🛡️ The Situation

Bulgaria has one of the higher HIV rates among EU member states and a challenging environment for LGBTQ+ people. Stigma is a documented barrier to care, and the public health system can be inconsistent or unwelcoming. Against this backdrop, community organisations — primarily Single Step Foundation and Checkpoint Sofia — are not just helpful, they are the system.

They provide the safe, affirming entry point to testing, prevention, and specialist referrals that you cannot reliably get through the public GP network.

⚖️ The Golden Rules

  • Single Step Foundation Is Your Anchor: For testing, PrEP referral, post-diagnosis support, and navigating a health system that can be hostile — start at Single Step Foundation or Checkpoint Sofia. They know which doctors are affirming and which pharmacies are reliable.
  • PrEP Is Affordable — Get On It: PrEP is not reimbursed in Bulgaria, but generic TDF/FTC is available privately for 60–120 BGN/month (€30–60). In a country with higher HIV prevalence and a stigma environment that makes testing harder, being on PrEP is more important, not less.
  • For PEP — SBALIPB in Sofia, Immediately: Go to the Infectious Disease Hospital (бул. Акад. Иван Гешов 17) for PEP. Outside Sofia: nearest large public hospital. The 72-hour window is absolute. Do not delay over cost or stigma fears.

⚖️ The Reality of the System

  • Strong community hubs: Checkpoint Sofia and Single Step Foundation provide safe, affirming entry points for sexual health.
  • Accessible rapid testing: Free and non-judgmental rapid HIV and syphilis testing through community organizations.
  • Affordable private options: Private labs allow you to get comprehensive STI panels out-of-pocket without public system gatekeeping.
  • Guaranteed HIV treatment: HIV treatment (ART) is free and provided by the state.
  • Public system stigma: The general healthcare system can be hostile or stigmatising toward LGBTQ+ individuals.
  • No PrEP reimbursement: PrEP must be purchased out-of-pocket, as it is not covered by the public system.
  • Sofia-centric care: Affirming and specialized sexual health services are severely limited outside the capital.
  • Gatekeeping: Navigating the public system for non-emergency sexual health requires an affirming GP, which can be hard to find.

💬 Anonymous Partner Notification

Bulgaria does not currently have a centralized, public anonymous notification portal. If you test positive, speak to the staff at the clinic where you were tested (e.g. Checkpoint Sofia or Single Step). They can often assist with the partner notification process anonymously on your behalf.

🗺️ Guide Map

Testing & Clinics

Prevention

Emergencies & Support

Result Management

Support & System