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

                     Please scroll down for addi­tion­al infor­ma­tion for trans peo­ple who use hor­mone therapy.

    • Take 2 pills the first time and from then on 1 pill every day.
      You are pro­tect­ed from HIV start­ing 2 hours after tak­ing the first two pills.
      (Pre­fer to start with 1 pill on the first day? In that case, you are pro­tect­ed from HIV after 5 days of using PrEP.)


    • If you want to stop tak­ing PrEP, keep tak­ing pills every day until 2 days after the last time you had sex.


    • If you start using PrEP again, use the same sched­ule. (That is: 2 pills on day one and then 1 pill every day, until 2 days 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

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.

If you start using PrEP again, fol­low the same sched­ule. That is, take 1 pill dai­ly for 7 days before sex and then dai­ly until 7 days after the last time you had sex.

If you have a vagi­na but only prac­tise recep­tive anal sex, you can fol­low the same sched­ules pro­vid­ed for peo­ple with a penis.

When using hormone replacement therapy

Using PrEP does not affect hor­mone replace­ment therapy.

The oth­er way around, hor­mones com­mon­ly used by trans women can slight­ly low­er the lev­els of PrEP in your sys­tem. In that case, PrEP is still just as effec­tive when tak­en dai­ly. Using PrEP only around sex is how­ev­er not suit­able for trans women. The advice is to use PrEP for 7 days before hav­ing sex. And also to con­tin­ue tak­ing 1 pill a day for 7 days after you last had sex if you want to stop using PrEP.

Hor­mones com­mon­ly used by trans men do not affect the lev­els of PrEP in your body. That said, for many trans men only dai­ly PrEP use is suit­able. See for exam­ple the advices for peo­ple with a vagi­na.

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

    • 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
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.

Your doc­tor will not give you a new pre­scrip­tion if you have not been test­ed, mean­ing it is impor­tant to keep track and make sure you make doctor’s appoint­ments in time.