Outside Sofia, Bulgaria's sexual health infrastructure for gay men is very thin. There are no Checkpoint equivalents, no community LGBTQ+ health organisations in other cities of comparable scale to Single Step, and HIV testing is primarily through the public KABKIS system or private labs.

Plovdiv

Bulgaria's second-largest city, with a slowly developing LGBTQ+ community.

Testing: The Regional Health Inspectorate (РЗИ Пловдив) operates an anonymous testing cabinet (KABKIS) — free, but quality and LGBTQ+ affirmation vary. Private laboratories offer a more reliable full STI panel.

PEP: УМБАЛ „Свети Георги" (St George University Hospital), бул. „Пещерско шосе" 66 — the main university hospital for Plovdiv. Go to the infectious disease department or emergency department. Out-of-hours PEP may require contacting Sofia's SBALIPB for clinical guidance.

PrEP: Via a private infectious disease specialist in Plovdiv, or by travelling to Sofia for Checkpoint referral.

Varna

Bulgaria's main Black Sea port city and the summer LGBTQ+ destination in the country.

Testing: KABKIS through the regional health inspectorate. Private labs. During summer, some NGO outreach testing may be available — check singlestep.bg for any Varna events.

PEP: УМБАЛ „Света Марина", бул. „Христо Смирненски" 1 — the main university hospital for northeast Bulgaria. Infectious disease department.

Note for summer visitors: Varna has a significantly larger LGBTQ+ visible population during the summer months, concentrated on Primorski Park and certain beach areas. If you need PEP while visiting, УМБАЛ Света Марина is your destination.

Other Cities

For all other Bulgarian cities, the guidance is:

Testing: Find the local private laboratory for a paid STI panel. KABKIS through the local RZI for HIV-specific anonymous testing.

PEP: Go to the nearest large public hospital (МБАЛ or УМБАЛ) and ask for the infectious disease department. If they cannot provide PEP directly, they can contact SBALIPB in Sofia for guidance. Go immediately — don't wait.

PrEP: Travel to Sofia for prescription via Checkpoint / Single Step referral, or arrange with a private specialist in a larger city. Then collect at any Bulgarian pharmacy.

The Honest Picture

Bulgaria outside Sofia has very limited LGBTQ+-specific health services. The combination of lower income levels (making private care harder to afford) and higher stigma (making public services harder to use) creates real barriers. Single Step Foundation (singlestep.bg) is aware of this and periodically runs outreach programmes in other cities — check their website and social media for current activities.

If you are based outside Sofia long-term, building a relationship with a non-judgmental GP or private specialist is your most important investment for ongoing sexual health.

Related: