The actions of the current administration through presidential orders, federal legislation and the recent government shutdown, has affected us all. The world around us has changed in so many ways since Trump reclaimed the oval office, it is practically unfathomable.
So we’re going to focus on one area: non-profit HIV/AIDS service organizations.
Here’s a look at what’s been impacted:
Research Grants: The National Institutes of Health (NIH) terminated dozens of HIV research grants, including an $18 million per year program for adolescents and young adults and a $2 million grant for an HIV research facility
DEI-linked Funding: The cuts were largely linked to the administration’s efforts to eliminate funding with diversity, equity, and inclusion (DEI) components, which disproportionately impacted HIV programs because the disease affects minority populations at a higher rate.
CDC Prevention Cuts: The administration’s proposed budget for Fiscal Year (FY) 2026 called for the elimination of all federal funding for HIV prevention at the Centers for Disease Control and Prevention (CDC), a cut of nearly $800 million.
Service Providers: Local ASOs that rely on federal funding for HIV testing, prevention (including PrEP access), and outreach services reported immediate difficulties with some programs having to reduce or halt services.
Advocacy groups and health experts have warned that these cuts could reverse decades of progress in fighting the epidemic and lead to an increase in new infections and AIDS-related deaths.
Ultimately, what does that mean for people who are HIV positive, if they cannot get their medication? Viral loads will start to creep back up. More individuals will get sick and some will die.
“Yes, that is a possibility,” says Ra’Shawn Flournoy, the Executive Director of Quality Comprehensive Health Care, which provides healthcare, and more, aimed at the area’s Black LGBTQ+ Community. “I think that we’re heading in that direction if we don’t make some shifts really quickly.”
Quality receives much of their funding through providers such as SAMHSA, CDC and HRSA. What their plans are for the future are uncertain. Clearly, services currently available will change even more if additional funds are discontinued.
“We’re being greatly impacted by the funds that are being withheld,” Flournoy continues. “Our STI grant was cut and because of the DEI mandate with Trump, the administration had actually even called us and said because we had language that had DEI in it, we had 48 hours to change it before we lost all of our funding.”
Flournoy believes there are two ways towards ending the struggle and making the changes that will keep our community from dissipating.
“I think that one of the best ways to make that happen is that folks need to wake up and understand that you know your voice matters. You have to get out there and vote. We cannot allow this same type of situation to take place again. Let [politicians] know how you really feel, and then let them know that if they won’t make changes, you will.”
In addition to changing the ways the government is treating the in-need LGBTQ+ population, Flournoy has some thoughts about how community members can keep organizations like Quality available and able to serve those in need.
“I think volunteering time, you know, sometimes just helping with greeting folks, working at the front desk, or something like that at the office makes a huge difference. With healthcare, especially if you’re a retired nurse or a provider, they can be able to provide a lot of help. We do not want to turn anyone away, and we’re going to do whatever it takes to make sure we stay open and our clients are getting the services they need.”
Chelsea Gulden, the executive director at RAIN, confirms there have been challenges unexpected from the government shutdown and there are many anticipated issues expected in the near future as a result of Trump and administration directives.
“We are not receiving our reimbursements,” she explains. “The thing is, with all of the cuts that are set to go into effect – and many are still being challenged – like if the CDC really shuts down their HIV division as a whole and moves to this new ‘Office of Healthy Americans’ they’re creating – that’s all domestic HIV testing nationally. It’s all of our disease tracking. All of that is supposed to be uprooted and put into a whole new government branch. Our state laws … are based on CDC guidelines. So if those guidelines no longer exist, it disrupts a whole system of care.
Gulden pauses for a moment as she thinks about a RAIN client. “There’s one case that I was looking at today with an individual who has had the same plan year after year after year, it’s one person, a non-smoker and they’ve made about $50,000 every single year. Their income has not changed. Their premiums in 2023 were about $780, in 2024 they were about $840, and this year they’re $1562 a month, and that plan is through the Affordable Care Act.
“So if you think about the loss of access to health care we’re going to be facing for not only people living with HIV, but also those who are on PrEP, we are poised to see numbers of HIV increase in a way we have not seen in years. When, on the flip side, just last year, we had the ability to literally see the end of HIV in sight. And now we’re faced with the loss of all CDC money, potentially a huge cut to Ryan White, a huge cut to HOPWA, (the housing program for people living with HIV) and increased cost of healthcare. When people can’t afford healthcare, how are they supposed to go to the doctor?”
When asked about what RAIN might do about a massive funding loss and ways they might work towards conquering that challenge, her response shows signs of worry and concern, but not defeat.
“The truth of the matter is, there are so many things that are poised to be cut or eliminated that I couldn’t realistically come up with a plan for each scenario. So I think one thing that we’re looking at doing is really trying to engage with more individual donors and really get the word out that HIV is still a problem and can potentially become a much larger problem.”
At Powerhouse 2.0, a part of Quality that serves as a drop-in center for economically-challenged HIV-positive clients to gain access to some of life’s regular needs, Director Craymon Garner talks about what they currently offer, and what they may end up losing.
“You’re able to come in, get some food and rest. We have resources for you. We have computers if you need to check emails and want to help apply for jobs and testing. That’s what we offer here. So that would all go away if the CDC goes away.”
Garner has also worked with a client who has experienced challenges, in this case with access to medication and food.
“I had a client that could not get his medication,” Garner recalls. “I don’t know what the reason was, but we came up with a full payment for him to get what he needed. And this client is on Medicaid and Medicare, and they had never experienced this issue before. So we were eventually able to find a resource to pay for it, but it was something that scared me, because this is the calm before the storm. This is really what we’re about to deal with, but on a much larger scale. He’s HIV positive. That means his levels are going to increase, his lab values are going to CD four, all that’s going to be impacted. What’s it going to be like when a lot of clients are faced with this?”
Despite Garner’s success with helping this client, he doesn’t have a resolution yet for the issue when the numbers start to climb.
But that doesn’t stop him, he continues to tackle problems for ASO clients facing varying issues, including conquering food insecurity, which many ASOs offer help with.
While the federal SNAP program was shut down with the rest of the government recently, it rarely provides adequate funding to cover nutritional expenses for an entire month.
“I’ve been hit every day this week with multiple phone calls like, ‘I need food. I need food. I don’t have my food stamps.’ So for me, I take the initiative to do the referral, and then I’ll go and pick it up myself and take it to their home, because a lot of the food banks around here in Charlotte are low on drivers. Even if you put in a full referral today, you may not be able to get it till next Thursday.”
On that same topic, especially as we move towards the holidays, Garner offers a way the Charlotte LGBTQ+ community can help tackle the challenge for the organization’s clients without access to adequate nutrition.
“I think if we all pull together, go in our pantries and look at what we’re not eating, we can provide for others. It doesn’t have to be a turkey and dressing with all the fixings, but let’s give them something to get them through the holidays or at least, get them through the week.”
