Pre-exposure prophylaxis (PrEP) with tenofovir/emtricitabine (TDF/FTC) will soon be available in the Netherlands. Moderate evidence concerning practical efficacy, small absolute risk reduction (1-2%) and a high number needed to treat (50-75) are key figures. Prevention of one HIV infection will cost EUR 350,000 to 500,000. No information is available on long-term renal function and antiretroviral resistance. Guidelines are needed before treatment with PrEP is introduced in the Netherlands.
Conflict of interest: none declared. Financial support: none declared.