against HIV.

For use around sex:
If you use PrEP only around the time of sexual activity, it’s crucial to take your pills on time. Again, you have up to 12 hours after the scheduled time to take the pill. After that, resume the original schedule (i.e., take the next pill 24 and 48 hours after the first two pills).

If you forget to take the pills before having sex or if you’ve missed several pills, you are NOT ADEQUATELY PROTECTED against HIV. In that case, contact the GGD (Public Health Service) or a hospital to discuss whether you may be eligible for a PEP (Post-Exposure Prophylaxis) treatment.

For more information, click here.

YES, in principle, you should take PrEP every day at approximately the same time.
However, it doesn’t have to be very precise. You can take your PrEP a few hours earlier or later than planned, and it will still be highly effective. There are many apps available that can help you remember to take your PrEP (via push notifications), so make smart use of them!

YES, as long as you have taken enough pills after the last time you had sex.
Depending on the dosing schedule, this means taking one pill every day for 2 to 7 days after the last sexual contact. After that, you can safely stop. And if you wish to start again later, you can do so, as long as you follow the dosing schedule rules once more.

Bad idea, don’t do it!
We strongly advise you to use PrEP only with a prescription from a doctor and through a pharmacy. This is especially important to ensure that you do not have HIV. If you already have HIV and you use PrEP, you could develop resistance to the drugs in PrEP. This makes your HIV harder to treat. Additionally, you need to continue taking PrEP for at least 2 days after having sex to be protected against acquiring HIV. These pills are often not available at (sex) parties. Be wise and arrange your PrEP through a doctor in a timely manner.

If your partner has tested negative for HIV and takes PrEP correctly, the chance of them transmitting HIV to you is very small. However, we still advise against relying solely on this method of HIV protection because it requires placing complete trust in your sexual partner. It is better to protect yourself by also using PrEP!

Transgender individuals can use PrEP just as safely as anyone else. It’s essential to know that PrEP does not affect the effectiveness of your hormone treatment, if you are using one. However, there are some slightly different recommendations for taking PrEP for transgender individuals. For more information, please refer to our page on Taking PrEP.

PrEP is a medication you take BEFORE being at risk of HIV. PEP is taken AFTER being at risk of HIV. If you have been at risk of HIV, for example, through condomless and PrEP-less sex with a partner whose HIV status you do not know, you can receive a PEP course within 72 hours after the sexual encounter from your Public Health Service (GGD) or hospital to prevent acquiring HIV. For more information, click here.

Most people do not experience any side effects from PrEP.
Some people may experience one or more of the following symptoms shortly after starting: nausea, diarrhea, vivid dreams, headache, or fatigue. After using PrEP for a few weeks, these symptoms subside for some individuals. This applies to both daily and event-based (around sex) use. However, for some people, the symptoms persist, and it may be a reason to stop taking PrEP.

In some people who use PrEP for a long time, bone strength may decrease. In theory, this could slightly increase the risk of bone fractures, but studies have not yet confirmed this. Since this is a side effect that may only occur after years of PrEP use and because it requires an expensive test that can only be done in a hospital, bone density is not initially monitored. Additionally, this effect is limited and probably smaller than, for example, smoking cigarettes. If you already have brittle bones (osteoporosis), consult your doctor to determine if PrEP is suitable for you.

YES.
PrEP has an effect on cells deep within your body. Even if you get small wounds during sex or experience anal bleeding, PrEP still works just as effectively.

NO.
HIV tests conducted in a laboratory are equally reliable for PrEP users as for non-PrEP users. Only HIV rapid tests may potentially detect an HIV infection at a later stage. Therefore, we recommend getting a regular HIV test, not just an HIV rapid test.

If you get semen in your mouth and swallow it, the risk of contracting HIV is very rare. If HIV enters your stomach, it will undoubtedly be destroyed by stomach acid. If you only engage in oral sex (fellatio) during sexual activities, that alone may not be a reason to use PrEP.

PrEP takes longer to penetrate the vaginal lining. Therefore, if you engage in receptive vaginal sex, the advice is to take 1 pill per day for 7 days before having sex, and then continue with a daily dosing schedule. If you want to stop taking PrEP, make sure to take the last pill 7 days after your last sexual encounter.

NO.
In various studies testing PrEP, PrEP users often had sexually transmitted infections (STIs). Even in these individuals, PrEP still worked remarkably well.

NO, BUT ALMOST!
Of the tens of thousands of people in the world, fewer than 10 individuals are known to have acquired HIV despite using PrEP correctly. There is, therefore, a very small chance that PrEP may not fully protect you. That’s why it’s essential to get regular HIV testing even while using PrEP. If you have contracted HIV, it can be promptly treated. In PrEP studies, HIV infections often occurred in individuals who did not use PrEP correctly, forgot to take the pills, or stopped taking them. PrEP only works when you take the pills correctly! If you stop using PrEP, remember to use other forms of protection, such as condoms.

There are different brands of PrEP available in the market. The appearance of the pills may vary from brand to brand. However, the active ingredient and dosage are always the same (Emtricitabine and Tenofovir disoproxil 200/245 mg). Usually, you will receive the same brand from the pharmacy, but occasionally, it may change. This does not affect its effectiveness: all brands provide the same level of protection against HIV in the same way. However, there might be differences in side effects due to variations in inactive ingredients. Most people experience little to no side effects, even when switching brands.

Yes, in consultation with your pharmacy. In most cases, this is not a problem, but some medications may interact with PrEP, causing one or both to work less effectively or leading to (additional) side effects. Often, there is a solution available, such as using sufficient time between the intake of both medications or switching to an alternative drug. Your pharmacy is responsible for monitoring drug interactions. Therefore, make sure to obtain PrEP from your regular pharmacy if you are also taking other medications.

NO.
The use of alcohol, drugs, or Viagra does not affect the effectiveness of PrEP. However, it’s possible that XTC (ecstasy) may have a stronger effect at a dose you were accustomed to before starting PrEP. If you combine PrEP with XTC, try not to take too much XTC the first time to see how it affects you.

Other medications (prescription or over-the-counter) may sometimes not be suitable to be used together with PrEP. Always consult with your doctor if you are taking any medications to ensure they can be safely used alongside PrEP.

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

It is of the utmost importance that you do not have HIV when starting PrEP. The substances used in PrEP are also used in combination with other HIV drugs to treat HIV. If you take PrEP while already having HIV, your HIV will only be partially treated, and there is a chance that your HIV will become resistant to the substances in PrEP. This makes your HIV treatment more challenging and may result in you transmitting this resistant HIV to others, including someone using PrEP. Therefore, get tested for HIV every 3 months. Learn more about HIV here.

In rare cases, PrEP can lead to a reduction in kidney function. You may not notice if your kidneys are not working well until it’s too late. That’s why you should have your kidney function checked by a doctor before and during the use of PrEP. If your kidney function worsens due to PrEP, you should stop using it, and your kidney function will recover. Therefore, make sure to get your kidney function tested every 3 months.

PrEP only protects against HIV, so you can still contract other STIs, sometimes without even noticing it. By promptly treating these STIs, you ensure that you don’t transmit them to your sexual partners. If everyone gets tested for STIs every 3 months, it helps reduce the circulation of STIs, resulting in fewer chances for everyone to acquire them. Read more about STIs here.

Hepatitis C is more common among people who use PrEP. There is no vaccination for hepatitis C, but there is a treatment available. If hepatitis C is diagnosed in you, insist on prompt treatment. This is beneficial for your own health and also prevents you from transmitting the virus to your partners. Read everything about hepatitis C here and how to minimize the risk of infection.

Most men have been vaccinated against hepatitis B or have become immune because they have had the virus before, and their immune system has cleared it. However, in a few individuals, the virus remains present, leading to a chronic hepatitis B infection. In such cases, you can only use PrEP on a daily basis. PrEP also serves as a treatment for hepatitis B, so you should not stop it without consulting a doctor first.
Before starting PrEP, you should get tested once to determine your hepatitis B status. If you have not been vaccinated yet, it is advisable to get vaccinated as soon as possible. You can get vaccinated for free at the GGD’s STI clinic. Read more about hepatitis B here.