PEP (Post-Exposure Prophylaxis) is a 28-day course of emergency HIV medication. It must be started within 72 hours of a high-risk exposure (e.g., a condom break with a partner of unknown status), but the sooner you start it, the more effective it is. In Bulgaria, it may be partially covered by NHIF or require payment.
🚨 Where to Go Right Now
Do not wait for a convenient appointment. Your route depends entirely on the time of day.
| Time / Day | Where to Go | What to Expect |
|---|---|---|
| Anytime in Sofia | SBALIPB (СБАЛИПБ) | Go to emergency admissions (спешно приемане). They have 24/7 capacity. |
| Anytime outside Sofia | Regional Hospital Emergency Dept (спешно отделение) | Ask for the infectious disease on-call. They may need to contact Sofia to arrange the medication. |
Major Hospitals
- Sofia: SBALIPB (бул. „Акад. Иван Гешов" 17) or University Hospital Alexandrovska (ул. „Св. Георги Софийски" 1).
- Plovdiv: УМБАЛ „Свети Георги" (St George University Hospital).
- Varna: УМБАЛ „Света Марина".
Do not go to your personal doctor (личен лекар / GP). They cannot access PEP and will only redirect you, wasting critical hours.
🗣️ Navigating Triage
At the hospital, you must clearly state that this is a time-critical emergency.
- Use the terminology: Say, "Имах рисков сексуален контакт с риск от ХИВ. Имам нужда от постекспозиционна профилактика (ПЕП)." (I had a high-risk sexual contact with HIV risk. I need post-exposure prophylaxis (PEP).)
- State the timeline: Include how many hours ago it was ("преди [X] часа").
- Be direct about the exposure: Most doctors in Sofia have some English if needed. Be specific about the type of exposure to speed up assessment.
The Starter Pack: The hospital provides a starter pack of PEP medication (5–7 days). The follow-up is mandatory. Before your starter pack runs out, you must arrange follow-up at the infectious disease outpatient clinic (инфекциозна амбулатория) to complete the full 28-day course.
💊 The Medication: What to Expect
The standard Bulgarian PEP regimen usually consists of Truvada (or a generic equivalent) taken alongside either raltegravir or dolutegravir (Tivicay).
- It is a strict regimen: PEP is not a morning-after pill. It is a mandatory 28-day course, and you cannot miss doses.
- Side effects are manageable: You may experience nausea, fatigue, or diarrhea, though not everyone does. The clinic will often prescribe anti-sickness medication alongside your PEP.
- Do not stop: Never stop taking PEP without speaking to a doctor first.
💶 Cost
PEP is covered by the NHIF (НЗОК) for people who are registered with the national insurance and have a health card (здравна книжка). However, some doctors may require payment or a deposit while insurance is processed. Do not let cost or uncertainty delay you. Go to the hospital immediately.
- EU/EEA visitors with EHIC: Emergency care is covered. Present your EHIC card.
- Non-EU visitors: Emergency care is provided. A bill may follow.
Related: