Madrid has the highest volume of PrEP users in Spain. To handle the national PrEP access crisis, the regional government expanded the renowned Centro Sanitario Sandoval model from a single clinic into a network of three specialized hubs.
🏛️ The Three CESS Hubs
The Centros Especializados en Salud Sexual (CESS) are the gateway to sexual health and PrEP in Madrid. They are entirely free if you are registered with the Madrid public health system (SERMAS).
| Clinic | Location | Best For |
|---|---|---|
| CESS Sandoval | Chamberí (Calle Sandoval) | The flagship. Full STI testing, PrEP initiation, complex cases. |
| CESS Montesa | Salamanca (Calle Montesa) | PrEP monitoring, routine asymptomatic testing. |
| CESS Alameda de Osuna | Barajas (Calle Alameda de Osuna) | Overspill clinic to handle the PrEP waitlists. |
Appointments are mandatory. You cannot walk into these clinics for routine PrEP initiation or asymptomatic screening. You must book an appointment (Cita Previa) either online or by phone. Slots open at specific times and disappear immediately.
🤝 The NGO Route: Apoyo Positivo
If you cannot secure a CESS appointment, your first stop should be Apoyo Positivo.
They are the premier LGBTQ+ sexual health NGO in Madrid. They offer rapid, anonymous HIV and Syphilis testing, and more importantly, they employ "navigators" who understand the intricacies of the SERMAS bureaucracy and can help fast-track your referrals into the hospital system if you need PrEP or HIV care.
🏥 Hospital Emergencies (PEP)
If you need emergency PEP (Post-Exposure Prophylaxis) outside of clinic hours, you must go to a hospital emergency room (Urgencias).
The primary reference hospital for sexual health emergencies in central Madrid is Hospital Clínico San Carlos, which manages the Sandoval network. Hospital Universitario La Paz is also highly competent. Go to Urgencias and state you need PEP for a sexual exposure.
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