Taking PrEP

If you are transgender and using hormones, then scroll down below.

• Take 2 pills the first time, and from that point forward, take 1 pill every day. Two hours after that initial dose, you are protected against HIV. (If you prefer to start with 1 pill on the first day, you will also be protected against HIV after using PrEP for 5 days.)
• If you want to stop taking PrEP, continue taking one pill every day for at least 2 days after the last time you had sex without a condom.
• If you start using PrEP again, follow the same schedule. (So, on day one, take 2 pills, and then take 1 pill every day until 2 days after the last sexual encounter.)
• Advantages of taking it daily: Due to the routine, you are less likely to forget to take your pill, and you can also have sex at unexpected moments.
• Advantages of ‘around the sex’ dosing: If you don’t have sex frequently or can plan your sexual encounters well, it can be more cost-effective, and you need to take fewer pills overall. However, please note: PrEP ‘around the sex’ is not suitable for people who occasionally (for example, in a drunken state) have unplanned sex without a condom.

PrEP takes longer to penetrate the vaginal wall. If you engage in receptive vaginal sex, the advice is to take 1 pill per day for 7 days before having sex and then continue with a daily schedule.

If you want to stop taking PrEP, make sure to take the last pill 7 days after your last sexual encounter.

If you start using PrEP again, follow the same schedule. So, take 1 pill per day for 7 days before having sex, and then continue daily until 7 days after the last sexual encounter.

If you have a vagina but only engage in receptive anal sex, follow the advice and schedule for people with a penis.

The use of PrEP does not affect your hormone treatment.

On the other hand, the hormones used by transgender women can slightly reduce the amount of PrEP in your body. PrEP is still equally effective if taken daily in such cases. However, taking PrEP around the sex is not recommended for transgender women. The advice is to take 1 pill per day for 7 days before having sex. If you want to stop taking PrEP after your last sexual encounter, continue taking 1 pill per day for 7 more days.

The hormones used by transgender men do not affect the amount of PrEP in your body. For many transgender men, taking PrEP daily is suitable for other reasons. For more information, refer to the advice for people with a vagina, among others.

Most people do not experience any side effects from PrEP.

Some people may have one or more of the following symptoms shortly after starting: nausea, diarrhea, vivid dreams, headache, or fatigue.

After using PrEP for a few weeks, these symptoms subside for some individuals. This applies to both daily use and use around the sex. For some people, the symptoms persist, and it may be a reason to stop taking PrEP.

Costs To save costs, you can get tests for HIV, chlamydia, gonorrhea, syphilis, and hepatitis B for free at your local GGD or arrange this online through Testlab van MantotMan.

Testing your kidney function is usually only possible at the general practitioner’s office, and if you also get tested for hepatitis C there, it may cost you approximately €15 in total from your deductible.

Naturally, you can have all tests done at the general practitioner’s office, but the costs for STI tests will be deducted from your deductible. Expect a cost of approximately €210 for the whole package each time. Once you have reached your deductible limit, it doesn’t matter where you get the tests done; they will be covered by your health insurance.

Read more about why these tests are necessary in the frequently asked questions section.

IMPORTANT: If you are using PrEP, make sure to get tested for HIV, kidney function, chlamydia, gonorrhea, syphilis, and hepatitis C EVERY 3 MONTHS.

You won’t receive a new prescription from your doctor if you haven’t done these tests, so it’s essential that you keep track of these tests yourself and schedule a new appointment with your doctor on time.