Bulgarian Citizens Research Articles

BULGARIAN CIVIL SOCIETY – POLITICAL PARTICIPATION AND APATHY

This article aims to analyze the contemporary manifestation of civil society in Bulgaria through the prism of political participation and apathy among citizens. For this purpose, the concept of civil society and the need for active political citizens have been examined successively; an analysis of the political participation of Bulgarian citizens was made, through a study of electoral activity, membership in political parties and their participation in the electoral process as advocates; finally, the main reasons for the relatively high levels of political apathy and anomie among Bulgarian society, in relation to the role of political parties, are presented.

General secondary education in Bulgaria: administrative law aspects

In the article, the author analyses the system of general secondary education in the Republic of Bulgaria from the perspective of administrative law and also examines the regulatory framework for education in this country with a view to identifying the specific features of school education which determine its efficiency and quality.
 The fundamental rights of Bulgarian citizens to education are enshrined in the Constitution of the Republic of Bulgaria. Education in Bulgaria is a national priority, and therefore educational policy is formed and implemented on the following principles: a unified state educational policy to ensure the right to preschool and school education; focus on the interest and motivation of the child and pupil, on age and social changes in life, as well as on the ability to apply the acquired competences in practice.
 Having analysed the fundamental law of the Republic of Bulgaria “On Preschool and School Education”, the author notes that it is supplemented by a significant number of legal acts issued in the form of resolutions of the Council of Ministers, orders of the Ministry of Education and Science of the Republic of Bulgaria and a number of other ministries on specialised education programmes.
 The author pays particular attention to the distribution of administrative powers in the field of education between the Council of Ministers, the Ministry of Education and Science of the Republic of Bulgaria, regional education departments, local self-government bodies and educational institutions.
 In the author’s opinion, the activities of bodies for consideration and addressing of a wide range of issues at the school level are worthy of further study: these are pedagogical councils, public councils established at each school, and boards of trustees established to attract additional financial and material resources to support school activities and control their intended use.
 Based on the study, the author concludes that public administration of the general secondary education in Bulgaria is characterised by deep democratization and decentralization, as well as expansion of the autonomy given to schools. While the main subject of public administration in the field of general secondary education in Bulgaria is the Ministry of Science and Education, a significant role is also played by regional education departments and local governments, where the former provide methodological support to educational institutions, and the latter supervise and control directly the educational institutions.

The Second National Assembly: Elections, Establishment, and Composition

The Bulgarian parliamentary system came into being with the formation of the First National Assembly in the fall of 1879. Political inexperience, constitutional opposition, as well as disagreements between the monarch, parliament and executive led to the first political crisis in the country, which had several possible outcomes. Ultimately, the idea was embraced that it was necessary to seek the vote of the people once again, in order to strike a balance between the three disputing authorities. The young state administration managed to develop what was achieved and to provide conditions for Bulgarian citizens to successfully and democratically declare their intention. The Second National Assembly was established after one general election and two additional elections were held for a period of one calendar year. The territorial scope of the electoral colleges was improved, and access to the polls and integrity of the electoral process were ensured. The vote took place in accordance with the Provisional Rules for the Election of Representatives to the First Ordinary National Assembly, adopted in April 1879. However, the election results unequivocally showed that the large voter turnout sought through them could not be achieved, and that the high electoral threshold on the first day of the vote was unrealistic and therefore necessary to be removed. Violations in the electoral process remained almost the same as those established during the vote for the previous Assembly, but quite frequently overexposed or neglected for political purposes. The electoral process related to the Second National Assembly triggered a rapid and definitive formation of the Liberals and Conservatives’ party structures at both the national and regional levels.

ANNUAL ANALYSIS OF PARASITIC INFECTIONS IN BULGARIA IN 2022

INTRODUCTION: Infections caused by parasites still represent an important global health problem. Although parasitic infections are responsible for significant morbidity and mortality in developing countries, they are also prevalent in developed countries. This study aims to establish the dynamics of the parasitic infections registered in the country (local and imported) and to analyze the situation, based on data from the previous years. METHODS: We used the annual reports of regional health inspectorates, diagnostic laboratories, medical universities, and data from the National center of infectious and parasitic diseases about all individuals infected with parasitic diseases in the country. RESULTS: A total of 635,522 persons were examined in 2022, of whom 1.82% were diagnosed with various parasitic infections. In the local helminthic zoonoses such as echinococcosis and trichinellosis, a significant decrease in morbidity was observed,1.3%₀₀₀ (n = 89) for cystic echinococcosis and 0.16%₀₀₀ (n = 9) for trichinellosis. For soil-transmitted helminthiases (ascariasis and trichuriasis), the incidence was 6.7%₀₀₀ and 0.5%₀₀₀, respectively. Data on enterobiasis does not show any particular dynamics in 2022 either. The registered prevalence for the country was 1.48%, and for children from various childcare facilities - 2.45%. During the year, seven cases of vector-borne parasitic diseases were registered in the country: imported malaria was diagnosed in 5 patients (4 Bulgarian citizens and one foreigner), and autochthonous visceral leishmaniasis - in two persons. CONCLUSIONS: The analysis shows that, in spite of a trend of declining morbidityfor some socially significant protozoan and helminth infections, human parasitic diseases still represent a significant problem with social and medical consequences for the population of our country. Therefore, it is necessary to preserve and strengthen the surveillance and control network by including new personnel in the medical parasitology structures.

The current state of oral health and dental care system efficiency in twelve selected East European countries

Objective: This investigation aims to highlight the often-overlooked landscape of oral care in East European countries by evaluating the dental status of their populations and the efficiency of their dental care systems. Method: The study employs the Dental Health Index (DHI), which measures the dental state of entire populations, allowing for quantifiable comparisons between differing countries and dental systems. The survey relies solely on existing epidemiological and various scientific data. Results: The findings reveal a wide range of results among the countries studied. On average, the oral health of the younger generation is satisfactory and has improved over the past two decades, with more significant progress observed in permanent teeth compared to deciduous teeth. However, the dental status of adults remains poor, with only a few signs of positive developments in the past decade. The most favourable DHIs are seen among Romanian and Serbian individuals, while Lithuanian and Bulgarian citizens exhibit a less favourable oral health status. Notably, the latter two countries have the highest dental density of those studied. In terms of benefit-cost reflections, Romania, Serbia and Poland perform best. Estonia and Lithuania appear to have untapped productivity resources. Conclusion: To enhance the overall oral health status of the population, the author advocates for a broader focus that extends the current prioritization of the young generation to include adults up to 35 years of age, as the period between 18 and 35 years significantly influences the future development of natural teeth. To implement effective measures for this reform, oral health policies must prioritize prevention and tooth retention. Suggestions are provided on how this could be achieved. An active, goal-oriented oral health policy is essential, for improving the currently unsatisfactory oral health status of adults. Without such efforts, the dental health of the elderly population is likely to deteriorate further.

The effect of obtaining EU citizenship in former transition economies on remittance flows

AbstractWe estimate the effect of the granting of European Union (EU) citizenship rights on the flow of remittances from Italy. We use the EU enlargements of 2007 and 2013 as natural experiments. The results show a negative impact on remittance flows. The effect of the 2007 EU enlargement shows how Romanian and Bulgarian citizens reduced the average annual amount of remittances by 1400 Euros per year per migrant. In the case of the 2013 EU enlargement, we find a smaller decrease of about 50 Euros per year per Croat. These results are consistent after a series of robustness checks. We analyse this decline in depth to the extent that remittances are an important source of monetary flows in transition economies. We find that both the change in the taxonomy of immigrants from the new Member States and the improvement of economic conditions in the country of origin after the EU accession provide suggestive evidence on plausible mechanisms behind our results.

The Future of National Identity in Bulgaria

The article is grounded in a 2021 national survey exploring the modern identity of Bulgarian citizens, undertaken as part of the National and European Dimensions of the Modern Identity of Bulgarian Citizens project, supported by the National Science Fund. It delves into the shifts occurring in the national identity of Bulgarians amid increased global mobility and communication between ethnicities and nations. This trend challenges traditional notions of national borders, eroding the insularity of national cultures and fostering a sense of supranational identity. Comparing two regions within Bulgaria—the Veliko Tarnovo district, predominantly inhabited by ethnic Bulgarians, and the Kardzhali district, characterized by an ethnically diverse populace, with a notable Turkish ethnic majority—the article examines the evolution of these processes. Despite signs suggesting a weakening of national identity and the emergence of supranational identities (such as European or global citizen) alongside indications of local identity formation, the research findings reveal that, presently, national identity remains the primary and guiding factor in the self-identification of Bulgarian citizens.

Комуникативни и социокултурни особености на представата за успех сред дигиталните потребители в България

Abstract: The paper presents the results of a survey among digital consumers in Bulgaria. The text proposes a concept of a four-dimensional model of the perception of success among digital consumers in the country. The model includes four sociocultural categories: well-being, happiness, achievement and social capital. The hypotheses are, first, that the sociocultural notion of success includes concepts belonging to at least one of the four dimensions of the success model; second, that the notion of success is associated with topics in respondents' daily lives, such as income size and employability. The aim of the study is to approbate whether and how many of the replicated associations fall into the four sociocultural categories. The study was conducted from January to June 2023, it covers 265 Bulgarian citizens who use the social networks Facebook (Meta) and LinkedIn. The methodology includes a combined questionnaire of a free association experiment and a close-ended questionnaire. The paper communicates some of the results of the free association experiment. According to the results the respondents’ answers belong to all four categories of success. There is a significant difference in the total number of reactions, produced by men and women, which belongs to the social capital category. The following conclusions are drawn at the end of the paper: the digital generation needs to understand its own values and attitudes to have a better quality of life; knowledge of notions of success is useful for team managers and HR professionals; and the new digital generation’s motivation differs from that of the so-called analogue generations. Keywords: success, sociocultural feature, digital users, associative experiment, achievement, well-being.

Restrictions on access to medical care for the uninsured in Bulgaria

Abstract Introduction There are two forms of health insurance in Bulgaria - mandatory and voluntary. Despite the fact that all Bulgarian citizens are required to have health insurance, a high proportion of persons with interrupted health insurance rights due to irregularly paid health contributions is reported every year. These persons have limited access to health services, as they cannot be provided with free preventive activities, planned hospitalizations, and for pregnant women there is a minimum number of free examinations (4 examinations during the entire pregnancy). The purpose of the present study is to determine the share of persons with suspended rights and their opportunities to access health services. Methods Official data from the annual reports of the Health Fund and the National Statistical Institute for the period 2020 - 2022 for the Pleven region were used. The data were processed with statistical methods. Results It was found that for the period from 2020 to 2022, an average of 20.6% of the population had interrupted health insurance rights. Provided that persons under 18 and those of retirement age are insured by the state, persons with suspended rights are only of active age. Among this group, the share of the uninsured is 34%. Uninsured women giving birth in 2020 are 19.35% of all women giving birth, in 2021 - 16.54%, and in 2022 - 18.33%. Conclusions The high share of persons with interrupted health insurance rights in Bulgaria represents a serious problem for the access to basic medical care of these people. Limitation of activities for prevention, planned treatment and regular monitoring of pregnant women. poses a risk to both their individual health and the health of the population. Key messages • In Bulgaria, a high proportion of persons with interrupted health insurance rights is observed. • The uninsured have very limited access to free medical care, preventive activities and planned treatment.

Link between COVID-19 Vaccination Attitudes and Support for Mandatory Childhood Vaccinations

Abstract Introduction Despite vaccines being a proven intervention over time to limit the spread of infectious diseases, in recent decades there has been fluctuation among parents regarding the mandatory immunization calendar in Bulgaria. Aim This study aimed to investigate the impact of the COVID-19 pandemic on parents’ decisions regarding mandatory immunizations for children in Bulgaria. Methods A total of 1200 Bulgarian citizens participated in the cross-sectional study, which included questions related to socio-demographic indicators, COVID vaccination status, attitudes towards mandatory immunization, beliefs in personal doctors, rumors about vaccines, and the desire to vaccinate their own children against COVID-19. Data was analyzed using Jamovi software, and a chi-square test for association was used to investigate the relationship between COVID-19 vaccination status and attitudes towards mandatory childhood vaccinations. Results The study found that 93% of the 1133 participants who expressed an opinion on mandatory childhood vaccinations had a positive attitude. Respondents who were vaccinated against COVID-19 and had a positive attitude towards mandatory COVID vaccination were more likely to support mandatory childhood vaccinations – 98.8% vs 1.2% (χ2=27.6; p < 0.001). Those who perceived moderate to high benefits of COVID vaccines were also more likely to support mandatory childhood vaccinations (χ2=43.4; p < 0.001). Participants who had not heard of or did not believe in rumors about COVID vaccines and those who had trust in primary care physicians were more likely to support mandatory childhood vaccinations. Conclusions The study indicates that attitudes towards COVID vaccination could influence parents’ decisions on mandatory vaccines for children in Bulgaria. If parents distrust the safety and effectiveness of COVID vaccines, they may also be hesitant towards mandatory vaccinations for children. Key messages • Implementation of a proper vaccination policy is necessary to protect public health and limit infectious diseases. • The COVID-19 pandemic has raised questions about the possibility of including mandatory vaccination against COVID-19 in Bulgaria's immunization calendar.

PSYCHOLOGICAL DETERMINANTS OF POLITICAL ORIENTATION AND ATTITUDES TOWARDS IMMIGRANTS IN BULGARIA

The influence of basic human values on citizens’ ideo-political orientation has been extensively documented in the literature. An important component of political orientation, attitudes towards immigrants in host societies are no exception in their dependence on some of the personal value categories identified by Schwartz in his Theory of basic values (Schwartz 1992). The results of two studies that employ Schwartz’s value categories and aim to explore the relationship between Bulgarian citizens’ values and their attitudes towards immigrants in the country are presented. Study 1 is a nationally representative sociological survey, and Study 2 uses qualitative research methods to examine the link between Bulgarian party members’ values on one hand and their political orientation and attitudes towards immigrants on the other. While Study 1 provides evidence of the dependence of Bulgarians’ attitudes towards immigrants on Universalism, Security, Tradition and Self-direction value categories, Study 2 results show a strong dependence of party members’ attitudes towards immigrants on political affiliation, and an insignificant one on individual values. Both studies contribute to ideology and immigration research literature in Bulgaria by proposing and empirically testing a values-based model of ideological orientation that is relevant to the Bulgarian context. Given the prevalence of the “conservative ideological and values complex” (Konstantinov 2022), in Bulgarian society and in other Eastern European countries, the findings could have implications for the analyses of negative attitudes towards immigration not only in the Balkan country but in the wider post-Soviet space as well.

PSYCHOLOGICAL DETERMINANTS OF POLITICAL ORIENTATION AND ATTITUDES TOWARDS IMMIGRANTS IN BULGARIA

The influence of basic human values on citizens’ ideo-political orientation has been extensively documented in the literature. An important component of political orientation, attitudes towards immigrants in host societies are no exception in their dependence on some of the personal value categories identified by Schwartz in his Theory of basic values (Schwartz 1992). The results of two studies that employ Schwartz’s value categories and aim to explore the relationship between Bulgarian citizens’ values and their attitudes towards immigrants in the country are presented. Study 1 is a nationally representative sociological survey, and Study 2 uses qualitative research methods to examine the link between Bulgarian party members’ values on one hand and their political orientation and attitudes towards immigrants on the other. While Study 1 provides evidence of the dependence of Bulgarians’ attitudes towards immigrants on Universalism, Security, Tradition and Self-direction value categories, Study 2 results show a strong dependence of party members’ attitudes towards immigrants on political affiliation, and an insignificant one on individual values. Both studies contribute to ideology and immigration research literature in Bulgaria by proposing and empirically testing a values-based model of ideological orientation that is relevant to the Bulgarian context. Given the prevalence of the “conservative ideological and values complex” (Konstantinov 2022), in Bulgarian society and in other Eastern European countries, the findings could have implications for the analyses of negative attitudes towards immigration not only in the Balkan country but in the wider post-Soviet space as well.

PSYCHOLOGICAL DETERMINANTS OF POLITICAL ORIENTATION AND ATTITUDES TOWARDS IMMIGRANTS IN BULGARIA

The influence of basic human values on citizens’ ideo-political orientation has been extensively documented in the literature. An important component of political orientation, attitudes towards immigrants in host societies are no exception in their dependence on some of the personal value categories identified by Schwartz in his Theory of basic values (Schwartz 1992). The results of two studies that employ Schwartz’s value categories and aim to explore the relationship between Bulgarian citizens’ values and their attitudes towards immigrants in the country are presented. Study 1 is a nationally representative sociological survey, and Study 2 uses qualitative research methods to examine the link between Bulgarian party members’ values on one hand and their political orientation and attitudes towards immigrants on the other. While Study 1 provides evidence of the dependence of Bulgarians’ attitudes towards immigrants on Universalism, Security, Tradition and Self-direction value categories, Study 2 results show a strong dependence of party members’ attitudes towards immigrants on political affiliation, and an insignificant one on individual values. Both studies contribute to ideology and immigration research literature in Bulgaria by proposing and empirically testing a values-based model of ideological orientation that is relevant to the Bulgarian context. Given the prevalence of the “conservative ideological and values complex” (Konstantinov 2022), in Bulgarian society and in other Eastern European countries, the findings could have implications for the analyses of negative attitudes towards immigration not only in the Balkan country but in the wider post-Soviet space as well.

Albena Shkodrova. Communist Gourmet. The Curious Story of Food in the People’s Republic of Bulgaria

Albena Shkodrova. <i>Communist Gourmet. The Curious Story of Food in the People’s Republic of Bulgaria</i>

Citizen Control in Primary Outpatient Care – Opportunities and Realities in Bulgaria

Abstract The significance of control increases with the push towards improving the overall effectiveness of the health insurance system. In order for public resources to be spent lawfully and effectively, there needs to be increased control not only from the National Health Insurance Fund (NHIF), but citizen control also needs to be incorporated in the process. Materials and Methods The goal of this survey is to analyze the opportunities for implementing citizen control over the spending of public health funds and compare them to the real conditions as far as the outpatient medical care level. Legislation and news from NHIF’s webpage related to citizen control opportunities were studied. A direct, anonymous survey was carried out on the Google forms platform amongst Bulgarian citizens past the age of majority. Results The results of the questionnaire survey carried out between 24.06.2022 and 16.10.2022 among 1045 adults with compulsory health insurance from all over the country, showed that they were poorly informed on the opportunities for citizen control which have been regulated and created in practice and don’t take advantage of them. Only 45,6% of the participants were aware of the digital services “Record review for health-insured persons”, which is found on NHIF’s webpage, and less than half of them (42,8%) used this service. The NHIF’s mobile application for feedback was used by as little as 11,8% of the respondents, and only seven patients have used it to share an opinion, while nine have used it to get notifications for data changes in their patient record. The portion of participants who have taken part in NHIF inquiries was also very small – 2,5%. Merely 2,8% have posted a complaint to the NHIF after being denied medical services. Conclusions All of this makes it evident that a change is necessary in order for citizen control to be strengthened as a mechanism. This will lead to the correction of proven deviations in reported medical activities and will make it easier to get the patients’ opinions on the medical care they have been provided with.

Bulgarians’ Motivation for Participation in Private Military Companies

Private military companies are becoming increasingly popular; their manpower is higher than the manpower of some national armies. Nevertheless, they still exist in the shadows and are often called “shadow armies”. Recently PMC have been participating in various military conflicts including the ongoing war between Russia and Ukraine. National armies are losing manpower because soldiers prefer to join private military companies. When such companies recruit staff internationally, they directly weaken the national armies because the PMC contractors are mostly ex-militaries and ex-police staff. PMCs could promote the interests of the countries from where they originate and there can be a strong link with the state despite the private nature of PMC. In this case, mercenaries contribute to the foreign policy of their own countries and their motivation is affected accordingly. The article aims at outlining the motives of Bulgarian citizens to join international private military companies, thus shedding light on this under-researched problem. It is usually considered that PMC contractors’ motives are mostly related to profit. However, there are other strong motivations that need examination. It is argued that their motivation depends on both personal characteristics, as well as on the environmental factors (social, economic, political) in contractors’ state of origin.

HEALTH LITERACY: A CALL FOR ACTION FOR A JUST AND EGALITARIAN SOCIETY

Health Literacy Survey -2019 (HLS19) undertook a two-year extensive comparative survey in 17 European countries whose results demonstrated that while health literacy levels have risen, there is vast room for improvement. 36% of the Bulgarian population has poor or unsatisfactory level of health literacy (very difficult/ difficult range answers). This means that more than a 1/3 of Bulgarian citizens are facing hurdles when presented with health or healthcare related issues to deal with which inexorably affects their quality of life and potential. To society this means that there is a measurable inequality between those with high and low health literacy that is evidenced by social gradient. Thus, low health literacy has direct effect on perpetuating health inequalities which in turn affects social justice and attainment of human development and flourishing. HL is closely associated with social determinants of health and poor health/ outcomes due to low literacy is as an injustice that needs to be addressed systematically from broad policy perspective. It is an injustice as studies demonstrate that HL is a modifiable factor that has a direct positive effect on improving well-being, reducing absenteeism, and triggering economic and social progress. The purpose of the project is to analyze available literature, draft and test questionnaires, analyze results in order to gain better understanding of the health literacy needs of Bulgarian population and to better inform public health policies and implement targeted evidence based interventions. Improved health literacy will lead to more effective and efficient healthcare utilization contributing to better patient outcome and optimal use of health and medical resources. In fact, the WHO Shanghai Declaration (2016) declared health literacy a critical determinant of health and established the direct link between adequate health literacy and achievement of Sustainable development goals.

Periodontal Status of Active Age Population in the Republic of Bulgaria

Periodontal health is an important component of oral health. Numerous studies prove the progressing nature of periodontal diseases and their dependence on a number of demographic and socio-economic factors.&#x0D; The purpose of the study is to examine the periodontal status of the active age population in the Republic of Bulgaria and to define its dependence on social and demographic factors.&#x0D; To accomplish the study goals epidemiological and survey cards were developed and approbated and epidemiological study was conducted, including clinical dental examination and anonymous survey among 416 Bulgarian citizens aged 18 to 65 years. The results were statistically analyzed to establish the dependencies between the periodontal status and socio-demographic factors.&#x0D; Only 69 (16.59%) of the study subjects have no periodontal problems (CPI = 0) in all sextants, while all other patients have different degrees of periodontal disease. One can witness an increase of the periodontal disease incidence, proportional to the age of the patients, as well as its decrease with increasing the frequency of dental visits on behalf of the patients and their oral health self-assessment. Healthy periodontal tissues prevail in young patients and urban population. Gingival inflammation and calculus are prevalent among middle-aged people, rural population as well as in individuals of lower educational level. Periodontal pockets of varying depths are being registered mostly among the older people and the subjects with low and average income. Higher severity of the periodontal pathology is observed in individuals of lower educational levels and lower income.&#x0D; These facts verify the conclusion about an inadequate state commitment as regards the dental health problems of the population, while bearing in mind that the treatment of periodontal conditions is not reimbursed by NHIF.

COVID-19 and return intentions among mobile Bulgarian citizens living abroad

&lt;abstract&gt; &lt;p&gt;The article presents the results from a virtual ethnographic study, focused on the return intentions of 11 mobile Bulgarian citizens living in several countries in the European Union and beyond, employed in highly qualified jobs. In-depth interviews were conducted online in the months of April-May 2020, at the time of the first lockdowns and restrictions on international travel both to/from Bulgaria and to multiple countries around the world. The core issues, analyzed in this article, are the motivations for potential return and how the Bulgarians abroad observe and feel the COVID-19 situation in their current destination country. The qualitative data shows that in this particular small number of respondents, the majority of the highly qualified mobile Bulgarians do not have intentions to return to Bulgaria, most of them prefer to stay in their current country. In several cases, COVID-19 blocked their opportunities to further move internationally, for example, to a new job position in a third destination country. Three figures of highly qualified mobile people are synthesized, explaining three models of return intentions at the beginning of the COVID-19 pandemic.&lt;/p&gt; &lt;/abstract&gt;

PRE-EXPOSURE PROPHYLAXIS (PREP) OF HIV INFECTION – A CRUCIAL TOOL FOR REDUCING THE BURDEN UPON THE PUBLIC HEALTH

HIV is a major global public health problem.The increased access to effective prevention, diagnosis and treatment transformed HIV-infection intoa manageable chronic health condition.Our purpose was to assess the effectiveness of oral pre-exposure prophylaxis (PrEP) of HIV-infection. Material and Methods: CheckPoint Sofia (former Sexual Health Centre – Sofia) is a medical center for consultations, prevention, diagnosis and treatment of sexually transmitted infections (STI’s) and HIV/AIDS. A retrospective study was conducted on 410 consulted males (HIV-seronegative) (October 2020 to August 2022). Results: The mean age was 32±7.6 years (18-57 years) with prevalent ages &lt;30 and 30-40 years (42% and 47%, respectively); Bulgarian citizens 90%, MSM (97%). The clients’ profile revealed active sporting (38%), past STI’s (26%), vaccinated for HBV (54%). No one of the subjects had chronic kidney disease and mandatory investigations of renal functions at starting of PrEP revealed mean levels of urea and creatinine 4.9±1.42 mmol/L and 78±18.2 µmol/L, respectively. On demand regimen (2+1+1 tablets) of PrEP was preferred at 91% and 15% switched to everyday receiving before an increased risk. After starting of PrEP, 55% of the subjects were tested voluntary and no one was positive for HIV, HBV, and HCV. The once reported side effect was transitory diarrhea (in 5%) after the start of PrEP. It is notable that the increased STI’s (syphilis, chlamydia and gonorrhea – 10%, 6% and 5%, respectively) – fact in accordance with global trends. Conclusion: PrEP is an effective prevention of HIV infectionand deserves budgetary finance. The increase of STI’s requires concrete preventive implementations.