Medical tests and checkups for PrEP users

Medical checkups are very important when taking PrEP. Get tested for HIV, kidney function and STIs before you start and while you are taking it. Your family doctor and some GGDs (local Public Health Services) can arrange these tests for you.

Make sure that you do not have (acute) HIV, before starting PrEP

PrEP is safe as long as you are certain that you do not have HIV. If you do have HIV, the HIV inhibitors in PrEP are not enough for proper treatment. So get tested for HIV at a laboratory. You can arrange it through the STI clinic, your family doctor and Man tot Man Testlab

If you have recently contracted HIV, it can take up to two weeks before the HIV tests can detect it. 

  • A laboratory test is more reliable and can detect HIV earlier than a rapid HIV test. A rapid HIV test that uses a finger prick or saliva is not as reliable.
  • Did you have unprotected anal sex shortly before your last HIV test? Get tested again for HIV at least two to six weeks after the first HIV test. In the meanwhile fuck with a condom to avoid getting HIV. If both tests are negative and you have not been exposed to HIV in the meantime, you are safe to start using PrEP. 
  • In the first 2 to 3 weeks after infection, most people with HIV will develop flu-like symptoms. Did you have sex without a condom recently and do you have flu-like symptoms? Go to your family doctor or the GGD (local Public Health Services). Get tested for HIV to make sure you don’t have acute HIV.

Get tested for HIV before you start using PrEP!

Get your hepatitis B status checked

Before starting PrEP, you will need to find out what your hepatitis B status is. This is done by means of a titer test. If you have had the full vaccination series or your body has fought off an infection by itself, meaning you are immune, then there should be no problem. If you have an active hepatitis B infection, then you must only take PrEP on a daily schedule and not on demand. If you have not been vaccinated or have never had hepatitis B, then you are required to get the hepatitis B vaccine before starting PrEP. 

Get your kidney function tested while using PrEP

PrEP may sometimes lead to very serious kidney problems, so getting your kidney function tested is very important:

  1. Before you start PrEP
  2. One month after starting
  3. Three months after starting
  4. Every half year afterwards
Can I take creatine and PrEP at the same time? - Man to Man. An elevated level of creatinine in you blood may be due to your kidneys not functioning as well because you take PrEP. However, creatinine levels also rise when you take creatine to build muscles. Let your doctor know that you take creatine so he/she can properly interpret your kidney function tests.

Check whether it is safe to take PrEP in combination with other medication 

Do you take other meds or muscle gain supplements? Ask your family doctor and/or your pharmacist whether you are safe to take PrEP in combination with the other remedies. Certain painkillers (NSAIDs) including ibuprofen and diclofenac increase the risk of kidney function problems when taking PrEP.

Always read the patient information leaflet in full before you start taking PrEP. Leaflets can be found here for each manufacturer: Centrafarm | Sandoz | Teva | Lupin | Truvada (Gilead).

Get tested for HIV and other STIs every three months

You have to be certain that you do not have HIV before starting PrEP. Get tested for HIV every three months for as long as you use PrEP. Do you often change sex partners? And do you have unprotected sex? Then the risk of contracting an STI is high and you should get tested every three months.

Get tested for hepatitis C

In a few cases, men who were about to start PrEP, tested positive for hepatitis C which they had caught by having sex. Your family doctor can get you tested for hepatitis C antibodies. The STI clinic rarely does this test. If you have already had hepatitis C, then you must get tested to see if the virus is still in your blood.

Get tested for STIs while using PrEP

Tell your family doctor that you use PrEP

Even if you got PrEP via some other route, it is important that you tell your family doctor you are taking PrEP.

  • PrEP is a medication that may interact with any other medications you are taking.
  • Your family doctor can arrange all the necessary tests for you.

Your family doctor can find more information here (Dutch). There are special Dutch Guidelines for PrEP that doctors can consult.  Doctors who have no prior experience with PrEP can also contact family doctors who belong to seksHAG which is a  family doctors’ advisory group for sexual health and they know everything about PrEP.

To keep this website up-to-date we regularly revise our texts. Last modification: June 2018.

Roderick (37) is fed up with peoples’ biases against PrEP

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