The Trump administration continues to make cuts that threaten the lives and health of people living with or at risk for HIV. While the earliest funding reductions affected international aid programs, like PEPFAR (the President’s Emergency Plan for AIDS Relief), more recent moves imperil the domestic HIV response.

 

In late March, Health Secretary Robert F. Kennedy Jr. announced a “dramatic restructuring” of the Department of Health and Human Services, reducing staff at federal health agencies, including the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH), by some 20,000 people. High-level staff cuts included Jonathan Mermin, MD, MPH, director of the CDC’s National Center for HIV, Viral Hepatitis, STD, and Tuberculosis Prevention, and Jeanne Marrazzo, MD, MPH, head of the National Institute for Allergy and Infectious Diseases.

 

The administration also canceled hundreds of NIH grants for HIV research; for example, it eliminated funding for the Adolescent Medicine Trials Network for HIV/AIDS Interventions. Grants for the AIDS Clinical Trials Group, the HIV Prevention Trials Network and the HIV Vaccine Trials Network were delayed, and their fate remains uncertain.

 

Many of the cuts are part of the administration’s push to eliminate “gender ideology” and diversity, equity and inclusion. HIV disproportionately affects gay and bisexual men, transgender people and Black and Latino people; as a result, much HIV research focuses on these populations. The grant termination “threatens to halt decades of progress,” says HIV Medicine Association chair Colleen Kelley, MD, MPH. “The return on investment in HIV research goes well beyond HIV, with the discoveries laying the foundation for curative therapies for hepatitis C and treatments for cancer.”