Federal Shifts May Punch Holes in HIV Safety Nets, Warn Experts

TALLAHASSEE, Fla. — Dallen Michael Greene recalls the fear that enveloped him upon being diagnosed with HIV in 1999. At 56, Greene, a Broward County resident, now mentors newly diagnosed individuals as a clinical manager at Community Care Resources of Florida, a nonprofit that facilitates testing for sexually transmitted infections.

Recent federal budget proposals have ignited concern among those within the HIV community. President Donald Trump’s fiscal year 2026 budget suggests substantial cuts to HIV prevention programs. Despite retaining some elements of the Ryan White HIV/AIDS Program, critical support structures face significant threats.

The U.S. Senate is deliberating Trump’s sweeping tax and spending bill, which includes provisions affecting HIV care. Notably, it prohibits clinics providing abortions — often vital testing sites for STD checks — from participating in Medicaid. Additionally, new work requirements could jeopardize access to medications for HIV patients, potentially undermining efforts to manage the virus.

Compounding the issue, state health departments report uncertainty regarding the renewal of federal HIV/AIDS grants. These grants are crucial for sustaining outreach and testing programs, with some organizations already forced to make staff cuts, including key disease contact tracers.

Greene emphasizes that such uncertainties leave individuals feeling isolated, fearing the absence of available resources. A spokesperson for the U.S. Department of Health and Human Services maintains that HIV/AIDS initiatives remain a priority, with plans for a new agency called the Administration for a Healthy America.

While advancements in treatment have allowed individuals with HIV to live longer, nearly 32,000 new infections emerge annually in the U.S. Efforts to curb this trend are often hampered by stigma, lack of access to care, and societal biases, particularly affecting marginalized communities such as Black and Latino individuals.

Rob Renzi, head of Big Bend Cares, critiques the proposed budget cuts sharply. “The operable term is ‘safety net.’ And you’re cutting holes in it,” he states, highlighting the potential for significant fallout among vulnerable populations relying on assistance.

His organization provides housing for HIV patients, with federal funding under threat. Losing these funds could lead to homelessness for those depending on this support. Renzi asserts that the fundamental needs of food and shelter often overshadow daily medication for patients.

Emily Schreiber from the National Alliance of State and Territorial AIDS Directors shared that while the CDC is beginning to distribute delayed grants, damage has already occurred. Several health departments, including those in Mecklenburg County, North Carolina, have had to reduce their workforce due to grant funding instability.

Dr. Thomas Dobbs, an expert on population health, warns that funding cuts could stall critical progress in HIV treatment, particularly affecting marginalized groups disproportionately. “The system has not been adequately designed to treat them,” he explains, describing the potential consequences of budget reductions as shortsighted.

Organizations like Coastal Bend Wellness Foundation in Texas are bracing for possible interruptions in services due to delayed grant renewals. Without timely funding, they may face suspension of HIV testing programs, an essential community resource.

In Maryland, uncertainty surrounding federal assistance is prompting nervousness among patients about their medication regimens. Health professionals have reported inquiries from patients contemplating adjustments to their treatment routines, fearing the worst.

As Greene reflects on the situation in Broward County, he questions the future of funding for essential programs. “Will there be enough funds? We’re not sure how much money we’re going to receive or when it’s going to come. So that’s a very scary thing,” he concludes.