PrEP FAQ

GGD STI clin­ics offer PrEP for €7,50 per 30 pills as part of the nation­al PrEP pro­gramme. All asso­ci­at­ed care is free of charge at the GGD. How­ev­er, the nation­al PrEP pro­gramme has a lim­it­ed capac­i­ty. Many GGD clin­ics have wait­ing lists, and it could be that the GGD in your region has run out of spots alto­geth­er. Your local GGD can give you all infor­ma­tion on the pos­si­bilites. If you can’t or don’t want to wait, ask your GP to pre­scribe PrEP. Prices dif­fer between phar­ma­cies (see our price list), start­ing at about €20 a month.

When using daily:
Don’t pan­ic! If you use PrEP dai­ly, you can take your pill up to 12 hours after you should have tak­en it. If more than 12 hours have passed, it is bet­ter to skip the pill. Even if you for­get your pill once or twice a week, PrEP remains a very reli­able pro­tec­tion against HIV.

When using around sex:
If you only use PrEP around sex, it is more impor­tant to take your pills on time. The same rule as above applies: take your pill up to 12 hours after you should have tak­en it. You then take the next pill accord­ing to the orig­i­nal sched­ule (that is, 24 and 48 hours after tak­ing the first two pills).

If you for­got the pills before sex or you for­got mul­ti­ple pills, you are NOT SUFFICIENTLY PROTECTED against HIV. In this case, you should con­tact your GGD or hos­pi­tal, and dis­cuss if you need a PEP treat­ment. Click here for more infor­ma­tion about PEP.

YES, you should take PrEP at approx­i­mate­ly the same time every day.
But the exact time is not so impor­tant. You can also take your PrEP a few hours ear­li­er or lat­er than planned, and it will still be very effec­tive. There are many apps avail­able to remind you to take your PrEP (via push noti­fi­ca­tions), you can make good use of these!

YES, as long as you’ve tak­en enough pills since you last had sex.
Depend­ing on the sched­ule you use, this means tak­ing a pill a day for 2 to 7 days after you last had sex. After that you can always safe­ly stop PrEP. And of course start again at a lat­er time if you want, pro­vid­ing you adhere to the appro­pri­ate sched­ule when start­ing PrEP as well.

Bad idea, don’t do it!
We advise to only use PrEP with a pre­scrip­tion, through a doc­tor and phar­ma­cy. The most impor­tant rea­son is that you need to be sure that you do not have HIV. If you have HIV and use PrEP, then your HIV virus can become resis­tant against the med­ica­tion in PrEP. This makes your HIV hard­er to treat. Also, you need to use PrEP for at least two days after sex; this is the only way you are pro­tect­ed against HIV infec­tion. Those pills are usu­al­ly not avail­able at a (sex) par­ty. Be smart and arrange your PrEP ahead of time, through a doctor.

If your part­ner has test­ed HIV-neg­a­tive and uses PrEP cor­rect­ly, the odds are very low that he can infect you with HIV. We still do not rec­om­mend using this as a method of pro­tec­tion against HIV, because it requires you to trust your sex­u­al part­ner com­plete­ly. A bet­ter strat­e­gy is to pro­tect your­self by also get­ting on PrEP yourself!

Trans peo­ple can use PrEP just as safe­ly as any­one else. It is good to know that PrEP does not influ­ence the effi­ca­cy of your hor­mone replace­ment ther­a­py, if you use this. Some dif­fer­ences do apply to the advice on the meth­ods of using PrEP for trans peo­ple. FOr this, see our page How do I use PrEP.

PrEP are pills you take BEFORE being at risk for HIV. PEP is a treat­ment for AFTER being at risk for HIV. For exam­ple, if you had sex with­out con­doms or PrEP with a part­ner whose HIV sta­tus you do not know, you are at risk for HIV. If so, you can get a PEP treat­ment for the first 72 hours after the sex through your GGD clin­ic or hos­pi­tal, to pre­vent you from get­ting HIV. Click here for more infor­ma­tion about PEP.

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.

In some peo­ple who use PrEP for a long time, bone strength can decrease. In the­o­ry, this can put you at a slight­ly high­er risk for bone frac­tures, but this hasn’t been defin­i­tive­ly proven. Since this is a side effect that only caus­es a prob­lem after using PrEP for years, it is not test­ed for ini­tial­ly. Also, the effect is lim­it­ed: by com­par­i­son, smok­ing cig­a­rettes would prob­a­bly have a larg­er effect. If you already have osteo­poro­sis, dis­cuss with your doc­tor if PrEP is appro­pri­ate for you.

YES.
PrEP works on the cells deep inside your body. Even if you get skin lesions dur­ing sex or expe­ri­ence anal blood loss, PrEP still works equal­ly well.

NO.
HIV tests that are per­formed in a lab­o­ra­to­ry are equal­ly reli­able for peo­ple who use PrEP com­pared to peo­ple who do not use PrEP. With rapid HIV-tests it can take longer to detect a poten­tial ongo­ing HIV infec­tion. We rec­om­mend you to get a reg­u­lar HIV test, and not just a rapid HIV-test.

The chances of get­ting HIV from swal­low­ing cum are very low. When HIV gets to your stom­ach it is killed instant­ly by the acids in your stom­ach. If you only have oral sex it is not nec­es­sary to use PrEP.

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.

NO.
In sev­er­al research tri­als that test­ed PrEP, peo­ple who used PrEP reg­u­lar­ly had STD’s. PrEP also worked remark­ably well for these people.

NO, BUT ALMOST!
Out of tens of thou­sands of peo­ple who use PrEP world­wide, less than 10 peo­ple are known to have con­tract­ed HIV while using PrEP cor­rect­ly. There is a very small chance that PrEP does not pro­tect you well. This is also why you need to get test­ed for HIV reg­u­lar­ly when you are on PrEP. If you con­tract HIV, this can be treat­ed quick­ly and well. HIV infec­tions did occur in the PrEP research tri­als with peo­ple who did not use their PrEP cor­rect­ly, or for­got to use it. PrEP only works if you actu­al­ly take the pills in the cor­rect way!

There are sev­er­al brands of PrEP on the mar­ket. What the pills look like may dif­fer from brand to brand. The active ingre­di­ent and dosis are always the same how­ev­er (Emtric­itabine and Teno­fovir diso­prox­il 200/245 mg). Your phar­ma­cy will usu­al­ly sup­ply the same brand every time, but there may be changes. This doesn’t make a dif­fer­ence for the effec­tive­ness of PrEP: all brands pro­tect you against HIV in the same way. There can be a dif­fer­ence in side effects because of dif­fer­ent addi­tives in the pills. Most peo­ple expe­ri­ence no or few side effects, also when switch­ing brands.

Yes, in con­sul­ta­tion with your phar­ma­cy. Many phar­ma­ceu­ti­cals can be tak­en with PrEP with­out any issues, but in some cas­es there may be inter­ac­tions caus­ing one of the drugs to be less effec­tive or lead­ing to (extra) side effects. Often­times a solu­tion can be found in leav­ing enough time between tak­ing both meds or switch­ing to an alter­na­tive drug. Your phar­ma­cy is respon­si­ble for mon­i­tor­ing inter­ac­tions. It is there­fore impor­tant to get PrEP at your reg­u­lar phar­ma­cy if you also take oth­er medication.

NO.
Using alco­hol, drugs or Via­gra does not change the effec­tive­ness of PrEP. It is pos­si­ble that XTC has an increased effect at the dos­es you were used to before using PrEP. If you com­bine PrEP and XTC, use a small­er dose of XTC the first time, to see how it goes.

Oth­er med­ica­tions (from the phar­ma­cy or drug­store) some­times can­not be used togeth­er with PrEP. Always dis­cuss with your doc­tor if you use oth­er med­ica­tions, to see if it goes togeth­er with PrEP.

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

It is enor­mous­ly impor­tant that you do not have HIV when you start PrEP. The med­ica­tions in PrEP are used in com­bi­na­tion with oth­er med­ica­tions to treat HIV. If you use PrEP but already have HIV, then your HIV is only treat­ed part­ly, and you are at risk that your HIV becomes resis­tant against the med­ica­tion in PrEP. This makes your HIV treat­ment more dif­fi­cult and may lead to you trans­mit­ting HIV to some­one else, even some­one who uses PrEP. Get test­ed for HIV every 3 months. Read more about HIV here.

In rare cas­es, PrEP can lead to a decrease in kid­ney func­tion. You won’t notice that your kid­ney func­tion is dete­ri­o­rat­ing until it is too late. This is why you need to get your kid­ney func­tion checked, both before and dur­ing use of PrEP. If your kid­ney func­tion gets worse because of PrEP, stop using PrEP, and your kid­ney func­tion will recov­er. Get your kid­ney func­tion test­ed every 3 months.

PrEP only pro­tects against HIV, so you can still con­tract oth­er STDs, some­times with­out notic­ing it. By treat­ing these STDs prompt­ly, you ensure that they are not trans­mit­ted to oth­er sex­u­al part­ners. If every­one gets test­ed for STDs every 3 months, then few­er STDs will go around, and the risk of get­ting an STD will decrease for every­one. Read more about STDs here.

Hepati­tis C occurs more often with peo­ple who use PrEP. There is no vac­ci­na­tion against Hepati­tis C, but there is a treat­ment. If a test shows that you have Hepati­tis C, make sure you get treat­ed quick­ly. This is good for your own health, and pre­vents you from trans­mit­ting the virus to your part­ners. Read every­thing about Hepati­tis C here, includ­ing how to make the risk of infec­tion as low as possible.

Most men are vac­ci­nat­ed against Hepati­tis B, or have acquired immu­ni­ty because they had the virus and their own immune sys­tem has killed it. In rare cas­es, the virus stays in the body: this is called chron­ic Hepati­tis B. In this case, you can only use PrEP dai­ly. PrEP is also a treat­ment for Hepati­tis B, and you should ask your doc­tor before you stop tak­ing PrEP. Before start­ing PrEP, you need to get test­ed for Hepati­tis B once. If you have not been vac­ci­nat­ed yet, make sure to get this done as soon as pos­si­ble. This is free at a GGD STD clin­ic. Read more about Hepati­tis B here.