PrEP in Lithuania: Reimbursed and Accessible

PrEP in Lithuania is reimbursed through the national drug reimbursement system. If you have state health insurance, you can get the medication for a fraction of its total cost. The system here is relatively straightforward compared to neighboring countries, provided you know exactly which doctor to book: you need an infectious disease specialist (infektologas), not a general practitioner.

Who Can Get It

To access reimbursed PrEP, you must:

• Be covered by the Lithuanian national health insurance system (privalomasis sveikatos draudimas).
• Test HIV-negative.
• See an authorized infectious disease specialist.

If you are a non-resident or do not have state insurance, you will have to pay the private, out-of-pocket rate for generic PrEP (typically around €30–€60/month).

The Pathway: How to Get It

You cannot get a reimbursed PrEP prescription from a regular GP. You must go through an authorized specialist.

1. Book the Specialist: Make an appointment with an infektologas (infectious disease specialist) at an authorized center. The two primary hubs are:
   • Vilnius: Santaros Klinikos (Infectious Diseases Centre), Santariškių g. 14.
   • Kaunas: Kauno Klinikos (Lithuanian University of Health Sciences Hospital), Eivenių g. 2.
2. The Initial Appointment: The doctor will take your history, confirm you are HIV-negative, run a kidney function test (kreatininas), and screen for Hepatitis B and other STIs.
3. The Prescription: Once cleared, the doctor writes a reimbursed prescription for generic tenofovir/emtricitabine (TDF/FTC).
4. The Pharmacy: You take the prescription to a standard pharmacy (vaistinė) and pay only a small co-pay for the pills.

If You Can't Wait

Unlike systems with massive waitlists, the Lithuanian system is generally functional if you use the designated hubs (Santaros/Kauno Klinikos). However, if you face delays:

• NGO Support: Organizations like LGL (lgl.lt) or Demetra can provide navigation support, advising on the current fastest route to a prescription and potentially directing you to private clinics with shorter waits.
• Importing Online: Importing prescription medication for personal use by mail is strictly regulated by Lithuanian Customs and the State Medicines Control Agency. You must have a valid prescription (ideally translated) to even attempt it, but given that PrEP is officially reimbursed and cheap locally, importing generics online is generally an unnecessary hassle that risks your package being seized.

Test before you start: Never start PrEP without a confirmed negative HIV test. Starting PrEP with an undetected HIV infection risks creating a drug-resistant strain of the virus, making it much harder to treat.

What Happens After (Monitoring)

You must check in every 3 months. This is required to keep getting your prescription.

• The Tests: You need an HIV test, a full STI panel, and a kidney function test. Ask for three-site testing (throat, rectum, urine) for STIs to ensure nothing is missed.
• How to manage it: You can do this all with your infektologas at the clinic. Alternatively, some guys combine visits: getting HIV/syphilis tests at Demetra and supplementing with a private lab or Santaros for the mandatory kidney check.

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. This is a clinically valid option for men having less frequent sex. Discuss with your infektologas whether this dosing strategy suits your pattern, as it significantly lowers your medication use.
• Injectable PrEP: Cabotegravir (Apretude) is not broadly accessible or funded as standard in Lithuania at this time. Oral pills are the default.

Route Comparison

Related:

• > Testing in Lithuania
• > PEP Emergency in Lithuania
• > Understanding Lithuanian Healthcare
• > PrEP Mechanics — General Guide