The Short Version
PrEP is available in Slovakia but the cost picture is uneven. VšZP (the main public insurer) covers PrEP 100% including testing. Dôvera and Union (private insurers) do not reimburse PrEP, so those insured by them pay out-of-pocket. Dom Svetla is the best navigation resource regardless of your insurance situation.
Path 1: VšZP-Insured — Full Coverage
If you are insured by VšZP (Všeobecná zdravotná poisťovňa), PrEP is reimbursed 100% including medication and associated testing.
Process:
- Contact Dom Svetla (domsvetlaslovensko.sk / +421 2 2102 8048) for referral support and to navigate the process efficiently
- Book an appointment at an infectious disease specialist (infektológ) — the National Reference Center for HIV/AIDS in Bratislava or Kramáre Hospital
- Pre-PrEP tests: HIV (negative required), hepatitis B, creatinine (kidney function), STI screen
- Receive an eRecept (electronic prescription) — valid for 3 months
- Collect from a pharmacy (lekáreň) — covered by VšZP
Follow-up every 3 months: HIV test, STI screen. Consultations and medications remain free.
Ask specifically for three-site swab testing at every follow-up: "Výter z hrdla, rektálny výter a uretrálny výter."
Path 2: Dôvera/Union-Insured — Private Pay
If you are insured by Dôvera or Union, your insurer does not currently reimburse PrEP. You pay out-of-pocket.
Cost:
- Infektológ consultation: ~€30–50
- Lab tests: ~€50 for baseline panel
- Generic PrEP (Tenvir-EM, Ricovir-EM): ~€30–50/month
- Ongoing monitoring consultations: ~€30–50 every 3 months
Where to see a specialist:
- Kramáre Hospital Infekčná klinika (Limbová 5, Bratislava)
- VÚSCH Košice (Rastislavova 43)
- Dom Svetla can provide a list of PrEP-friendly specialists and help navigate any barriers to care
Pharmacies for generic PrEP:
- Bratislava: Benu (Obchodná 5), Dr. Max (Kamenné námestie)
- Košice: Lekáreň na Hlavnej
- Generics are the same medication as branded Truvada at a fraction of the cost
Path 3: Telemedicine / Online Access
For those facing doctor refusals, long waiting times, or who prefer to avoid the Slovak healthcare system:
- PrEPinfo.sk — Slovak-language telemedicine consultations (
€20) plus generic PrEP shipped from EU warehouses (€40/month); check current availability at prepinfo.sk - GetOnPrEP.com and similar EU-based services — ship generic PrEP without a Slovak prescription; legal to import for personal use within EU; you self-manage testing
If using the self-managed route, Dom Svetla's Checkpoint can provide the regular HIV and syphilis rapid tests. For full monitoring including kidney function and bacterial swabs, you will still need to visit a lab or clinic periodically.
On-Demand PrEP
The 2+1+1 on-demand protocol is clinically established. Some Slovak infektológovia will prescribe it. Discuss this option if you prefer not to take a daily pill — it may also reduce cost.
Required Monitoring (All Routes)
Regardless of how you access PrEP, follow this testing schedule:
| Time | Tests Required |
|---|---|
| Baseline | HIV (negative), Hepatitis B, creatinine |
| Every 3 months | HIV, syphilis, gonorrhoea, chlamydia (three-site swabs) |
| Every 6–12 months | Creatinine re-check |
PrEP protects only against HIV. Three-site swab testing is essential for catching gonorrhoea and chlamydia.
Barriers and Navigation
| Problem | Solution |
|---|---|
| Doctor refusal or hostility | Contact Dom Svetla for a list of PrEP-friendly specialists |
| VšZP coverage confusion | Dom Svetla staff can help navigate the VšZP approval process |
| High cost (Dôvera/Union) | Consider switching to VšZP at next renewal; use generic generics in the interim |
| Testing access | Dom Svetla Checkpoint for HIV/syphilis; Medirex/Unilabs/Alpha Medical for swabs |
See also: PEP emergency | Dom Svetla testing | PrEP mechanics
Anonymous Partner Notification
If you test positive for an STI and absolutely cannot face the direct message (e.g., safety concerns, extreme anxiety), you must still ensure partners are warned.
Slovakia does not currently have a centralized, public anonymous notification portal. The most effective route is to ask the clinic or doctor who diagnosed you to assist; many local sexual health units can facilitate confidential partner notification on your behalf without revealing your identity. It's always better than silence.