PrEP (the combination tenofovir/emtricitabine) prevents an HIV infection. Because it does not protect against other STIs and because it can strain the kidneys, PrEP use comes with standard medical monitoring. So this is not about the pills themselves, but the checks around them.
What does PrEP monitoring involve?
- An HIV test (must be negative to start and continue PrEP safely).
- An STI screen for chlamydia, gonorrhoea and syphilis, with chlamydia/gonorrhoea at three sites (throat, urine, anus).
- Kidney function (creatinine and eGFR).
- Hepatitis B at baseline (vaccination if not yet protected) and hepatitis C for those at higher risk.
Triple-site: why three locations?
PrEP users more often have throat and anal chlamydia or gonorrhoea infections, which cause no symptoms and are missed by a urine-only test. That is why all three sites are sampled at every check.
How often?
First a baseline at the start, then an HIV test after one month. Under the current Dutch guideline (revised in 2024) HIV and STIs are then generally checked every six months; more often with symptoms or higher risk. Kidney function is checked at least annually, and more often for people aged 50+ or with reduced kidney function. Note: before 2024 three-monthly monitoring was standard, and some commercial providers still use that schedule.
Where: GGD, GP or home
Since 1 August 2024, PrEP care (consults and the HIV, STI and kidney checks) is free at the GGD for everyone at elevated HIV risk; you pay for the pills yourself via the pharmacy (about €17–€30 per month). However, many GGDs have waiting lists. The GP can also manage PrEP, without a waiting list, but then the lab costs count toward your deductible. Private and online providers work without a wait, but are more expensive.
The limit of home testing
Much of the monitoring can be done at home: self-collected swabs for chlamydia and gonorrhoea at three sites, an HIV rapid test via finger-prick and often hepatitis C via finger-prick too. Kidney function, however, usually requires venous blood, which cannot reliably be done fully at home. So a home kit covers most STI and HIV monitoring, but usually does not replace the kidney-function check.
Costs at a glance
Via the GGD the monitoring is free and you only pay for the pills. Via the GP the lab costs run through your deductible (€385 in 2026). Online providers charge roughly €500–€720 a year for a complete pathway including pills; some private clinics more.
This information is general and was compiled with care from public sources, but it does not replace medical advice. For symptoms or doubt, always consult a doctor.
