Cuts to HIV programming are affecting local prevention programs across the United States, but the potential impacts on public health and healthcare costs are especially high in the South, which accounted for approximately half of the nation's new HIV diagnoses in 2023, according to data from the US Centers for Disease Control and Prevention (CDC).
As previously reported by Medscape Medical News, infectious disease experts emphasized how federal funding cuts threaten to undo decades of progress in HIV research, prevention, and treatment as programs are discontinued because of the lack of staff and money.
"States are unable to compensate for the significant shortfalls the president's budget will create, and funding losses will exacerbate physician shortages, limit access to care, curtail our ability to prevent outbreaks overseas before they reach our shores and decimate our ability to deliver lifesaving cures for generations to come," said Tina Tan, MD, president of the Infectious Diseases Society of America (IDSA), in a statement.
"While funding for some crucial activities, such as emerging infectious diseases surveillance, is maintained, virtually all areas of health are likely to be impacted by such massive cuts to foundational infrastructure," Tan said.
HIV programs are at particular risk. "The drastic cuts to HIV public health and research programs proposed in the president's budget would leave America's HIV response in peril if enacted by Congress," said Colleen Kelley, MD, MPH, professor of medicine at Emory University School of Medicine in Atlanta, and chair of the board of the HIV Medicine Association, in a statement shared by the IDSA.
"From small towns to big cities, every state across the country may lose lifesaving HIV prevention, testing and research programs," Kelley said in the statement. "The result will be more HIV infections nationwide, taking a devastating toll on health and the healthcare system," she added. "We are counting on Congress to keep Americans healthy by rejecting these ill-considered proposals," Kelley said.
One success story of HIV prevention slated to lose federal support is the Together TakeMeHome project, based out of Emory University.
Georgia currently has the nation's highest rate of new HIV infections, with an estimated HIV incidence rate of 23.1 per 100,000 people in 2022, according to data from ahead.hiv.gov.
The Together TakeMeHome project was a tremendously successful home testing program that reached hundreds of thousands of people across the United States, Kelley said in an interview. Since its inception in 2023, the program has identified approximately 7000 individuals with new HIV diagnoses, she said. "Those people can now get care and get into treatment, and those who tested negative through the program can seek PrEP [preexposure prophylaxis] if needed," she added.
The project will disappear 2 years ahead of schedule because of funding and personnel cuts, and the result will be more infections and more illnesses related to AIDS, Kelley said.
Since half of the Division of HIV Prevention at the CDC has been laid off, much of the capacity building programs for state health departments is gone, Kelley told Medscape Medical News. The cuts to HIV prevention programs, especially in the South where rates are high, affect more than public health; they will drive up healthcare costs overall, she said. "People getting sick and needing more care will increase costs, as someone getting their HIV/AIDS treatment in a hospital will incur far more than the few dollars cost to provide a home HIV test," Kelley said.