HIV testing, treatment and prevention could be facing large cuts next year. That's especially tough news for Florida, where HIV diagnoses were the second largest in the country behind Georgia, according to the Centers for Disease Control and Prevention.
This month, President Donald Trump signed into law his "Big Beautiful Bill," which included about $800 million in cuts to HIV research and prevention funding, according to KFF estimates. That includes funding started by Trump during his first term.
During his State of the Union address in 2019, Trump announced his "Ending the HIV Epidemic Initiative," which challenged states to decrease HIV cases by 90% by 2030. Florida received about $50 million in five years through the initiative. That's because multiple counties in the Sunshine State were identified as "priority jurisdictions" in the president's initiative.
HIV in Florida
Seven Florida counties were among 48 priority jurisdictions in the country due to their high rate of new diagnoses: Miami-Dade, Broward, Orange, Hillsborough, Pinellas, Duval and Palm Beach. In 2023, Miami-Dade, Broward and Orange had the highest rate of new diagnoses in Florida, according to the state Department of Health.
The president's move to cut funds is a surprising turn from his 2019 position, said Carl Schmid, the executive director of the HIV and Hepatitis Policy Institute.
"He created this program to heighten the activities so we'd have more people in treatment, more people getting tested, more people on PrEP (preexposure prophylaxis), which are drugs to prevent HIV. And the program was humming along, and they provided great leadership," Schmid said.
Heading in a new direction
Last year, the federal government requested $593 million specifically for the HIV initiative, a $20 million increase over the previous year. Although Trump appears to have backed off some from his 2030 goal, Schmid said he hasn't backed off completely with $220 million set aside this year.
"They are keeping the ending the HIV epidemic initiative, funding for CDC, but then that has to be spread out throughout the whole country, and it's just not enough money," Schmid said.
The cuts could also potentially affect the ability of the Centers for Disease Control and Prevention and state health departments to make treatments more publicly known, Schmid said.
That includes treatments like the recently FDA-approved lenacapavir, or LEN injection, which is an injectable form of PrEP taken every six months to reduce the risk of getting HIV in people who are HIV-negative. Previously, users could take a daily oral pill to prevent HIV. But the drawback is remembering to routinely take the pill.
"Now we have an injection, and this is remarkable, that you just have to take it once every six months, and you're protected from HIV, but people have to know about it," Schmid said. "It's one thing to have a product, a successful product that works. It's another thing to get it to people who need it. And I think that's where the public health care system is really needed."
'Stigma is the enemy'
Health experts agree that the biggest challenge to combating HIV rates is the stigma around HIV that prevents people from getting tested.
"Stigma is the enemy of public health," Schmid said.
While the 2019 HIV initiative is taking a large hit, the Ryan White program, which provides HIV treatment for uninsured people, will continue next year with some minor funding decreases.
The Ryan White program is the third largest source of federal funding for HIV care. During the 2024 fiscal year, the program had $2.6 billion. It will lose some funding previously received from the HIV intiative, as it is moved to the Department of Health and Human Services.
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