The Trump administration is ending direct federal funding for dozens of community-based organizations that provide HIV prevention services, instead redirecting those funds to state and local health departments.
Earlier this month, the Office of Management and Budget (OMB) informed the Centers for Disease Control and Prevention (CDC) that it will not renew approximately $46 million in grants that currently support 96 community-based organizations nationwide. The organizations provide services including HIV testing, referrals to care, access to pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP), prevention education and outbreak response.
Under the new funding structure, the CDC will distribute supplemental funding to state and local health departments, which may choose whether to continue supporting the same community organizations. The supplemental funding is expected to run through May 2027.
The decision has drawn criticism from HIV advocacy organizations, which argue that community-based providers play a unique role in reaching populations disproportionately affected by HIV.
“For decades, direct federal investment in community-based HIV prevention has helped trusted local organizations reach people and communities that traditional health systems too often fail to serve,” AIDS United said in a July 17 statement.
The organization said ending the direct funding model could reduce access to HIV testing; interrupt pathways to PrEP, PEP and HIV care; eliminate frontline positions and jeopardize eligibility for the federal 340B drug discount program for some organizations.
“Community-based organizations are the bedrock of our nation’s HIV response,” AIDS United President and CEO Carl Baloney Jr. said. “We cannot end the HIV epidemic by dismantling the trusted community systems that make prevention possible.”
Carl Schmid, executive director of the HIV+ Hepatitis Policy Institute, said the impact of the funding shift will likely vary by state.
“But other states and jurisdictions don’t have that relationship with the community-based organizations,” Schmid told the Washington Blade. “It depends on the state. Not all states send their money to the communities that really need it most. And not all states are fast in getting money to the community-based organizations.”
Schmid also said organizations that lose direct federal grants could face challenges maintaining access to discounted medications through the 340B program if they are not funded by their states.
More than 70 organizations signed a July 22 letter urging Health and Human Services Secretary Robert F. Kennedy Jr. and acting CDC Director Jay Bhattacharya to reconsider the decision. The letter argues that the existing funding model has helped advance the federal Ending the HIV Epidemic initiative launched during President Donald Trump’s first term and warns that dismantling the program could increase long-term healthcare costs by reducing HIV prevention efforts.
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