Everything you need to know about PrEP in The Netherlands

Prep is increasingly used as a way to prevent hiv. But what exactly is it, how do you use it safely, and who is eligible? We list the most important questions and answers for you.

What is prep?

Prep stands for pre-exposure prophylaxis. It is a medication that prevents hiv. By using prep, someone who is hiv-negative can protect themselves against an hiv infection. The pill contains the same active ingredients (tenofovir and emtricitabine) as medications used by people with hiv, but in a lower dose.

Prep is intended for people at increased risk of hiv, such as men who have sex with men (MSM), trans individuals, and people with multiple sexual partners or changing contacts.

How does prep work?

The medications in prep prevent the hiv virus from establishing itself in the body. When used correctly, prep can reduce the risk of hiv by more than 99%.

There are two ways to use prep:

• Daily use: take one pill every day.

• Use around sex: a flexible method where you take two pills up to two hours before sexual contact, and one pill per day for the two days after.

Which method is suitable depends on your sex life and preference. Your doctor or GGD can help determine what suits you best.

Is PrEP safe?

Yes, PrEP is generally safe and well-researched. Most users experience no or mild side effects, such as slight nausea or headache in the first weeks. It is important to have regular medical check-ups: usually every six months. During these, your kidney function and HIV status are checked, and tests for STIs are conducted.

According to the GGD and Soa Aids Nederland, long-term use of PrEP is safe, provided it is done under supervision.

What should I pay attention to if I want to use PrEP?

• Get tested for HIV and STIs (including hepatitis B) before you start.

• Always use PrEP under medical supervision, not via the internet or friends.

• Consider combining PrEP with condom use to also protect yourself against other STIs.

• Stick to the schedule (daily or around) and do not skip doses.

How do you use PrEP?

You take PrEP as a tablet, but there are also new developments. The American FDA has now approved an injectable form of PrEP: one injection every six months, which reduces the risk of HIV by 96%. This form is gradually being introduced in the United Kingdom as well. In the Netherlands, research is being conducted on when this option can become available.

Until then, the pill form is the most common. Those who use PrEP must return every six months for check-ups and new medication.

How can I get PrEP?

Since 2015, PrEP is gradually becoming more accessible in the Netherlands. The public health services (GGD) provide PrEP to people at increased risk, but there are still issues with waiting lists.

You can:

• Register with the GGD in your region (note: most GGDs have waiting lists).

• Get PrEP on prescription through your general practitioner or a commercial provider (such as Dokteronline.nl).

• The costs vary: at the pharmacy, 30 pills cost between 25 and 50 euros. On PrEPnu.nl you can find a handy list of pharmacies, including the price at which the respective pharmacy offers PrEP.