In October 2016, the Minister for Health, Welfare and Sport requested advice from the Health Council of the Netherlands on the use of medication to prevent HIV infection (pre-exposure prophylaxis, or PrEP) in people with an increased risk of HIV. The National Institute for Public Health and the Environment (RIVM) compiled background information to support the Health Council of the Netherlands. Important points in this background information are:
HIV continues to be a dangerous viral infection but can be regarded as a chronic disease, provided that it is discovered early on and properly treated. In these cases there is also a very small chance of the virus being transmitted to another individual. HIV transmission can be prevented by condom usage, regular HIV testing and prompt treatment of infection.
PrEP is a new method of preventing HIV infection, which involves taking antiviral medication before sexual contact with a (possibly) HIV-positive individual. Healthcare providers determine who is eligible to use PrEP based on a professional guideline on the risk of HIV and sexual behaviour. PrEP is registered and available in the Netherlands, but the high costs of usage and associated healthcare are not covered by insurance.
PrEP has been proven to be effective and safe when used properly. Compliance is essential, as is the associated healthcare: anyone using PrEP must be tested for HIV on a regular basis in order to promptly detect (resistant) HIV infections for which the medication is ineffective. Regular liver and kidney function tests are also required, and PrEP users should also undergo regular testing for other sexually transmitted diseases.