Trump budget proposes over $1.5 billion cut to domestic HIV programs

Direct Care, Treatment & PrEP Programs Maintained

Washington DC… The Fiscal Year 2027 budget released by the Trump administration today maintains funding for existing domestic HIV care, treatment, and PrEP programs but proposes to cut over $1.5 billion in HIV prevention, substance use, housing, and other programs.

“Congress rejected these massive attacks on HIV prevention last year and we will urge them to do the same again this year. While we are reassured that over 600,000 low-income people currently accessing care and treatment through the Ryan White HIV/AIDS Program and those using PrEP programs in community health centers can maintain their services, the dismantling of HIV prevention and surveillance and other programs will just lead to more HIV infections and higher health costs down the road,” commented Carl Schmid, executive director of the HIV+Hepatitis Policy Institute.

He continued, “We have been pleased by statements by Trump administration leadership, including NIH Director and CDC leader Jay Bhattacharya, who has repeatedly highlighted the success of HIV prevention, including long-acting PrEP, and the need to end HIV in the United States. However, to end HIV we need funding for prevention, including testing, surveillance, education, outreach and PrEP programs.”

As with last year’s proposal, the budget would consolidate all domestic HIV treatment and prevention programs into the Administration for a Healthy America (AHA) at dramatically reduced funding levels. Current HIV prevention funding totals over $1 billion; the proposed budget would reduce that to only $220 million. Without federal support, most local HIV prevention programs will be unable to conduct the necessary surveillance, testing, and linkage to care and PrEP in their communities.

“Last year was full of disruptions in HIV prevention grants and services, which created great instability. Not only do we need to maintain current funding levels, but increases are urgently needed, particularly for the AIDS Drug Assistance Program (ADAP) due to rising enrollment and insurance premium costs,” continued Schmid.

Several states have already lowered income eligibility and disenrolled people from their ADAP programs, which provide life-saving medications. Without additional funding, more states are expected to take similar actions. The HIV community is urging Congress to increase ADAP funding, which has remained at $900 million since 2013, by $175 million.

Other proposed cuts include Part F of the Ryan White Program, which funds dental reimbursements, clinical training, and community-driven implementation research ($74 million); the Secretary’s Minority HIV/AIDS Fund ($56 million); and SAMHSA’s Minority HIV/AIDS Initiative programs ($119 million).  HUD’s entire Housing Opportunities for Persons with AIDS program, which currently serves 100,000 households and is funded at $529 million, would be eliminated. NIH research would be cut by 16 percent, dealing a major setback for America’s leadership in medical research. If applied to the current AIDS research portfolio, it would result in a more than $500 million cut.   

The budget eliminates $46 million in dedicated funding for hepatitis prevention at the CDC and instead proposes a $300 million combined program that would include STD and tuberculosis prevention, totaling $70 million less than current funding, and also ends the opioid-related infectious diseases program.  Eliminated would be a new $100 million SAMHSA hepatitis C initiative begun last year that provides linkage to curative drugs.

The budget further proposes to move the Office of Infectious Diseases and HIV/AIDS Policy at OASH to AHA in order to coordinate EHE and other HIV activities, funded at $8 million. Funding for HIV and hepatitis C testing at the Indian Health Service would continue.

Schmid concluded, “We are extremely disappointed by this budget that will continue to destabilize domestic HIV efforts in the U.S.  Instead, we should be dedicating our efforts to productive discussions on how to ensure everyone, whomever they are, has access to the care, treatment, preventive services, including PrEP, they need, along with other safety net and infectious disease programs combatting hepatitis B and C. These are all the responsibility of the federal government and must be properly supported and funded.” 

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The HIV+Hepatitis Policy Institute is a national, non-profit organization whose mission is to promote quality and affordable healthcare for people living with or at risk of HIV, hepatitis, and other serious and chronic health conditions.