Integrating Internet of Things (IoT) sensor data from heterogeneous sources with domain knowledge and context information in real-time is a challenging task in IoT healthcare data management applications that can be solved with semantics. Existing IoT platforms often have issues with preserving the privacy of patient data. Moreover, configuring and managing context-aware stream processing queries in semantic IoT platforms requires much manual, labor-intensive effort. Generic queries can deal with context changes but often lead to performance issues caused by the need for expressive real-time semantic reasoning. In addition, query window parameters are part of the manual configuration and cannot be made context-dependent. To tackle these problems, this paper presents DIVIDE, a component for a semantic IoT platform that adaptively derives and manages the queries of the platform’s stream processing components in a context-aware and scalable manner, and that enables privacy by design. By performing semantic reasoning to derive the queries when context changes are observed, their real-time evaluation does require any reasoning. The results of an evaluation on a homecare monitoring use case demonstrate how activity detection queries derived with DIVIDE can be evaluated in on average less than 3.7 seconds and can therefore successfully run on low-end IoT devices.