Trump administration weighs deep cuts to CDC’s HIV prevention program

LGBT+ groups and public health advocates warn against potential threats that could jeopardize progress and ‘set us back decades’

Donald Trump’s administration is reportedly mulling cuts to a public health program that accounts for nearly all federal spending on HIV prevention efforts, reaching thousands of people a year.

With no other programs to replace them, cuts to the Centers for Disease Control and Prevention’s HIV Prevention Division could jeopardize progress in addressing the nation’s HIV epidemic and potentially cost lives, according to public health experts and LGBT+ advocacy groups.

More than $1 billion was appropriated for HIV prevention efforts this year, and the agency spent roughly $1.3 billion on the prevention of HIV and sexually transmitted infections within the previous fiscal year. About three-quarters of that spending supports state and local health departments and nonprofit groups working to prevent HIV in their communities.

In 2022, more than 22 million HIV tests were performed by 60 CDC-funded state and local health departments and community organizations, which connected roughly 8,000 people newly diagnosed with HIV to healthcare they may have otherwise not received.

CDC support is “extremely significant in terms of funding efforts” for HIV prevention, according to Lindsey Dawson, associate director of HIV policy and director of LGBTQ health policy with nonprofit health research and news organization KFF.

The Centers for Disease Control and Prevention, under HHS Secretary Robert F. Kennedy Jr, is reportedly mulling cuts to a domestic HIV prevention program despite Trump’s ambitious plan to end the epidemic by 2030 (AFP via Getty Images)

“The role of the CDC prevention funding is to provide states, local jurisdictions and community-based orgs with funding to do surveillance [and] HIV testing to help shore up prevention … including linking people to care,” she told The Independent.

Threats to that funding follow declining numbers of new infections in the United States, which saw a 12 percent drop between 2018 and 2022. Those declines were even more dramatic in jurisdictions that received additional federal funding.

Eliminating those funds will “jeopardize” continued success and potentially lead to an increase in new infections, Dawson told The Independent.

During his first term in office, Trump announced an initiative that sought to end the nation’s HIV epidemic by “focusing resources in the 57 jurisdictions where they’re needed most.”

The president’s target date for “Ending the HIV Epidemic in the U.S.” was set for 2030.

Eliminating funding to combat the epidemic would make that virtually impossible.

“The success of the ‘Ending the HIV Epidemic’ initiative is in peril,” according to Colleen Kelley, chair of the HIV Medicine Association’s board of directors.

“Not only will we not end the HIV epidemic with the current administration’s policies, we could reverse these gains and go back to the dark days of the ’80s when people died from HIV every day,” she said in a statement.

LGBT+ advocacy groups fear those impacts would be particularly acute among LGBT+ Americans.

“An effort to defund HIV prevention by this administration would set us back decades, cost innocent people their lives and cost taxpayers millions,” according to Kelley Robinson, president of the Human Rights Campaign, the nation’s largest LGBT+ civil rights group.

In 2022, the CDC supported 60 local health departments and community groups that connected roughly 8,000 people newly diagnosed with HIV to healthcare they may have otherwise not received (REUTERS)

“This is not just a policy debate — it is a direct assault on the 1.2 million people living with HIV in the United States and countless others who are vulnerable to HIV,” she said. “The LGBTQ+ community still carries the scars of the government negligence and mass death of the HIV/AIDS epidemic. We should be doubling down on our investment to end the HIV epidemic once and for all, not regressing to the days of funeral services and a virus running rampant.”

A spokesperson for the Department of Health and Human Services — now under the direction of Secretary Robert F. Kennedy Jr — stressed to The Independent that a final decision on the CDC’s HIV prevention efforts has not been made, and a timeline for a decision is unclear.

“HHS is following the Administration’s guidance and taking a careful look at all divisions to see where there is overlap that could be streamlined to support the President’s broader efforts to restructure the federal government,” deputy press secretary Emily G. Hilliard told The Independent.

“This is to ensure that HHS better serves the American people at the highest and most efficient standard,” she said. “No final decision on streamlining CDC’s HIV Prevention Division has been made.”

If HHS does cut the program, that work would be continued elsewhere within the agency, according to a statement from an HHS official speaking on background about the administration’s plans.

But it’s unclear where the agency could continue that work, and other agencies and programs focused on HIV are statutorily obligated to administer other forms of medical care, not prevention efforts, according to KFF.

If that funding is wholly eliminated, the burden for prevention efforts would fall on state and local governments and cash-strapped community groups facing their own budget constraints against a shrinking pool of federal grant opportunities, forcing public health officials across the U.S. to make difficult decisions.