First, there is an intake with the doctor where the ins and outs of PrEP are discussed with you. If there is an indication for PrEP and all tests are good before starting treatment, you will receive a 3-month prescription that will be sent to your own pharmacy or a nationwide online pharmacy. For a list of pharmacies and prices, visit https://www.prepnu.nl/prijs/.

Tests must be repeated every 3 months. If requested and depending on your personal situation, this period may be extended if necessary.

Please note that keeping appointments is important for your safety. If you do not keep the appointments, we will not give you a new prescription.

The most common side effects are headache, nausea and gastrointestinal upset. These side effects often occur with daily use, but they usually disappear within a week or a few weeks. Because there is a small chance of adverse effects on kidney function, we recommend regular blood checks. If you experience side effects always discuss this with your practitioner before you decide to stop.

Several tests should be done when starting the treatment:

- blood tests: HIV, kidney function, syphilis, hepatitis B and hepatitis C
- STD testing: chlamydia and gonorrhea; from throat, urine and anus (if applicable)

One month after starting, a small examination should be done:

- blood test: HIV

Then every 3 months (or by agreement after a longer period) the following tests:

- blood tests: HIV, syphilis
- STD testing: chlamydia and gonorrhea; from throat, urine and anus

With increased risk (such as intravenous drug use, chemsex or group sex), additional testing should be done every 6 months:

- blood tests: hepatitis C

Every 12 months, additional testing should be done in every PrEP user:

- blood tests: renal function on indication, hepatitis C

Test samples wil be processed by Diagnovum. Check www.diagnovum.nl for test locations near you and the costs. The costs of tests are initially paid for by your health insurance, but you might have to pay for your "own risk" (eigen risico) at the end of the year. Please contact your health insurance company for more information about "own risk". After a consultation with one of our doctors, you will be given new test forms and materials for the next check-up.

For daily use: If you forget a pill, take it again within 12 hours. If it has been more than 12 hours, take the next pill at the usual time to stay protected.

For "on-demand" or intermittent use: If you have not taken the PrEP pills beforehand, always use a condom. If you forgot the PrEP after the risk contact, take it within 12 hours. If it is longer than 12 hours, or if you think there is still a risk of HIV infection, contact the GGD or out-of-office hours GP care (huisartsenpost) to arrange PEP if necessary. PEP stands for "Post-Exposure Prophylaxis" and involves a heavier regimen of multiple medications for 4 weeks.

If an STD is unexpectedly diagnosed, we will see if treatment with tablets is possible, so you can get the treatment at your own pharmacy. If other treatment is needed, you will be referred back to your GP or the best treatment options will be considered in consultation. In the case of an HIV diagnosis, you will be referred to a specialized HIV treatment center.