Pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) are highly effective biomedical interventions that reduce the risk of HIV infection. In the Netherlands, access to these medications has expanded significantly in recent years, particularly for men who have sex with men (MSM) and other high-risk groups. This article provides a detailed, evidence-based overview of how to obtain PrEP and PEP in the Netherlands, covering eligibility, costs, clinic procedures, and practical tips for integration with safer sex practices.

What Are PrEP and PEP?

PrEP (pre-exposure prophylaxis) involves taking a daily pill (or, more recently, an event-driven regimen) containing tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC), sold under the brand name Truvada or generic equivalents. When taken consistently, PrEP reduces the risk of HIV infection by over 90% for sexual transmission and over 70% for injection drug use. PEP (post-exposure prophylaxis) is a 28-day course of antiretroviral medication taken after a potential HIV exposure (e.g., condom break, needle stick) and must be started within 72 hours to be effective.

PrEP Access in the Netherlands

Eligibility and Risk Assessment

In the Netherlands, PrEP is recommended for individuals at substantial risk of HIV, including:

  • Men who have sex with men (MSM) with condomless anal sex with multiple partners
  • Transgender women who have sex with men
  • Sex workers
  • Individuals with a partner living with HIV who is not virally suppressed
  • People who inject drugs and share equipment

Eligibility is assessed during an intake appointment at a sexual health clinic (GGD) or a specialized HIV treatment center. You will be asked about your sexual behaviour, number of partners, condom use, and any recent STI diagnoses. A negative HIV test is required before starting PrEP.

Where to Get PrEP

PrEP is available through:

  • GGD sexual health clinics (Gemeentelijke Gezondheidsdienst) in major cities like Amsterdam, Rotterdam, The Hague, Utrecht, and others. These clinics offer free or low-cost PrEP through the national PrEP pilot program.
  • HIV treatment centers at university hospitals (e.g., Amsterdam UMC, Erasmus MC, UMC Utrecht). These centers also provide PrEP for individuals with complex medical needs.
  • General practitioners (huisarts) who are trained in PrEP prescribing. However, many GPs refer patients to GGD clinics due to the specialized monitoring required.

Costs and Insurance

Until 2024, the Dutch government funded a PrEP pilot program that provided PrEP medication for free (or a small co-payment) at GGD clinics, with a limited number of slots. As of 2025, the program continues but with changes: the medication itself is free for those enrolled, but you must pay for the quarterly consultations and lab tests (STI screening, kidney function, HIV test). These costs vary by clinic but typically range from €20 to €50 per visit. If you have Dutch health insurance (basisverzekering), the consultation and lab costs may be partially reimbursed from your deductible (eigen risico). The PrEP medication is not covered by standard insurance but is provided free through the government program. For those not in the program, PrEP can be obtained via a specialist prescription and purchased at a pharmacy; the cost of generic Truvada is about €50–€70 per month out-of-pocket.

Step-by-Step PrEP Process at a GGD Clinic

  1. Make an appointment online via the GGD website or by phone. Specify that you are interested in PrEP.
  2. Attend the intake consultation (30–60 minutes) with a nurse or doctor. They will discuss your risk, test for HIV and other STIs, and check kidney function (blood test).
  3. Receive a 3-month supply of PrEP medication (generic Truvada) if you are eligible and test negative.
  4. Schedule follow-up visits every 3 months for repeat HIV/STI testing, kidney function monitoring, and medication refill.
  5. Adhere to the regimen: either daily dosing (one pill every day) or event-driven dosing (2 pills 2–24 hours before sex, then 1 pill 24 hours later, then 1 pill 48 hours after the first dose).

Event-Driven PrEP (On-Demand)

The Netherlands officially supports event-driven PrEP for cisgender men who have sex with men. This regimen involves taking a double dose (2 pills) 2–24 hours before anticipated sex, then a single pill 24 hours after the first double dose, and another single pill 24 hours later. It is not recommended for vaginal or receptive anal sex for people with a vagina due to lower efficacy. Discuss with your provider which regimen suits your lifestyle.

PEP Access in the Netherlands

When and How to Get PEP

PEP must be started within 72 hours of a potential HIV exposure, ideally within 24 hours. In the Netherlands, PEP is available through:

  • Emergency departments (SEH) of hospitals – available 24/7.
  • GGD sexual health clinics during opening hours (often 8:30–17:00 on weekdays).
  • General practitioners (huisarts) who can prescribe PEP and refer you to a pharmacy.

If you have a high-risk exposure (e.g., condom break with a partner of unknown HIV status, needle stick injury), go immediately to the nearest hospital emergency department. Do not wait for a GP appointment.

PEP Medications and Cost

The standard PEP regimen in the Netherlands is a 28-day course of Truvada (tenofovir/emtricitabine) plus Isentress (raltegravir) or Tivicay (dolutegravir). The medication is provided free of charge at GGD clinics and hospital emergency departments for eligible exposures. If you obtain PEP through a GP, the medication costs about €200–€400 out-of-pocket, but may be partially covered by insurance (check with your insurer).

PEP Process

  1. Seek care immediately – call the GGD or go to a hospital ER. State that you need PEP after a potential HIV exposure.
  2. Risk assessment – a healthcare provider will evaluate the exposure (type of contact, HIV status of source if known, time elapsed).
  3. HIV test – you must test negative for HIV before starting PEP.
  4. Receive a 28-day supply of medication and instructions on adherence (usually 1–2 pills twice daily).
  5. Follow-up testing – you will need HIV tests at 4 weeks and 12 weeks after exposure to confirm you are negative.

Important Notes on PEP

PEP is not 100% effective; adherence is crucial. Side effects (nausea, diarrhea, fatigue) are common but usually manageable. Do not stop PEP early unless advised by a doctor. PEP does not protect against other STIs; use condoms and get tested.

Integrating PrEP and PEP with Safer Sex Practices

PrEP and PEP are powerful tools, but they do not prevent other sexually transmitted infections (STIs) such as chlamydia, gonorrhea, syphilis, or hepatitis C. Regular STI testing (every 3 months for PrEP users) is essential. Combining PrEP with condom use provides the highest level of protection. For more on safe dating practices, see our complete guide to safe adult dating in the Netherlands.

Discussing PrEP and STI testing with partners can be challenging. Learn how to talk about STIs with your partner effectively. Setting boundaries around safer sex is also important – read our article on setting boundaries early.

Common Questions and Misconceptions

Is PrEP safe?

Yes, PrEP is safe for long-term use. The main side effect is mild kidney function decline, which is monitored via blood tests every 3 months. Bone density loss can occur but is reversible after stopping PrEP. Serious side effects are rare.

Can I get PrEP if I am undocumented?

Yes, the GGD clinics provide PrEP regardless of insurance or residency status. The medication is free, and consultations are low-cost. Your data is kept confidential and not shared with immigration authorities.

Do I need a referral?

No, you can directly contact a GGD sexual health clinic or hospital ER. For PrEP, some GGDs require you to be registered in the Netherlands, but many accept walk-ins.

Additional Resources

For more on recognizing red flags in dating, see our article on red flags in communication. If you suspect you've been exposed to HIV through a scam or assault, learn how to report scams to Dutch police.

Related Articles

  • The Complete Guide to Safe Adult Dating in the Netherlands
  • STI Testing in the Netherlands
  • Talking About STIs with Your Partner
  • Setting Boundaries Early
  • Red Flags in Communication