Domestic HIV Prevention Efforts in Crisis as Funding is Stalled or Cut

Reductions in Force at CDC and Plans for Eliminating FY2026 Funding Put the Future of HIV Prevention Activities in the United States in Jeopardy 

WASHINGTON, DC – Domestic HIV prevention efforts across the United States are in crisis as reductions in force (RIFs) at the CDC have caused funding delays and cuts.   

Delayed HIV Prevention Funding to State and Local Health Departments 

CDC award 24-0047, Funding for High-Impact HIV Prevention and Surveillance Programs for Health Departments, is a cooperative agreement that provides funding to state and local health departments to implement a comprehensive HIV prevention and surveillance program to prevent new HIV infections and improve the health of people with HIV. Year 2 of 24-0047 awards were supposed to begin on June 1, however health departments have not received their Notice of Awards (NOAs) from CDC.  

This means that health departments have not been given their funding for Year 2, even though it is FY2025 appropriated funding. As a result,  some jurisdictions are sending stop work orders to community-based organizations and notifying grantees of delays in funding. In addition, HIV prevention activities at many health departments are on pause, limiting access to HIV testing, linkage to PEP and PrEP, linkage to treatment, and other services.   

“Though Congress appropriated these funds, the funds are not being released on time. NASTAD has been working with CDC and Congress on expediting the release of these funds,” said Dr. Stephen Lee, NASTAD Executive Director. “We are hopeful the funding will be released soon and  prevention activities will resume as normal; however, we do not have an approximate timeline for the release of funding.” 

Rural Outreach, HIV Surveillance, and HIV Testing Programs to End 

As a result of the CDC reductions in force, grantees have been notified that their grants will not continue past the current funding period because, as CDC has informed grantees, there are no staff to do the legally required monitoring of the grants.   

• REACH: Rural Re-Engagement and Care using CHWs for Persons with HIV – This grant worked with HIV care providers to identify people living with HIV in rural communities who are not in care or have not achieved viral suppression and to implement a Community Health Worker (CHW)-mediated model of re-engagement to care and outreach services to ensure that people are engaged in care. 
• Grantees: Indiana, Kansas, Puerto Rico, South Carolina   

• Enhanced Surveillance of Persons with Early and Late HIV Diagnosis to Understand System and Individual Factors Associated with New Infection and Delayed Testing –The Enhanced Surveillance program conducted enhanced public health surveillance of people diagnosed with HIV during the earliest and latest stages of infection (stages 0 and 3, respectively). It is an effort to understand their recent experiences with HIV prevention and testing services and the system- and individual-level barriers that led to failures in early diagnosis and prevention. It is critical that people vulnerable to HIV are tested often and linked to care and prevention services.  
• Grantees: Florida, Houston, Louisiana, Michigan  

• Together Take Me Home – A project that distributed HIV self-testing kits to people who requested them through an online portal. From March 2023 to January 2025, the Together TakeMeHome (TTMH) program has mailed 746,950 HIV self-tests to 402,843 orders in all 50 U.S. states and Puerto Rico. In this time TTMH helped identify nearly 7,000 new HIV diagnoses, avert 479 new HIV infections, and produce a net savings (who/what is saving) of an estimated $197 million.   

“The reductions in force at the CDC have directly impacted services provided to people vulnerable to HIV,” said Dr. Stephen Lee, NASTAD Executive Director. “Unfortunately, we expect that further grant termination notices will be released.” 

President’s Budget Proposes Further Cuts 

The President’s Budget proposes eliminating HIV prevention activities at CDC. This is a decrease of $793.7 million. This would impact funding for health departments, community-based organizations, and surveillance programs. If this is actualized, HIV prevention activities in most states would cease.   

The budget proposes moving Ending the HIV Epidemic initiative’s HIV prevention activities to the Administration for Healthy America. It is unclear how this program would be implemented if there is no other funding for HIV Prevention.  

Any cuts to HIV prevention and surveillance funding would significantly damage the ability of state and local health departments to combat the HIV epidemic in their jurisdictions. Health departments are the cornerstone implementers of HIV prevention, coordinating federal, state, and local public health programs and policies. Their leadership is paramount to achieving national goals to reduce new HIV diagnoses and improve outcomes for people living with and vulnerable to HIV.    

“NASTAD strongly opposes the proposed changes outlined in the President’s budget request,” said Dr. Stephen Lee, NASTAD Executive Director. “We will continue to advocate for strong federal investments in HIV, hepatitis, STI, and harm reduction programs and ensure these services are not weakened through funding cuts or structural changes.”  

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About NASTAD  

Founded in 1992, NASTAD is a leading non-partisan non-profit association that represents public health officials who administer HIV and hepatitis programs in the U.S. Our singular mission is to end the intersecting epidemics of HIV, viral hepatitis, and related conditions. We do this work by strengthening governmental public health through advocacy, capacity building, and social justice.