Trump Budget Proposal Confirms HIV Advocates' Worst Fears

May 5, 2025 (New York, NY) The topline FY26 budget request released by the Trump administration on Friday would decimate domestic HIV prevention, treatment, and research while derailing U.S. work toward ending the HIV epidemic. The cuts would destroy the decades-long bipartisan response to HIV by cutting and reorganizing HIV programs within the Department of Health and Human Services (HHS) without the input of people living with HIV, state and local health departments, medical providers, and other experts. The budget request ominously omits mention of key HIV initiatives and offices, including the Ending the HIV Epidemic initiative, the CDC's Division of HIV Prevention, and both the SAMHSA and HHS Minority AIDS Funds.

These proposed cuts will harm people, increase cases of HIV, and cost our nation more in terms of lives and spending. Organizers of the Save HIV Funding campaign urge Congress to continue its support for HIV funding at current levels and maintain the critical infrastructure of federal offices and programs responding to HIV, viral hepatitis, STDs, and TB.

The proposed budget threatens the lives and wellbeing of all Americans affected by HIV by taking aim at several critical offices and initiatives, including:

• Omitting CDC's Division of HIV Prevention (DHP), which has been eviscerated in recent weeks as part of so-called "reductions in force." This essential agency and its work are not mentioned in the President's FY26 budget request. Cuts to DHP - which passes 89% of its funding directly to state and local HIV programs - will hit all states and localities hard but especially states such as Alabama and Mississippi that depend on the CDC division to fund up to 100% of their HIV prevention efforts. According to recent analysis from amfAR, a 100% reduction in DHP funding would lead to 143,486 new HIV infections by 2030, 14,676 additional AIDS related deaths, and $60.3B in additional lifetime healthcare costs.

• Block granting CDC funding for viral hepatitis, STDs, and TB masks devastating funding cuts. The $300M that would be dedicated to a new block grant would cut $77.3M, resulting in a loss of capacity to prevent and respond to viral hepatitis, STD and TB outbreaks nationwide.

• Cutting the Health Resources and Services Administration (HRSA) by $1.7B, after it has been hit hard by the firing of hundreds of key personnel. This cut would include a $74M cut to the Ryan White HIV/AIDS Program that would eliminate crucial dental care for patients as well as provider education that helps secure the success and effectiveness of the Ryan White Program. An earlier leaked FY26 budget request also included the elimination of HRSA's Ending the HIV Epidemic funding which has engaged thousands of new people into effective HIV care and prevention.

• Cutting and then consolidating the Housing Opportunity for People with HIV/AIDS (HOPWA) program into the Emergency Shelter Grant (ESG) program, making HOPWA a short-term housing program with capped eligibility for 2 years. 45,000 low-income people living with HIV who depend on HOPWA including more than 4,000 veterans would soon face homelessness under this approach.

• Cutting the Substance Abuse and Mental Health Services Administration (SAMHSA) by $1.065B during an ongoing, devastating overdose crisis nationwide. SAMHSA is the only federal agency specifically charged with addressing the needs of millions in the U.S. with substance use and mental health conditions. The cut also would eliminate funding for harm reduction services, which would result in more lives lost to overdose, more HIV outbreaks, and worse outcomes for communities.

• Cutting the Minority AIDS Fund at both the Secretary's Office in HHS and SAMHSA. These cuts would exacerbate health disparities by eliminating support for effective interventions that improve the care, treatment, and prevention of HIV among racial and ethnic minorities nationwide.

• Making additional cuts to the National Institutes of Health (NIH), where already hundreds of millions in research grants, including the entire Adolescent Medicines Trials Network (ATN), have been canceled, and critical leaders with deep experience and expertise have been dismissed, including leaders of the National Institutes of Allergy and Infectious Diseases (NIAID), NIAID's Division of Microbiology and Infectious Diseases (DMID), the Fogarty International Center, and the NIH's lead bioethicist. The "skinny" budget would continue this assault on America's scientific leadership by axing another 40% or $18B in agency funding.

The FY26 budget request's attacks on US-based programs, services, and leaders would occur alongside the devastation of the global HIV response through the elimination of USAID and the slashing of the President's Emergency Plan for AIDS Relief (PEPFAR) created during the George W. Bush Administration. The destruction of global and domestic HIV/AIDS programs are making the U.S. and world less safe, less healthy, less able to develop economies and care for families and communities while destroying good will built upon decades of US partnership and diplomacy.

Congress must recommit to address HIV here and abroad to save lives and to honor the commitments and leadership our nation has demonstrated over the past 4 decades. HIV programs play an important role in providing access to life-saving, cost-saving services, while sustaining and accelerating the remarkable progress we have made in controlling HIV. The cuts proposed by the administration will set the HIV response back decades. We urge Congress to stay the course on these successful federal programs for HIV and related prevention, treatment and research.