Why PrEP?

You take PrEP because you want to protect yourself against HIV.

Other methods to avoid contracting HIV are:

  • never have sex
  • Only have sex with people who are 100% certain they do not have HIV.
  • Only have sex with people with HIV who have a suppressed viral load.
  • Always use a condom during intercourse.

The question you need to ask yourself is: am I at risk of HIV? Be honest with yourself.”

PrEP is for everyone. For heterosexual, homosexual, and bisexual individuals, for men and women, cisgender, transgender, and non-binary. There is a difference in PrEP usage though:

  • Men and other people with a penis take 2 pills on day one, and then 1 pill every 24 hours. Two hours after the first dose, you are protected against HIV. If you want to stop taking PrEP, continue taking 1 pill every 24 hours until at least 2 days after the last time you had sex without a condom. Alternatively, if you prefer to start with 1 pill on the first day, you will be protected against HIV after using PrEP for 5 days.
  • Women and other people with a vagina take 1 pill on day one, and then 1 pill every 24 hours. It takes 7 days for PrEP to provide protection against HIV, as it needs more time to penetrate the vaginal lining. If you want to stop taking PrEP, continue taking it for an additional 7 days after the last time you had sex without a condom. If you only have anal sex, the extra start-up and tapering time does not apply, and you can follow the schedules for people with a penis.
  • No more fear of HIV
  • No feelings of guilt when not using a condom occasionally
  • A more enjoyable sexual experience
  • Increased confidence in your own actions
  • Never reliant on someone else’s condom use
  • If you undergo an STI test every 3 months and contract something, you will be treated immediately

Whether you should use PrEP is a personal choice. It is wise to make this decision well-informed. In making this decision, consider at least these two factors: how important is it to remain HIV-negative? And what is the likelihood of contracting HIV?

HIV is currently very well treatable, with usually just one pill per day being sufficient. Most people experience no side effects from these medications, live as long as someone without HIV, and with a suppressed viral load, people with HIV cannot transmit the virus.

However, it is still better not to contract HIV because:

  • You HAVE TO take pills every day for the rest of your life. With PrEP, you can stop whenever you want.
  • You need to remain under the care of a specialist at the hospital for the rest of your life.
  • Many people with HIV experience stigma.
  • If you don’t start HIV treatment on time, you can develop AIDS.
  • Your health may be worse in later life if you have lived with an untreated HIV infection for a long time.
  • Before you start treatment and have not yet achieved a suppressed viral load, you can transmit HIV to your sexual partners, putting their health at risk.

In 2021, 6 out of 10 HIV diagnoses in the Netherlands were among men who have sex with men.

If you are a man who has sex with men, you have a considerable risk of contracting HIV in the Netherlands.

As a man who has sex with men, it is advisable to use PrEP unless:

  • ALWAYS use a condom during intercourse, even with your regular partner.
  • You do not always use a condom, but you are 100% certain that your sexual partner is HIV-negative and has no chance of contracting HIV from another sexual partner.
  • You do not always use a condom, but you know that your sexual partner has HIV with a suppressed viral load. Someone with a suppressed viral load cannot transmit the virus

Three out of ten HIV diagnoses in the Netherlands are made in women and men who only have heterosexual sex. Since there are many more women and heterosexual men than men who have sex with men, the chances of acquiring HIV in the Netherlands as a woman or heterosexual man are particularly low.

As a woman or man who only has sex with women, it is not necessary to use PrEP unless, for example:

  • When you, as a woman, have sex with a man who also has sex with men.
  • When you have sex with people from or in a country where HIV is prevalent (e.g., in parts of Southern Africa or Southeast Asia).
  • When you are a sex worker and do not always use condoms.
  • When your partner has HIV without a suppressed viral load. Someone with a suppressed viral load cannot transmit the virus

Unfortunately, there is limited information about the risk of HIV for transgender individuals in the Netherlands. In other parts of the world (such as the United States), the risk is considered high for trans women.

Of course, everything depends on the people you have sex with. Our advice is to read the above chapters on ‘homosexual sex’ and ‘heterosexual sex’ and make a thoughtful assessment for yourself. This also applies to taking PrEP. For more information, read ‘How do I take PrEP?’

PS: In order to maintain clarity in the chapters on ‘homosexual sex’ and ‘heterosexual sex,’ we have chosen not to use inclusive language, for which we apologize.

On Facebook, you can join the Facebook group #PrEPNu. It is a closed group that you need to become a member of. People who are not in the group cannot see who the members are and cannot follow the discussions.

If you have a question that you want to be answered by an expert, send an email here or send a message to the regular Facebook page of PrEPnu.