The Short Version

PrEP is available in Slovakia but the cost picture is uneven. VšZP (the main public insurer) covers PrEP 100% including testing. Dôvera and Union (private insurers) do not reimburse PrEP, so those insured by them pay out-of-pocket. Dom Svetla is the best navigation resource regardless of your insurance situation.

Path 1: VšZP-Insured — Full Coverage

If you are insured by VšZP (Všeobecná zdravotná poisťovňa), PrEP is reimbursed 100% including medication and associated testing.

Process:

  1. Contact Dom Svetla (domsvetlaslovensko.sk / +421 2 2102 8048) for referral support and to navigate the process efficiently
  2. Book an appointment at an infectious disease specialist (infektológ) — the National Reference Center for HIV/AIDS in Bratislava or Kramáre Hospital
  3. Pre-PrEP tests: HIV (negative required), hepatitis B, creatinine (kidney function), STI screen
  4. Receive an eRecept (electronic prescription) — valid for 3 months
  5. Collect from a pharmacy (lekáreň) — covered by VšZP

Follow-up every 3 months: HIV test, STI screen. Consultations and medications remain free.

Ask specifically for three-site swab testing at every follow-up: "Výter z hrdla, rektálny výter a uretrálny výter."

Path 2: Dôvera/Union-Insured — Private Pay

If you are insured by Dôvera or Union, your insurer does not currently reimburse PrEP. You pay out-of-pocket.

Cost:

  • Infektológ consultation: ~€30–50
  • Lab tests: ~€50 for baseline panel
  • Generic PrEP (Tenvir-EM, Ricovir-EM): ~€30–50/month
  • Ongoing monitoring consultations: ~€30–50 every 3 months

Where to see a specialist:

  • Kramáre Hospital Infekčná klinika (Limbová 5, Bratislava)
  • VÚSCH Košice (Rastislavova 43)
  • Dom Svetla can provide a list of PrEP-friendly specialists and help navigate any barriers to care

Pharmacies for generic PrEP:

  • Bratislava: Benu (Obchodná 5), Dr. Max (Kamenné námestie)
  • Košice: Lekáreň na Hlavnej
  • Generics are the same medication as branded Truvada at a fraction of the cost

Path 3: Telemedicine / Online Access

For those facing doctor refusals, long waiting times, or who prefer to avoid the Slovak healthcare system:

  • PrEPinfo.sk — Slovak-language telemedicine consultations (€20) plus generic PrEP shipped from EU warehouses (€40/month); check current availability at prepinfo.sk
  • GetOnPrEP.com and similar EU-based services — ship generic PrEP without a Slovak prescription; legal to import for personal use within EU; you self-manage testing

If using the self-managed route, Dom Svetla's Checkpoint can provide the regular HIV and syphilis rapid tests. For full monitoring including kidney function and bacterial swabs, you will still need to visit a lab or clinic periodically.

On-Demand PrEP

The 2+1+1 on-demand protocol is clinically established. Some Slovak infektológovia will prescribe it. Discuss this option if you prefer not to take a daily pill — it may also reduce cost.

Required Monitoring (All Routes)

Regardless of how you access PrEP, follow this testing schedule:

Time Tests Required
Baseline HIV (negative), Hepatitis B, creatinine
Every 3 months HIV, syphilis, gonorrhoea, chlamydia (three-site swabs)
Every 6–12 months Creatinine re-check

PrEP protects only against HIV. Three-site swab testing is essential for catching gonorrhoea and chlamydia.

Barriers and Navigation

Problem Solution
Doctor refusal or hostility Contact Dom Svetla for a list of PrEP-friendly specialists
VšZP coverage confusion Dom Svetla staff can help navigate the VšZP approval process
High cost (Dôvera/Union) Consider switching to VšZP at next renewal; use generic generics in the interim
Testing access Dom Svetla Checkpoint for HIV/syphilis; Medirex/Unilabs/Alpha Medical for swabs

See also: PEP emergency | Dom Svetla testing | PrEP mechanics