Sexual health services in Europe vary wildly — from comprehensive, free clinics to countries where PrEP requires private payment. This guide covers the EU-wide infrastructure: your rights, what works across borders, and how to navigate the system when you're traveling or living abroad.

New here? Start with Your Guide to Sexual Health (No Bullshit Edition) for the mindset, then use the guide map below to find what you need.

Your Rights: EHIC and Cross-Border Healthcare

European Health Insurance Card (EHIC)

The EHIC guarantees you access to medically necessary treatment in any EU/EEA country on the same terms as residents of that country.

What it covers:

  • Emergency treatment (including PEP after potential HIV exposure)
  • Pre-planned treatment (with prior authorization from your home insurer)
  • Ongoing treatment if you fall ill during travel

What it doesn't cover:

  • Routine sexual health screening (varies by country — some treat this as "preventive" and cover it; others don't)
  • PrEP (in most countries, it's classified as preventive, not "necessary" treatment)
  • Private clinic visits (EHIC only works in public/state-contracted facilities)

Bottom line: EHIC is your safety net for emergencies and major medical issues, but don't expect it to automatically cover sexual health services everywhere.

The Cross-Border Healthcare Directive

EU law gives you the right to seek treatment in another member state. If your home country doesn't offer PrEP, you can potentially get a prescription in another country and bring it home. Technically legal, but bureaucracy varies. Some countries make this easy; others create barriers.

The practical version:

  • A prescription from one EU country is valid in another (with some exceptions).
  • You may need to pay upfront and claim reimbursement from your home insurer.
  • PrEP prescriptions specifically are a grey area — some insurers reimburse, others refuse. Check before you travel.

The UK Exception

The UK is no longer in the EU. Your EHIC does not work there (unless you have a UK-issued GHIC or a specific bilateral agreement). Budget for private care if visiting.

The Reality: A Continent of Contrasts

Where It's Easy

  • France: Free PrEP, free testing, CeGIDD clinics everywhere, DoxyPEP pilots active.
  • Ireland: Free PrEP through HSE since 2019; GUIDE Clinic (St James's, Dublin) is the main hub; regional sexual health clinics expanding.
  • Spain: PrEP free through public system, strong Checkpoint network.
  • Netherlands: High quality but waitlisted — GGD is free if you get in; otherwise pay via GP.
  • UK: PrEP free on NHS, excellent GUM clinic network, postal testing available.
  • Nordics (SE, DK, NO, FI): Generally free or very cheap, but specialist access can be slow.

Where It's Harder

  • Poland: PrEP available only privately, social stigma, need to vet doctors carefully.
  • Hungary: No public PrEP funding, limited infrastructure, hostile political environment.
  • Romania: PrEP through specific hospitals only, limited availability outside Bucharest.
  • Bulgaria: Very early-stage PrEP access, strong stigma.
  • Croatia: PrEP only at UHID Zagreb, expanding but not yet operational elsewhere.

The Pattern

Western/Northern Europe: more infrastructure, more funding, less stigma. Eastern/Southern Europe: less funding, more out-of-pocket costs, more creative navigation required.

This isn't fair. It's just the current reality. The country guides help you navigate whatever system you're in.

Traveling Within Europe: The Checklist

If you're moving between EU countries or traveling:

  1. Your medication supply: Bring enough PrEP or HIV treatment for your entire trip plus a buffer. Don't assume you can refill in another country immediately.
  2. EHIC card: In your wallet, always.
  3. Medical summary: List your meds, allergies, recent STI test results. In English or the local language if possible.
  4. Emergency number: 112 works in all EU countries.
  5. Your doctor's contact info: In case you need to contact them from abroad.
  6. Know the local Checkpoint: Many cities have community-run sexual health checkpoints. Search "[city name] checkpoint gay men" before you arrive.

PrEP Across Borders: The Fine Print

  • Your home prescription is legally valid in other EU states, but pharmacies may not honor it without hassle.
  • If your supply runs low abroad, a local sexual health clinic or HIV specialist can usually issue a bridging prescription.
  • Generic PrEP prices vary: from ~€5/month (some countries with full coverage) to ~€130/month (private purchase in countries without coverage).

HIV Treatment Across Borders

If you're HIV-positive and on antiretroviral treatment:

  • Your treatment is covered under EHIC in any EU/EEA country as ongoing medically necessary care. You have the right to continue your medication while traveling or living abroad.
  • Bring a medication summary listing your exact regimen (drug names, dosages), your most recent viral load result, and your prescribing doctor's contact details. Carry this in English and, if possible, the local language.
  • If you run out: A local HIV specialist or infectious disease unit at a university hospital can issue a bridging prescription. Sexual health clinics and community HIV organisations can usually direct you to the right person quickly.
  • Viral load monitoring: If you're abroad for an extended period, schedule a local blood draw to keep your monitoring on track. Most EU countries allow this under EHIC.
  • Know before you go: Some Eastern European countries have less developed HIV care infrastructure. If traveling to Poland, Hungary, Romania, or Bulgaria, identify a local HIV specialist in advance through organisations like EATG (European AIDS Treatment Group) or local community networks.

PEP Abroad: The Emergency

If you need PEP while traveling:

  • Go to the nearest hospital emergency department. Say "HIV risk contact" in the local language (see country vocab guides).
  • EHIC covers emergency PEP in public hospitals across the EU.
  • Don't go to a small rural hospital if you can avoid it — university hospitals and city ERs are more likely to stock the meds.
  • You have 72 hours. Don't wait.

🗺️ The Guide Map

The Mindset

EU Access & Cost Guides

These cover where to go, what it costs, and how to navigate the EU-specific landscape. For clinical detail on each topic, follow the link at the top of each guide.

General Education

The clinical and educational content lives in the general section — these are the most relevant starting points:

Bottom line: Europe has incredible sexual health infrastructure, but you need to know where it is. Your EHIC, your medication supply (whether that's PrEP or HIV treatment), and your knowledge of the local system are the three things that travel with you. Everything else is in the country guides.