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.
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- 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.)
- Take 2 pills the first time and from then on 1 pill every day.
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- If you want to stop taking PrEP, keep taking pills every day until 2 days after the last time you had sex.
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- 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.)
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- 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 every day:
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- 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.
- Advantage of taking PrEP ‘around sex’:
People with a vagina
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
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
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
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- Before starting PrEP, and a month after starting PrEP, you must get tested for:
· HIV
· Kidney function
- Before starting PrEP, and a month after starting PrEP, you must get tested for:
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- Before starting PrEP, you must also get tested for:
· Chlamydia
· Gonorrhea
· Syphilis
· Hepatitis B
· Hepatitis C
- Before starting PrEP, you must also get tested for:
- 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.