The Trump administration is preparing to eliminate all federal funding for domestic HIV prevention programs, a move that health experts say will undo decades of progress in combating the epidemic. The decision, which could be announced within the next 48 hours, would shut down the Centers for Disease Control and Prevention’s HIV prevention division and halt all federally funded prevention efforts, according to multiple sources familiar with the matter.
The Wall Street Journal was the first to report on the development, citing sources within the Department of Health and Human Services who say the move is part of a broader restructuring effort targeting federal public health programs.
Related: Trump administration takes away life-saving HIV prevention medications from vulnerable LGBTQ+ people worldwide
When asked for comment, HHS Deputy Press Secretary Emily Hilliard told our sister site The Advocate that no decision had been made. “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. This is to ensure that HHS better serves the American people at the highest and most efficient standard," she said.
Additionally, an HHS official told The Advocate that if this decision is made, this work would be continued elsewhere at HHS.
“We are so close in the United States to ending the HIV epidemic, and it’s within reach in many ways,” Adrian Shanker, who was deputy assistant secretary for health policy in the Biden administration, told The Advocate. He now leads Shanker Strategies LLC, a consulting firm focused on advancing LGBTQ+ health and nonprofit development. “It takes continued investment, not pulling back from it. And it’s shocking and horrifying to hear that the Trump administration’s CDC is looking at devastating cuts to domestic HIV funding — cuts that would take us backward instead of forwards in our domestic fight to end the HIV epidemic in the United States," Shanker said.
20 years of work will be erased
For organizations on the front lines of the HIV epidemic, the stakes couldn’t be higher.
Stacie Walls, CEO of the LGBT Life Center in Norfolk, told The Advocate that her Virginia organization relies on federal HIV prevention funding to provide free testing, access to pre-exposure prophylaxis, and linkage to treatment.
“We have spent 20 years building these HIV and STI prevention programs to keep our community healthy,” Walls said. “The cuts to these programs would undo 20 years of work. People come to us for free testing. We link them to care, and they’re able to get treatment. Without these programs, that all disappears.”
The vast majority of people who rely on these services, she said, are uninsured and would have nowhere else to go.
“It’s already difficult to find providers who offer nonjudgmental, affirming care,” Walls said. “Without us, people won’t be able to go anywhere else to get this kind of treatment.”
Beyond HIV and STI testing, organizations like the LGBT Life Center provide comprehensive services addressing housing instability, nutrition, and mental health challenges — all issues that disproportionately affect marginalized communities.
“When people come here, they’re getting more than just an HIV test,” Walls said. “They’re getting support for homelessness, food insecurity, and other challenges. The return on investment in public health is immeasurable.”
The danger of this move
Jirair Ratevosian, an associate research scientist at Yale University and a global health expert, warned that the move would lead to more infections, greater economic strain, and increased health care costs over time.
“This is a dangerous move,” Ratevosian told The Advocate. “Putting prevention programs on hold today means paying a much higher price tomorrow — in lives, economic stability, and public health.”
Ratevosian emphasized that scientific advancements have brought HIV prevention to a turning point, with long-acting PrEP options expanding access.
“This was our chance to take HIV prevention to a whole new level, and instead we’re hitting the brakes,” he said. “This isn’t just bad policy — it’s a direct threat to public health.”
While he acknowledged that reviewing government programs for efficiency is reasonable, Ratevosian stressed that a wholesale elimination of prevention efforts defies logic.
“It’s reasonable to look for ways to improve HIV outcomes,” he said. “But stopping prevention altogether? Exactly at a time when we should be accelerating? This is how we risk losing hard-earned progress.”
The bipartisan approach to HIV prevention now at risk
Shanker noted that HIV prevention has long been a bipartisan issue, with previous administrations recognizing its importance.
“In recent years, the last Trump administration started the Ending the HIV Epidemic program, which the Biden administration continued,” he said. “There’s been a universal agreement that this is an important public health priority. HIV prevention keeps all of us healthier and safe.”
The Trump administration’s sudden reversal, he said, defies public health logic. “We are close, but we’re not there yet,” Shanker said. “And it’s not the time to cut these programs.”
“This isn’t just about HIV,” Walls said. “It’s about public health, it’s about unemployment, and it’s about people who have built their careers serving the community losing everything overnight. It’s painful to watch this being dismantled.”
For many experts and advocates, the sheer scale of the proposed cuts is staggering. In recent days, the Trump administration and Elon Musk’s Department of Government Efficiency have cut programs across the federal government, often because they included keywords that indicated diversity, equity, inclusion, accessibility, or LGBTQ-related programs.
“I can’t speak to the inner thinkings of the Trump administration,” Shanker said. “But I can say that ending the HIV epidemic has been and should continue to be a priority for all Americans, regardless of their political party. It’s unthinkable that the Trump administration would even consider such cuts.”
Cutting HIV prevention won’t save money — it will cost more
For those who see these cuts as a way to save taxpayer dollars, Ratevosian pushed back, emphasizing that the long-term costs will be far greater.
“When we prevent an HIV infection, we save hundreds of thousands of dollars in health care costs down the road,” he explained. “Keeping people HIV-negative protects not just those at risk but the entire public health system.”
Beyond public health, he pointed out that HIV prevention contributes to economic stability and workforce productivity.
“A healthier nation drives economic growth,” Ratevosian said. “And if we stop investing in prevention now, it’s only going to cost us more to get back on track later.”
This article originally published March 18, 2025, on our sister site, advocate.com.
