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HIV & PrEP

There is a pill that stops HIV from infecting you. There is treatment that makes the virus untransmittable. Both exist in Bulgaria. Here is exactly what they are, where to get them and what they cost — with nothing prettied up.

Verified 13 August 2026

Had a risk in the last 72 hours?There is emergency treatment — PEP — that can prevent infection. But the window is 72 hours and every hour reduces the chance. Do not wait until tomorrow.Go straight to PEP
On this page

What PrEP is

PrEP (pre-exposure prophylaxis) is a tablet an HIV-negative person takes so that they do not acquire HIV. It is not a vaccine and not a treatment — it is protection that works for as long as you take it.

Bulgaria uses the combination of tenofovir disoproxil (TDF) and emtricitabine (FTC) — a generic of the original Truvada. One tablet contains both.

Taken correctly, PrEP is extremely effective. For years the US CDC published a specific figure — about a 99% reduction in the risk of getting HIV from sex when taken as prescribed. In 2026 CDC removed the percentage from its page and now says only that PrEP “greatly reduces” the risk. The number comes from real studies and remains a good guide to the order of magnitude, but we report it with that context.

~99%risk reduction when taken as prescribed — the figure CDC published until 2026
Active ingredients
Tenofovir disoproxil + emtricitabine
Status in Bulgaria
Legal, prescription only
Covered by NZOK?
No. Paid entirely out of pocket
Available online?
No. Online sale is illegal

The two dosing schedules

There are two ways to take PrEP. Which one suits you depends on the kind of sex you have — this is not a matter of preference.

Daily

The only schedule suitable for both anal and vaginal/frontal sex.

  • One tablet every day, at roughly the same time. Every day — not “most days”.
  • When stopping: continue for 7 more days after the last risk.
  • If you have hepatitis B, stopping needs medical supervision — see the warning below.

Time to full protection depends on the kind of sex. Per CDC: about 7 days for receptive anal sex and about 21 days for receptive vaginal sex. No data exist for insertive sex. WHO states 7 days. Use other protection until then.

On demand (“2-1-1”)

Anal sex only.

  • 2 tablets between 2 and 24 hours before sex.
  • 1 tablet 24 hours after the double dose.
  • 1 more tablet 48 hours after the double dose.
  • If sex continues over several days: 1 tablet every 24 hours until 2 days have passed without sex.

NOT suitable for women or trans women having vaginal sex, nor for trans men having vaginal sex. Also not recommended with an active hepatitis B infection.

The 2-1-1 schedule is not in the EU-approved product information, so it is formally off-label. It is nonetheless recommended by the World Health Organization — explicitly and only for men who have sex with men — and is used in Bulgaria. Discuss it with your doctor.

Getting it in Bulgaria

There is no clinical pathway for PrEP and you cannot get a consultation on a GP referral. In practice the route runs through a private consultation and then a pharmacy.

  1. Get an HIV test

    Mandatory before starting — PrEP is only for HIV-negative people. Testing is free and anonymous at CheckPoint Sofia and at the 20 KABKIS cabinets around the country. A fourth-generation laboratory test on venous blood is recommended.

  2. Get the other tests done

    Creatinine and urea (kidney function), hepatitis B, and a full STI panel. You need the results on the day of your consultation.

  3. Book a consultation with an infectious-disease doctor

    CheckPoint Sofia runs online consultations over Zoom specifically for PrEP and PEP. Booking is mandatory. The prescription is issued by email.

  4. Buy the medication at a pharmacy

    The generic is stocked by the SUBRA chain — in Sofia, Varna, Plovdiv and Stara Zagora — and can be ordered in advance at other branches. Phone ahead: in 2024 there was a genuine nationwide shortage.

What it costs

HIV testCheckPoint Sofia and KABKISFree
Creatinine and urea, with interpretationCheckPoint Sofia€7.56 / 15 BGN
PrEP consultation30 min, online, prepaid€25.56 / 50 BGN
Medication, 30 tabletsmaximum retail price, depending on the generic — roughly one month€57 – 83
“Virology” panelHIV, hepatitis B, hepatitis C, syphilis€15.34 / 30 BGN

Bulgaria adopted the euro on 1 January 2026 (€1 = 1.95583 BGN), so prices are quoted in both currencies. These figures were current at our last check but must be confirmed on the spot — they are not guaranteed.

CheckPoint София — Център за сексуално здраве

Address
София, ул. „Цар Самуил“ 111
Hours
понеделник, вторник, сряда и петък: 10:00 – 12:30 и 13:00 – 18:00 (За четвъртък не публикуват нищо — не пише, че са затворени, просто липсва. Обади се, ако ти трябва четвъртък.)

Tests before and during

Before you start

  • HIV test — mandatory, and it must be negative
  • Creatinine and urea — kidney function
  • Hepatitis B — critical, see the warning below
  • A full sexually transmitted infection panel

While you are on it

  • Every 3 months: HIV test, full STI screen, creatinine and urea
  • Over 40: a full renal panel every 3 months
  • Every 12 months: creatinine and urea, plus hepatitis C
  • On stopping: HIV and STI testing at least 4–6 weeks after the last unprotected contact

Important to know

PrEP protects against nothing else

Syphilis, gonorrhoea, chlamydia, hepatitis C, HPV — PrEP does nothing against any of them. That is why three-monthly testing is part of the regimen, not an optional extra.

Hepatitis B — do not skip this

The drugs in PrEP also suppress hepatitis B. The approved product information ties the risk to STOPPING: in people with hepatitis B, discontinuing can cause a severe flare of hepatitis. That is why testing before you start is mandatory — not because starting is dangerous, but because you need to know what you are managing when you stop, and stopping should be supervised. Note: Bulgarian providers advise against on-demand dosing with active hepatitis B, while WHO since 2022 no longer treats hepatitis B as a contraindication. Discuss it with your doctor.

Painkillers

Tenofovir can strain the kidneys in combination with non-steroidal anti-inflammatory painkillers. The approved product information reports acute kidney failure after starting HIGH-DOSE or MULTIPLE such drugs, and only in people who already have risk factors for kidney problems. This is not about the occasional tablet for a headache. Tell your doctor what you take regularly so kidney function can be monitored.

Do not buy online

Selling PrEP online is illegal in Bulgaria and what arrives is unverified. Several Bulgarian PrEP websites have not been updated since 2019 and now contain things that are simply false — including the claim that PEP is unavailable in Bulgaria.

PEP: within 72 hours

PEP (post-exposure prophylaxis) is an emergency course of medication that can stop an infection if it is started quickly enough after a risk.

Start as early as possible. WHO recommends ideally within 24 hours, and no later than 72 hours after the exposure.

Take it every day for 28 days — a full four weeks (some sources say 28–30 days).

PEP works, but it is not a guarantee, and the sooner it starts the better. You will see the figure “over 80%” — it comes from a 1997 study of needlestick injuries in healthcare staff, on a single drug. No equivalent figure exists for sexual exposure and you should not plan around one.

The uncomfortable truth about PEP in Bulgaria

  • PEP is free ONLY for healthcare workers with occupational exposure. Both the Ministry of Health’s national programme and the head of the Infectious Diseases Clinic, speaking publicly in December 2025, confirm it. There is no carve-out for sexual assault.
  • Everyone else has to buy it. CheckPoint Sofia quotes around €320 for the course. Working it out from the national price register gives roughly €260–340 depending on which generic is used. Treat it as an order of magnitude, not a tariff.
  • It is sold in a small number of pharmacies in a few cities — per the IVOR Foundation in April 2026, Sofia, Plovdiv, Varna and Stara Zagora. Availability has swung sharply in recent years. Do not go touring pharmacies — phone first.
  • There is no publicly advertised 24/7 PEP service. BUT the reception and consultation offices of the Prof. Ivan Kirov hospital in Sofia run a 24-hour rota staffed by an infectious-diseases doctor and accept self-referred patients. If it is three in the morning and you are inside the 72-hour window — do not wait for morning.

  1. Do not wait. The clock started at the exposure

    Every hour reduces effectiveness. 72 hours is the deadline, not the target.

  2. Phone an infectious-diseases clinic

    The five specialist centres are in Sofia, Plovdiv, Varna, Pleven and Stara Zagora. Their numbers are in the living-with-HIV section below. Out of hours, ask for the duty doctor or admissions.

  3. Phone CheckPoint Sofia too

    They run PEP consultations and know which pharmacies stock it. Phone: +359 878 33 93 94.

  4. Finish the course

    All 28 days, every day. An interrupted course does not work. Then re-test on the schedule your doctor gives you.

Undetectable = untransmittable

A person with HIV on successful treatment CANNOT pass the virus on sexually. At all.

This is not an encouraging turn of phrase and it is not approximate. It is one of the best-evidenced facts in modern medicine, confirmed by several large international studies which together followed tens of thousands of acts of sex without a condom.

To be precise: the studies define viral suppression as a load below 200 copies/mL, sustained — that is the threshold at which U=U holds. “Undetectable” is slightly stricter and depends on the assay, which typically reports below 20–50 copies/mL. On modern treatment suppression is usually reached within a few months and then held.

PARTNER (JAMA, 2016)

  • 1,166 enrolled, 888 in the analysis
  • 1,238 couple-years with viral load under 200 copies/mL
  • around 58,000 condomless acts

Zero transmissions

PARTNER2 (The Lancet, 2019)

  • 972 enrolled male couples, 782 in the analysis
  • 1,593 couple-years with viral suppression
  • 76,088 condomless anal sex acts

Zero transmissions

  • You can have sex without infecting anyone.
  • You can be in a relationship with an HIV-negative person.
  • You can have children.
  • You are not a danger to the people you love.

Living with HIV in Bulgaria

If your test is positive: this is not the end of your life. HIV today is a chronic condition managed with medication — usually one tablet a day — and with timely treatment life expectancy is close to everyone else’s.

And here is something almost nobody says: people on treatment get regular bloodwork, their markers are tracked, and they receive a level of medical attention most people never get. That is not nothing.

Antiretroviral therapy is free to you

The medication is paid from the state budget through the Ministry of Health, not by NZOK — under Art. 82(1)(6a) and (8) of the Health Act, Ordinance No. 3 of 2019 and Ordinance No. 34 of 2005. Inpatient treatment, outpatient monitoring and monthly outpatient HIV care are free too. Collecting the medication requires only a prescription and an ID card.

Your insurance status does not cancel that right

The law places these activities “outside the scope of compulsory health insurance”. So the right to treatment does not flow from your insurance, and lapsed contributions under Art. 109 of the Health Insurance Act do not affect it. No official text says this in those words — it is the conclusion the legal structure forces, not a quotation.

What stays paid

What is free is treatment on the HIV pathway. Everything outside it — your GP, other specialists, unrelated hospital stays — runs through NZOK as it does for everyone. And one more thing that has to be said: the legislation says “Bulgarian citizens”. For foreign nationals the regime is different.

Five centres nationwide

The specialist centres are in Sofia, Plovdiv, Varna, Pleven and Stara Zagora. Their contact details are below.

No Bulgarian law criminalises HIV

The Bulgarian Criminal Code has no HIV-specific provision. Article 135 concerns “venereal disease” and nowhere mentions HIV or AIDS. That is the fact; for an individual situation, talk to a lawyer.

The five treatment centres

СБАЛИПБ „Проф. Иван Киров“ — Отделение за придобита имунна недостатъчност

София

бул. „Акад. Иван Гешов“ 17

02 90 23 700·02 90 23 709

Hours not published — phone first

Първите два номера са централа и регистратура. Приемно отделение: 02 90 23 716. Дежурен лекар: 02 90 23 723 и 02 90 23 724. Сайтът не потвърждава денонощна услуга за самото отделение.

Website

УМБАЛ „Св. Георги“ — Клиника по инфекциозни болести

Пловдив

бул. „Пещерско шосе“ 66

032 60 29 11

Hours not published — phone first

Посоченият телефон е централата. Адресът и преките номера, които се срещат в други списъци, не успяхме да потвърдим на сайта на болницата.

Website

УМБАЛ „Св. Марина“ — Първа клиника по инфекциозни болести

Варна

бул. „Христо Смирненски“ 1

Hours not published — phone first

Клиниката заявява денонощно консултиране и приемане при остри инфекциозни заболявания. Това не означава, че PEP се изписва денонощно — звънни.

Website

УМБАЛ „Д-р Георги Странски“ — Клиника по инфекциозни болести

Плевен

бул. „Георги Кочев“ 8А

064 886 100

Hours not published — phone first

Посоченият телефон е централата.

Website

УМБАЛ „Проф. д-р Стоян Киркович“ — Клиника по инфекциозни болести

Стара Загора

ул. „Генерал Столетов“ 2

Hours not published — phone first

Не открихме работещ сайт на болницата, за да потвърдим адрес и телефон. Провери, преди да тръгнеш.

Where to get tested

Bulgaria has 20 cabinets for anonymous and free HIV counselling and testing (KABKIS) — one in almost every regional city. The service is free and anonymous: no ID is asked for and the result goes nowhere.

CheckPoint Sofia runs a rapid test with a result in 20 minutes, also free and without an appointment.

Window period — when a test is reliable

Rapid antibody testusually from 3 monthsThe most available. A negative before that does not rule infection out.
Fourth-generation lab test (antigen/antibody)usually from 4–6 weeksThis is the test recommended before starting PrEP.
PCR / viral RNA testearliest, around 10–14 daysUsed where very recent infection is suspected. Not a routine screen.

Free anonymous testing (KABKIS)

Opening hours are published for only some of these. Where no hours are shown, the official sources simply do not state them — phone before you travel. We will not invent hours to make the table look complete.

КАБКИС при Столична РЗИ

София

ул. „Враня“ 20, ет. 5, ст. 520

02 813 04 81

9:00 – 13:30

КАБКИС при РЗИ – Варна

Варна

ул. „Брегалница“ 3, ет. 9, стая 908

052 665 312

понеделник – петък, 9:00 – 12:00 и 12:30 – 16:00

КАБКИС при РЗИ – Пловдив

Пловдив

ул. „Перущица“ 1, Южно крило, ет. 1

032 643 436

9:00 – 16:00

КАБКИС при РЗИ – Бургас

Бургас

ул. „Александровска“ 120, ет. 1

056 807 203

вторник 12:00 – 16:00; петък 8:30 – 12:30

Работи само два дни в седмицата.

Show 15 more

КАБКИС при РЗИ – Русе

Русе

бул. „Придунавски“ 68

0882 609 376

понеделник – петък, 9:00 – 15:00

КАБКИС при РЗИ – Стара Загора

Стара Загора

ул. „Стефан Караджа“ 10, ет. 1, стая 116

042 604 151

понеделник 8:30 – 12:30 · вторник 13:00 – 17:00 · сряда 8:30 – 12:30 · четвъртък 13:00 – 17:00 · петък 8:30 – 12:30

КАБКИС при РЗИ – Благоевград

Благоевград

ул. „Братя Миладинови“ 2 (партер)

0878 43 42 87

8:30 – 12:00 и 12:30 – 16:00

КАБКИС при РЗИ – Велико Търново

Велико Търново

ул. „Никола Габровски“ 23

062 614 358·062 614 305·062 614 330

понеделник и сряда, 9:00 – 12:30 и 13:00 – 15:00

Само с предварително записване.

КАБКИС при РЗИ – Враца

Враца

ул. „Черни Дрин“ 2

0879 144 799·0886 697 999

понеделник – петък, 9:00 – 12:00 и 13:30 – 15:30

КАБКИС при РЗИ – Смолян

Смолян

бул. „България“ 26, ет. 2, стая 210

0301 5 89 40·0301 5 89 30

само сряда и петък, 9:00 – 12:00

Работи само два дни в седмицата.

КАБКИС при РЗИ – Кърджали

Кърджали

ул. „Ген. Владимир Стойчев“ 2

0361 6 35 67·0884 331 617·0884 331 633

понеделник – петък, 8:30 – 12:00

Сайтът на РЗИ не е в UTF-8 и адресът се чете нестабилно при автоматична проверка. Потвърди по телефона.

КАБКИС при РЗИ – Сливен

Сливен

ул. „Пейо Яворов“ 1

044 616 290

8:30 – 12:00 и 13:00 – 15:00

КАБКИС при РЗИ – Ямбол

Ямбол

ул. „Димитър Благоев“ 71

046 66 31 73

вторник 14:30 – 16:00 · четвъртък 10:00 – 12:30

Отворен около четири часа седмично. Планирай съответно.

КАБКИС при РЗИ – Силистра

Силистра

ул. „Петър Мутафчиев“ 82, каб. 310

0885 93 08 33·0879 95 85 67

всеки работен ден 13:00 – 16:00

Само с предварително записване. Списъкът на МЗ посочва № 81 — РЗИ Силистра пише № 82 на три свои страници. Обади се, преди да тръгнеш.

КАБКИС при РЗИ – Кюстендил

Кюстендил

кв. „Румена войвода“, ул. „Тинтява“

0884 787 174·078 558 224

Hours not published — phone first

Сайтът на РЗИ посочва две различни работни времена на две свои страници. Затова не публикуваме нито едното — обади се.

КАБКИС при РЗИ – Добрич

Добрич

ул. „Кирил и Методий“ 57

058 588 614

Hours not published — phone first

Посоченият телефон е на инспекцията, не директна линия на кабинета. Страницата за КАБКИС не се зарежда.

КАБКИС при РЗИ – Ловеч

Ловеч

ул. „Съйко Съев“ 27А

068 601 518

Hours not published — phone first

Посоченият телефон е централата на РЗИ, не директна линия на кабинета.

Национална референтна лаборатория по ХИВ, НЦЗПБ

София

бул. „Ген. Н. Столетов“ 44А

02 931 80 71

Hours not published — phone first

Влиза в списъка на МЗ с 20-те кабинета, но е потвърдителна лаборатория, а не кабинет за влизане от улицата. Обади се първо.

Myths still being repeated

HIV is a death sentence.

No. With timely treatment, life expectancy is close to average. Treatment in Bulgaria is free.

Being on PrEP means you are reckless.

PrEP is a seatbelt. People who take it get tested more often than anyone else.

HIV passes through kissing, hugging or a shared toilet.

No. Saliva, sweat and tears do not transmit HIV. Neither do shared cups or toilets.

If my partner has HIV, I will catch it.

If they are on successful treatment and undetectable, they cannot pass it to you sexually. Zero transmissions across tens of thousands of acts in the studies.

PrEP destroys your kidneys.

That is why creatinine and urea are checked every 3 months. Most people have no problem, and where a change appears it is caught early and is usually reversible.

In Bulgaria PrEP can only be bought online.

False since 2019. It is sold in pharmacies with a prescription. This myth comes from Bulgarian websites that have not been updated since 2019.

Sources

Every number on this page comes from a source opened and checked on 13 August 2026. Where sources contradict each other — and they do — we say so in the text. Prices and opening hours change: phone before you travel.

  1. CheckPoint Sofia — PrEPCheckPoint Sofia · 2026
  2. CheckPoint Sofia — price listCheckPoint Sofia · 2025
  3. CheckPoint Sofia — PEPCheckPoint Sofia · 2026
  4. Summary of Product Characteristics, emtricitabine/tenofovirEuropean Medicines Agency · 2026
  5. HIV prevention in Bulgaria — investigationAEJ Bulgaria · 2024
  6. Rodger et al., Sexual activity without condoms and risk of HIV transmission (PARTNER)JAMA · 2016
  7. Rodger et al., Risk of HIV transmission through condomless sex (PARTNER2)The Lancet · 2019
  8. Criminal Code, Article 135lex.bg · 1997
  9. National HIV and STI Prevention Programme 2026–2030strategy.bg · 2026
  10. Health Act, Article 82Ministry of Health · 2024
  11. Ordinance No. 3 of 2019 on subsidising healthcare providers, Art. 26 and Annex 4Ministry of Health · 2019
  12. Ordinance No. 34 of 2005 on state-budget payment for treatment outside compulsory health insuranceMinistry of Health · 2005
  13. Pre-Exposure Prophylaxis (PrEP)HIV.gov (U.S. Department of Health and Human Services) · 2026