How to get PrEP in Germany

If you're looking for HIV prevention medication in Germany, the good news is that PrEP is widely available and affordable. With public health insurance, you'll pay just a €10 co-payment per 3-month pack. Without public insurance, you can still get PrEP on a private prescription for around €50 per month.

In this guide, you'll learn:

• Who is eligible for PrEP in Germany
• How to get a prescription, step by step
• How much PrEP costs with and without insurance
• Where to find a PrEP doctor
• Daily vs. on-demand dosing options
• What medical tests you'll need

What is PrEP and how does it work?

PrEP stands for pre-exposure prophylaxis — a medication taken by HIV-negative people to prevent HIV infection. It reduces the risk of getting HIV through sex by about 99%.

The most common form of PrEP is a tablet containing two active ingredients: tenofovir disoproxil and emtricitabine (originally sold as Truvada, now available as generics). PrEP works by blocking the enzyme that HIV needs to replicate. By keeping the drug in your system, any potential exposure to the virus is stopped before it can take hold.

Common side effects are mild and usually temporary — nausea, headache, or stomach discomfort in the first few weeks. In rare cases, PrEP can affect kidney function or bone density, which is why regular monitoring is part of the process. There is no evidence that PrEP interferes with hormone therapies.

PrEP is part of a broader approach to sexual and reproductive health in Germany and works best alongside regular STI and STD testing, since PrEP only protects against HIV — not other sexually transmitted infections.

Who is eligible for PrEP in Germany?

Since September 2019, PrEP has been a legal entitlement under Germany's statutory health insurance system, established through the Terminservice- und Versorgungsgesetz (TSVG).

To qualify for insurance-covered PrEP, you must:

• Be aged 16 or older
• Be covered by public health insurance (GKV)
• Be assessed by a doctor as having a "substantial" risk of HIV infection

Your doctor will determine whether you meet the risk criteria during an initial consultation. This typically applies to men who have sex with men, transgender people, people whose sexual partners are HIV-positive, people who have sex without condoms with partners of unknown HIV status from regions with high HIV rates, and people who inject drugs.

Even if you don't have public insurance, you can still get PrEP — more on that in the insurance section below.

How to get a PrEP prescription: step by step

Getting PrEP in Germany is straightforward once you know where to go. Here's the process:

1. Find a PrEP-experienced doctor. Not every GP prescribes PrEP, so look for one experienced with HIV prevention. Use the Federal Ministry of Health directory, the PrEP.Jetzt doctor list, or the dagnä list of HIV specialists. You can also book via Doctolib.

2. Attend an initial consultation. Your doctor will discuss your sexual health history, risk factors, and whether PrEP is right for you. If you need help finding and seeing a doctor in Germany, we have a separate guide for that.

3. Complete the required medical tests. Before prescribing PrEP, your doctor must check your HIV status (to confirm you're HIV-negative), screen for Hepatitis B, and test your kidney function (creatinine levels).

4. Receive your prescription. If your doctor determines you have a substantial HIV risk, they'll issue a Kassenrezept (health insurance prescription) for a 3-month supply.

5. Pick up your medication at any pharmacy. Take your prescription to any pharmacy in Germany to collect your PrEP tablets.

6. Return every 3 months for check-ups. PrEP requires ongoing monitoring. At each visit, you'll be re-tested for HIV, have your kidney function checked, and typically get screened for STIs. Your doctor will issue a new 3-month prescription at each visit.

How much does PrEP cost in Germany?

PrEP costs have dropped dramatically in recent years. Here's what you'll pay depending on your situation:

For context, PrEP used to cost around €800 per month before the patent expired in 2017. The price dropped to ~€50/month with generic availability, and then became effectively free (just the €10 co-pay) when public insurance coverage started in September 2019.

If you want to understand how much health insurance costs more broadly, that's a separate but related question — especially if you're weighing which type of insurance to get.

PrEP and health insurance in Germany

How you access PrEP depends on your insurance type. Here's the breakdown:

Public health insurance (GKV)

This is the simplest and cheapest path. If you're on any public health insurance plan in Germany, PrEP is covered as a legal entitlement. Your insurer pays for the medication, all required lab tests, and doctor consultations. You only pay the €10 co-payment per 3-month prescription.

Since public insurance introduced PrEP coverage, prescriptions doubled within one month — and uptake has grown steadily to approximately 40,000 users by the end of 2023.

Private health insurance (PKV)

Private health insurance providers are not legally required to cover PrEP. Most private plans don't include it, though it's worth asking your specific insurer. If your PKV doesn't cover PrEP, you can still get it on a private prescription and pay out of pocket (~€50/month for generics).

An important consideration: if you're already HIV-positive or taking PrEP, this may be classified as a pre-existing condition when applying for private insurance. If you're considering PrEP and haven't chosen your insurance yet, public insurance is likely the better option for this reason.

Expat health insurance

Expat health insurance is designed for temporary stays and does not cover PrEP. It's emergency and accident coverage, not a long-term health plan.

If you need PrEP while on expat insurance or while waiting to join the public system, you'll need to pay out of pocket. A doctor can write you a private prescription, and generic PrEP (such as ratiopharm) costs approximately €50 per month at any pharmacy.

For information and support, Liebes Leben provides English-language guidance on HIV prevention, testing, and accessing PrEP — by phone, email, or in person.

Paying out of pocket (no insurance or private prescription)

Anyone in Germany — including tourists, students waiting for their insurance to activate, and undocumented residents — can get PrEP on a private prescription from any doctor. The generic version (ratiopharm) costs approximately €50 per month at a pharmacy. You'll also need to pay for the consultation and lab tests separately.

Daily PrEP vs. on-demand PrEP: dosing options

There are two ways to take oral PrEP:

Daily PrEP

Take one tablet every day at roughly the same time. This provides continuous protection and is the standard approach. Daily PrEP reaches full protection after about 7 days of consistent use for receptive anal sex, and about 21 days for receptive vaginal sex.

On-demand PrEP (2-1-1 protocol)

If you don't have frequent exposure, on-demand dosing may be an option. The protocol — sometimes called "event-based" or "2-1-1" — works like this:

1. Take 2 tablets 2 to 24 hours before anticipated sex
2. Take 1 tablet 24 hours after the first double dose
3. Take 1 tablet 24 hours after that

On-demand PrEP was shown to be 97% effective in the IPERGAY trial. However, it's currently only validated for receptive anal sex — it's not recommended for vaginal sex. It also cannot be used if you have Hepatitis B.

Discuss with your doctor which protocol is right for you.

Coming soon: injectable PrEP

Two injectable PrEP options have been approved by the European Medicines Agency:

• Cabotegravir (Apretude): An injection given every 2 months. EMA-approved in 2023.
• Lenacapavir (Yeztugo): An injection given every 6 months. EMA-approved in 2025.

Availability in Germany is still limited, but these options may become more accessible in the coming years. Ask your PrEP doctor about the latest availability.

Medical tests and ongoing monitoring

PrEP isn't a "take and forget" medication. Regular medical supervision is required — and it's fully covered by public insurance.

Before starting PrEP

Your doctor must carry out:

• HIV test — to confirm you're HIV-negative (taking PrEP while HIV-positive could lead to drug resistance)
• Hepatitis B screening — PrEP medications can also treat Hep B, so stopping PrEP could cause a flare-up if you're infected
• Kidney function test (creatinine) — since PrEP can occasionally affect kidney function

Every 3 months while on PrEP

At each follow-up visit, your doctor will:

• Re-test for HIV
• Check kidney function
• Screen for sexually transmitted infections
• Issue a new 3-month prescription

These regular check-ups are similar to other preventive check-ups and screenings available in Germany — they're a standard part of responsible PrEP use.

Where to find a PrEP doctor in Germany

PrEP doctors are available in all federal states, not just Berlin or other major cities. Use these resources to find one near you:

When booking, mention that you're interested in PrEP (HIV-Prophylaxe) so the practice can confirm they offer it.

PrEP in Germany: key facts and statistics

Germany has one of the most accessible PrEP programs in Europe. Here are the key numbers:

• ~40,000 people were taking PrEP in Germany by the end of 2023 (RKI)
• PrEP use doubled within one month of public insurance coverage starting in September 2019 (Frontiers study)
• An estimated 2,300 new HIV infections occurred in Germany in 2024, up slightly from 2,200 in 2023 (RKI)
• Approximately 97,700 people are living with HIV in Germany as of end-2024
• Globally, about 86 million people have contracted HIV since the beginning of the epidemic

PrEP is a key part of Germany's HIV prevention strategy, alongside treatment-as-prevention (people on effective HIV treatment cannot transmit the virus) and condom use.