Time window: Under 72 hours. Ideally under 24. Every hour matters. Cost: Variable — may be partially covered by NHIF or require payment. Do not let cost uncertainty delay you.

For the full clinical picture — what PEP is, how it works, and who it's appropriate for — see PEP: The Emergency Protocol first.

Where to Go

Sofia

SBALIPB — Специализирана болница за активно лечение на инфекциозни и паразитни болести (Specialised Hospital for Active Treatment of Infectious and Parasitic Diseases) бул. „Акад. Иван Гешов" 17, Sofia (Blvd. Academician Ivan Geshov 17)

This is the primary infectious disease hospital in Sofia and the main PEP access point in Bulgaria. Go to the emergency/admissions entrance (спешно приемане). This hospital has 24/7 infectious disease capacity.

Alternative in Sofia: University Hospital Alexandrovska (УМБАЛ „Александровска") also has an infectious disease department and emergency services. ул. „Св. Георги Софийски" 1.

Outside Sofia

Go to the nearest large public hospital (МБАЛ / УМБАЛ) and ask for the infectious disease department (инфекциозно отделение) or the emergency department (спешно отделение). Not all regional hospitals stock PEP — the staff may need to contact the SBALIPB in Sofia for advice and to arrange medication. This makes acting early within the 72-hour window even more critical outside the capital.

  • Plovdiv: УМБАЛ „Свети Георги" (St George University Hospital) — has infectious disease department
  • Varna: УМБАЛ „Света Марина" — infectious disease department
  • Elsewhere: Go to the nearest large hospital emergency department and ask for infectious disease on-call

What to Say

In Bulgarian (Cyrillic): "Имах рисков сексуален контакт с риск от ХИВ преди [X] часа. Имам нужда от постекспозиционна профилактика (ПЕП)."

Transliterated: "Imah riskov seksualen kontakt s risk ot HIV predi [X] chasa. Imam nuzda ot postekspozitsionna profilaktika (PEP)."

In English, if needed: "I had a high-risk sexual exposure for HIV [X] hours ago and need post-exposure prophylaxis (PEP)."

Most infectious disease doctors in Sofia hospitals have some English. Provide clinical context: partner's HIV status (positive or unknown), type of exposure (receptive anal sex without a condom is highest risk).

Cost

PEP medication in Bulgaria is covered by the NHIF (НЗОК) for people who are registered with the national insurance and have a health card (здравна книжка). In practice, the cost situation can be unclear — some doctors will access medication at no charge; others may require payment or a deposit for the medication while insurance is processed.

Do not let cost or uncertainty delay you. Go to the hospital immediately. Cost issues can be resolved afterward.

EU/EEA visitors with EHIC: Emergency care is covered. Present your EHIC card. Non-EU visitors: Emergency care is provided. A bill may follow.

The Process

Starter pack: The hospital provides a starter pack of PEP medication (5–7 days) to begin immediately.

Follow-up: You must continue the full 28-day course. Arrange follow-up at the SBALIPB infectious disease outpatient clinic before your starter pack runs out. Get the outpatient contact details before leaving the hospital.

Testing timeline: Follow-up HIV tests at 6 weeks and 3 months after completing PEP.

After PEP: Consider PrEP

If you've needed PEP more than once, or you're regularly in higher-risk situations, PrEP is the appropriate tool. See PrEP in Bulgaria: Private Access — at 60–120 BGN/month, it is genuinely affordable.

Related: