To the Members of the 119th Congress:
Ending the HIV epidemic in the United States is an ambitious but achievable goal. With sustained investment in HIV research, prevention, treatment, and care, we can live in a world with no deaths from AIDS-related illnesses, no new HIV transmissions, and universal viral suppression and improved quality of life for all people living with HIV. Ensuring the availability and accessibility of a just and equitable healthcare system—and society—for those with and vulnerable to HIV are at the heart of the work done by AIDS United and the 60 members of AIDS United’s Public Policy Council.
This work—our work—does not exist in a vacuum. Our shared vision of a world without HIV-related deaths requires collaboration between the public and private sectors, between federal, state, and local governments, and between community based organizations and those they serve. It encompasses every stage of the HIV care continuum and all of the essential wraparound services that allow people living with and affected by HIV to live their best and healthiest lives. But, this healthcare delivery system must operate as just that: a system. When one collaborative relationship or service breaks down, the harms from that disruption do not remain confined, but spread throughout every aspect of the system. Such instability and volatility endangers decades of hard won progress, but most importantly, it puts human lives at risk.
On June 1, 2025, the precariousness of our HIV healthcare system came into clear view. A threat to the federal government’s role in HIV prevention that we knew was percolating, came to the surface. State and local health departments nationwide failed to receive the HIV prevention funding from the Centers for Disease Control and Prevention that had already been allocated to them by Congress through the Fiscal Year 2025 (FY25) appropriations process. HIV prevention programs that allow people to access vital interventions like pre- and post-exposure prophylaxis (PrEP and PEP) are being halted – with no idea if or when they’ll resume.
In the short time since we first heard rumors in March that this Administration planned to eliminate the Division of HIV Prevention, health departments and community based organizations have been forced to abruptly stop their HIV prevention work. Community-based organizations, including members of the Public Policy Council, have received “stop work orders” and have been forced to institute major layoffs. In one California county, for instance, across 16 organizations, 200 positions will be lost – with the potential for more losses the longer funds are withheld. HIV transmissions inevitably will increase, placing further pressure on the continuum of care. One county in Illinois expects similar losses, harkening back to the height of the COVID-19 pandemic when prevention services could not be delivered and they saw an increase in new HIV diagnoses. We can expect a similar outcome if prevention funding isn’t restored and there will be no end in sight to the rise in new HIV cases. Aside from the human toll, the lifetime costs of an HIV diagnosis is around $500,000.
This failure to promptly award already appropriated FY25 funding comes at a time when the long-term future of our nation’s HIV prevention infrastructure—and by extension the entire US HIV response—is being compromised. In its Fiscal Year 2026 budget, the Trump Administration has proposed the elimination of all core HIV Prevention funding administered by the CDC’s Division of HIV Prevention, slashing more than $750 million that serves as the backbone of our nation’s HIV prevention work.
The loss of this federal support for HIV would be all but impossible for states to cover on their own. More than 90% of all federal HIV prevention funding comes from the CDC, and nearly 90% of that funding goes directly to state health departments and community-based organizations. State budgets are tight and it’s unlikely states can or will replace these lost resources, and the flagship Ryan White HIV/AIDS Program cannot pick up the slack of these losses either, as the Program cannot cover prevention services.
In the short-term, every day that federally appropriated HIV prevention funding is held up in Washington, DC and denied to our nation’s state and local health departments and community based organizations, is another day where those most in need of PrEP are denied it and needlessly placed at risk of contracting HIV. With each day that HIV prevention funding is denied, more dedicated case managers and disease intervention specialists and outreach workers are laid off, upending lives and breaking linkages to care within our communities that took years to form.
In the long-term, the threats we are facing to our nation’s HIV prevention infrastructure would unravel a generation’s worth of work to drive down new HIV transmissions and establish trust with the underserved and marginalized communities most impacted by HIV. Robust, evidence-based federal support for HIV prevention is essential to the successful operation of every other aspect of the HIV continuum of care. Without it, we have no hope of ending the HIV epidemic.
We urge each Member of Congress to publicly condemn the withholding of CDC HIV prevention funds by the Trump Administration and demand that this Congressionally appropriated funding be disbursed to state health departments immediately. We also urge you to show continued support for lifesaving federal HIV prevention programs in the FY26 appropriations process and demand the Trump Administration honor its past commitments to ending the HIV epidemic in the US.
We represent more than 30 states in the nation and provide care and services to hundreds of thousands of Americans. We ask that you stand with us in our fight to end the HIV epidemic.
The AIDS United Public Policy Council
