Continuing HIV treatment and care in Spain

Key rules

• Medication: Antiretroviral treatment is dispensed free of charge from the hospital pharmacy.
• Confidentiality: Your HIV status is protected by law, and discrimination is prohibited.
• No health card: Urgent care is guaranteed without a card, and HIV treatment is usually still provided, but ask the hospital first.
• Regional differences: Delivery, multi-month supplies, proof requirements and PrEP sites vary by region.

The short route to care

HIV care in Spain is run by hospital HIV units, in infectious disease or internal medicine departments. Antiretroviral medication is free of charge and comes from the hospital pharmacy. Your HIV status is confidential, and discrimination because of it is prohibited.

If you have a health card

1. Register for a health card at your local health centre if you do not have one yet.
2. Ask your primary care doctor for a referral to the hospital HIV unit. A sexual health clinic can also refer you.
3. At the HIV unit, ask them to set up your antiretroviral therapy through the hospital pharmacy.
4. Ask the pharmacy whether you can collect your medication near home or have it delivered. Some regions offer this, and options such as multi-month supplies vary by region.

Bring your recent treatment records, your latest viral load and CD4 results, and your current medication list if you have them. They help the unit continue your treatment without a gap.

Your privacy

Health data are protected by law. At your first visit, ask how the unit protects your confidentiality and who can see your records. The checklist below lists these questions.

If you do not have full entitlement yet

Do not delay treatment while you sort out your paperwork. What applies to you depends on your situation:

• Irregular immigration status: you can get a health card by registering. Each region sets what proof of time in Spain it asks for, so ask at your local health centre.
• No card at all: urgent care is guaranteed. In practice, HIV treatment is usually provided anyway because it is treated as a public health issue. Contact the hospital's HIV unit before your first visit to ask about treatment and costs.
• Visitor from the EU: use your EHIC for necessary care.
• Other visitors without cover: you may be treated as a private patient or be charged. Ask about costs before you start.

Requirements and practice differ between regions and hospitals, so get the answer from the hospital itself.

PrEP

PrEP is the medicine that prevents HIV infection. It has been publicly funded across Spain since November 2019 for people with public health entitlement. It is prescribed and dispensed through hospital pharmacies and some sexual health or STI clinics. Eligibility focuses on higher-risk groups, mainly men who have sex with men, trans women and sex workers with recent STIs or condomless sex. Where you collect it depends on your region: some use dedicated clinics, others hospital HIV units. Ask your health centre or a sexual health clinic where to start.

Checklist

• Get a referral to a hospital infectious disease or internal medicine HIV unit from your primary care doctor or a sexual health clinic.

• Ask the hospital about treatment and costs before your first visit if you have no health card, or show your EHIC if you are an EU visitor.

Frequently asked questions

Can I get HIV treatment in Spain if I have no health card?

Often yes, because HIV treatment is usually provided in practice even without a card, as it is treated as a public health issue. Urgent care is guaranteed regardless. Others without cover may be treated as private patients or be charged, so ask the hospital before your first visit.

Can people in an irregular situation get a health card?

Yes, people in an irregular situation can get a health card when they register, usually after proving they have been in Spain. Each region sets the proof it asks for, so check with your regional health service.

Is PrEP free in Spain?

Yes, PrEP has been publicly funded nationally since November 2019 for people with public health entitlement who meet the risk criteria.

Is PrEP available at the same places in every region?

No, PrEP sites differ by region, because some regions use dedicated clinics and others use hospital HIV units. Dispensing also started at different times in each region. Ask your regional health service where to start.