Despite past pilot programs and policy discussions, PrEP is not reimbursed through the public healthcare system in Latvia as of 2026. If you want PrEP, you will have to pay for it out of pocket. Latvia has consistently high HIV incidence—significantly above the EU average—so getting on PrEP is a critical personal and public health decision, but the financial burden falls on the patient.
Who Can Get It
Anyone can access a PrEP prescription privately if they meet the clinical requirements, which include:
- Testing HIV-negative
- Normal kidney function
- Being able to pay for the medication, consultations, and the mandatory 3-month monitoring tests.
Because there is no national reimbursement, your sexual orientation or risk profile is secondary to your ability to pay for the private prescription and the pills.
The Pathway: How to Get It
The Latvian Infectology Center (LIC) remains the primary hub for HIV prevention, even without state funding for the pills.
- The Appointment: Book an appointment with an infektologs (infectious disease specialist) at LIC (Latvijas Infektoloģijas centrs) in Riga, or at a private clinic.
- The Baseline Tests: The doctor will confirm your HIV-negative status, check your kidneys (kreatinīns), and screen for STIs. You will generally pay for these tests out of pocket unless covered by premium private insurance.
- The Prescription: The doctor writes a private prescription for generic TDF/FTC (tenofovir/emtricitabine).
- The Pharmacy: You take the prescription to a pharmacy (aptieka) and pay full retail price for the medication (approximately €40–€70 for a month's supply).
If You Can't Wait (Or Can't Afford It)
Navigating the cost is the biggest barrier in Latvia.
- NGO Support: Contact Mozaika (mozaika.lv). They are deeply connected to the realities of the system, know the current fastest and cheapest routes to a prescription, and can advise if any localized pilot projects or community funding options are currently active.
- Importing Online: Given the high local costs, importing cheap generics from abroad seems appealing. However, Latvian Customs strictly regulates imported medicines. To import PrEP legally, you absolutely must have a valid prescription, and the package must be clearly for personal use. Even with documentation, customs can be rigorous, and importing from outside the EU/EEA carries a high risk of seizure.
Test before you start: If you do manage to self-source generic pills, you must confirm you are HIV-negative before taking them. Starting PrEP with an undetected HIV infection creates drug resistance, making the virus much harder to treat.
What Happens After (Monitoring)
You must undergo monitoring every 3 months while on PrEP.
- The Routine: HIV test, a full STI panel (ensure you ask for three-site testing: throat, rectum, and genitals), and kidney function.
- Where to do it: Because you are paying out of pocket, you can shop around. Many guys use Testpunkts for free or low-cost HIV and syphilis testing, and then use a private lab like Gulbja Laboratorija purely for the kidney function check, presenting all the results to their infektologs to renew the prescription.
What's Available
- Daily Oral PrEP: The standard. Generic TDF/FTC.
- On-Demand PrEP (2-1-1): Taking two tablets 2–24 hours before sex, one 24 hours after, and one 48 hours after. Because you are paying full price for pills, on-demand dosing is a massive cost-saver if you are not having sex every week. Discuss this with your infektologs.
- Injectable PrEP: Not available or funded in Latvia.
Route Comparison
| Route | Cost | Speed | Monitoring |
|---|---|---|---|
| Public System (LIC Out-of-Pocket) | Meds: €40–€70/month + Consult fee | Varies by booking | Handled by clinic |
| Private Clinic | Meds: €40–€70/month + Consult fee | Immediate | Included |
| Self-Sourced (Import) | Varies | 1-3 weeks | Patient must book separately |
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