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HIV & PrEP

There is a pill that stops HIV infecting you. There is treatment that makes the virus untransmittable. Both exist in Bulgaria.

Verified 13 August 2026

A risk in the last 72 hours?There is emergency treatment — PEP. The window is 72 hours and every hour reduces the chance. Do not wait until tomorrow.Go straight to PEP

What PrEP is

PrEP (pre-exposure prophylaxis) is a tablet an HIV-negative person takes so they do not get HIV. Not a vaccine, not a treatment — it works for as long as you take it.

Bulgaria uses tenofovir disoproxil (TDF) + emtricitabine (FTC) — a generic of Truvada. One tablet contains both.

Taken as prescribed, PrEP cuts the risk of getting HIV from sex by about 99% — a figure from real studies that the US CDC published until 2026, then removed, leaving only “greatly reduces”.

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

The two dosing schedules

Which one is for you depends on the sex you have — not on 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: 7 more days after the last risk.
  • With hepatitis B, stopping needs a doctor — see below.

Full protection: per CDC about 7 days for receptive anal and about 21 days for receptive vaginal sex; no data for insertive. WHO says 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 days: 1 tablet every 24 hours until 2 days have passed without sex.

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

2-1-1 is not in the EU-approved product information, so it is formally off-label. WHO recommends it explicitly and only for men who have sex with men; it is used in Bulgaria. Ask your doctor.

Getting it in Bulgaria

There is no clinical pathway and no consultation on a GP referral. The route is a private consultation, then a pharmacy.

  1. Get an HIV test

    Mandatory — PrEP is only for HIV-negative people. Free and anonymous at CheckPoint Sofia and at the 20 KABKIS cabinets around the country. Ask for a fourth-generation lab test on venous blood.

  2. Get the other tests done

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

  3. Book a consultation with an infectious-disease doctor

    CheckPoint Sofia runs Zoom consultations for PrEP and PEP. Booking is mandatory; the prescription comes by email.

  4. Buy the medication at a pharmacy

    The generic is stocked by the SUBRA chain — Sofia, Varna, Plovdiv, Stara Zagora; elsewhere it can be ordered in. Phone first: in 2024 there was a real nationwide shortage.

What it costs

HIV testCheckPoint Sofia and KABKISFree
Creatinine and urea, with interpretationCheckPoint Sofia€7.67 / 15 BGN
PrEP consultation30 min, online, prepaid€25.56 / 50 BGN
Medication, 30 tabletsmaximum retail price by generic — roughly one month€57 – 83
“Virology” panelHIV, hepatitis B, hepatitis C, syphilis€15.34 / 30 BGN

Since 1 January 2026 prices are quoted in euro and leva (€1 = 1.95583 BGN); confirm them on the spot. Be careful with the medication: no official register publishes a final price for the combination, and pharmacy websites often quote tenofovir alone — a different drug at a different price. Ask for emtricitabine/tenofovir.

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 below
  • A full STI panel

While you are on it

  • Every 3 months: HIV, 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 — it does nothing against them. That is why three-monthly testing is part of the regimen.

Hepatitis B — do not skip this

The drugs in PrEP also suppress hepatitis B. The risk is in STOPPING: in people with hepatitis B, discontinuing can cause a severe flare of hepatitis. So testing before you start is mandatory, and stopping must be supervised by a doctor. Bulgarian providers advise against on-demand dosing with active hepatitis B; WHO since 2022 no longer treats it as a contraindication. Ask your doctor.

Painkillers

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

Do not buy online

Selling PrEP online is illegal in Bulgaria and what arrives is unverified. Several Bulgarian PrEP sites have not been touched since 2019 and still say false things — for instance that PEP is unavailable here.

PEP: within 72 hours

PEP (post-exposure prophylaxis) is an emergency course of medication that can stop an infection if it starts fast enough.

The sooner the better. WHO: ideally within 24 hours, no later than 72 hours after the exposure.

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

PEP works, but it is not a guarantee. You will see “over 80%” — from a 1997 study of needlestick injuries in healthcare staff, on a single drug. No such figure exists for sexual exposure.

The uncomfortable truth about PEP in Bulgaria

  • Free ONLY for healthcare workers with occupational exposure — confirmed by the Ministry of Health’s national programme and by the head of the Infectious Diseases Clinic (December 2025). There is no carve-out for sexual assault.
  • Everyone else buys it. CheckPoint Sofia: around €320 for the course; the national price register works out at €260–340 depending on the generic. An order of magnitude, not a tariff.
  • It is in few pharmacies — per the IVOR Foundation, April 2026: Sofia, Plovdiv, Varna, Stara Zagora. Availability swings sharply: phone, do not tour.
  • No 24/7 PEP service is advertised. But the reception and consultation offices of the Prof. Ivan Kirov hospital in Sofia run a 24-hour rota with an infectious-diseases doctor and accept self-referred patients. Three in the morning, inside the 72 hours — do not wait.

  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 centres: Sofia, Plovdiv, Varna, Pleven, Stara Zagora; numbers below. Out of hours — the duty doctor or admissions.

  3. Phone CheckPoint Sofia too

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

  4. Finish the course

    All 28 days. An interrupted course does not work. Then re-test on your doctor’s schedule.

Undetectable = untransmittable

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

Not an encouraging turn of phrase. One of the best-evidenced facts in medicine — several large international studies, tens of thousands of condomless acts.

The threshold for U=U is a sustained viral load below 200 copies/mL. “Undetectable” is slightly stricter and depends on the assay — usually below 20–50 copies/mL. Treatment gets there within a few months and holds it.

PARTNER (JAMA, 2016)

  • 1,166 couples, 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 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 is a chronic condition — usually one tablet a day — and with timely treatment life expectancy is close to everyone else’s.

And something rarely said: on treatment you get regular bloodwork, your markers are tracked, and you get a level of attention most people never get.

Therapy is free to you

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

Your insurance status does not cancel that right

These activities sit “outside the scope of compulsory health insurance”. So the right 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 it that way — it is what the legal structure forces.

What stays paid

The HIV pathway is free. Everything outside it — GP, other specialists, unrelated hospital stays — runs through NZOK as for everyone. And: the legislation says “Bulgarian citizens”; for foreign nationals the regime is different.

Five centres nationwide

Sofia, Plovdiv, Varna, Pleven and Stara Zagora. Contact details below.

No Bulgarian law criminalises HIV

The Bulgarian Criminal Code has no HIV provision. Article 135 concerns “venereal disease” and nowhere mentions HIV or AIDS. For an individual situation — 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, free HIV counselling and testing (KABKIS) — one in almost every regional city. No ID asked for; the result goes nowhere.

CheckPoint Sofia does a rapid test with a result in 20 minutes — also free, no appointment.

Window period — when a test is reliable

Rapid antibody testusually from 3 monthsA negative before that does not rule infection out.
Fourth-generation lab test (antigen/antibody)usually from 4–6 weeksThe one 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, and treatment here is free.

Being on PrEP means you are reckless.

PrEP is a seatbelt. People on 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. Nor do shared cups or toilets.

If my partner has HIV, I will catch it.

If they are on successful treatment and undetectable, they cannot. Zero transmissions across tens of thousands of acts.

PrEP destroys your kidneys.

That is why creatinine and urea are checked every 3 months. Most people have no problem, and a change 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.

Sources

Every number comes from a source checked on 13 August 2026. Where sources contradict each other, we say so. Prices and 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

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