PrEP in Romania: Navigating a System in Transition

PrEP in Romania exists in a gray zone. While a national framework is currently being developed as of 2026, there is no streamlined, fully state-funded public PrEP programme like in Western Europe. Access relies heavily on infectious disease specialists at specific hospitals (like Matei Balș) and community NGOs like ARAS. You can get PrEP, but you have to actively navigate a system that is still figuring itself out, and you will likely have to pay out of pocket or rely on limited NGO resources.

Who Can Get It

Because there is no formalized public reimbursement system for PrEP, eligibility is less about state criteria and more about clinical appropriateness determined by an infectious disease (ID) specialist.

If you seek a prescription, ID doctors will assess you based on European guidelines. You are an ideal candidate if you are:

• A man who has sex with men (MSM) with recent condomless sex
• A sex worker
• Someone who has had a recent STI

Cost: Be prepared to pay for the medication itself if you are prescribed it privately or outside of any specific pilot programmes. Generic PrEP in Romania costs approximately 500–600 RON per month (e.g., around 540 lei for a box of 30 tablets at major pharmacies).

How to Get It

Do not try to navigate the hospital system completely alone. The bureaucracy is dense, and many doctors outside of specific infectious disease hubs will not know how to prescribe PrEP.

Step 1: Start at ARAS (PrEPpoint) ARAS (Romanian Association Against AIDS) is the most critical resource for PrEP in Romania. They operate Checkpoints and a dedicated PrEPpoint service in Bucharest.

• Contact them first (checkpointaras.ro / 0751 010 539).
• Their staff can run the necessary pre-PrEP tests (HIV, Syphilis, Hepatitis B, Creatinine) for free or low cost.
• They act as navigators, directly referring you to ID specialists who are actually willing to prescribe PrEP.

Step 2: The Specialist Appointment You will be referred to an infectious disease doctor, typically at Institutul Național de Boli Infecțioase "Prof. Dr. Matei Balș" or Spitalul "Victor Babeș" in Bucharest.

• You must bring a recent negative HIV test and your kidney function (creatinine) results.
• The doctor will assess you and issue a prescription.

Step 3: The Pharmacy With your prescription, you will purchase generic PrEP from a pharmacy. ARAS can point you to pharmacies that reliably stock tenofovir/emtricitabine.

If You Can't Wait

Because the official pathway involves private costs and navigating hospital bureaucracies, some people look for alternatives.

• Private Clinics: You can bypass the public hospitals entirely by going to a private ID specialist at clinics like Regina Maria or MedLife. If you bring negative HIV test results, they can write a private prescription which you fill at your own cost. This is the fastest route if you have the money.
• Self-sourcing generics by mail is HIGHLY RISKY: Romanian Customs is notoriously strict. While some EU residents use online pharmacies, packages of PrEP ordered from outside the EU or without a Romanian prescription attached are frequently seized and destroyed by customs. It is not a reliable method.
• Travel imports: If you buy PrEP in another EU country with a valid EU prescription, you can legally bring it back in your luggage for personal use.

Non-negotiable: You must confirm you are HIV-negative before starting any PrEP regimen, whether sourced privately or abroad. Starting PrEP with an undetected HIV infection risks developing drug resistance and makes the virus much harder to treat.

What Happens After

Medical supervision is critical, but because there's no streamlined national programme, you have to actively manage your own monitoring.

Every 3 months, you must get tested. You can do this at ARAS Checkpoints or through a private lab (like Synevo).

• The Tests: HIV test and Syphilis test.
• Three-Site Swabs: Ask specifically for throat (exsudat faringian), rectum (exsudat anal), and urethra (exsudat uretral) swabs for chlamydia and gonorrhoea. Romanian doctors may default to blood-only testing unless you specifically request the swabs.
• Kidney Function: A creatinine blood test. Do not skip this, as PrEP can affect your kidneys.
• Vaccinations: Ask your doctor or ARAS about Hepatitis A, Hepatitis B, HPV, and Mpox vaccines.

What's Available

• Daily Oral PrEP: The standard. Generic tenofovir/emtricitabine is what you will find at pharmacies.
• On-demand (2-1-1): Taking two tablets 2–24 hours before sex, one 24 hours after, one 48 hours after. This is recognized by European guidelines, and progressive specialists at Matei Balș will support it. It's an excellent way to reduce your out-of-pocket pill costs.
• Injectable (CAB-LA / Apretude): As of early 2026, while injectable PrEP is being authorized across Europe, it is not yet practically available or funded in Romania.

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