trump’s HIV Policy Reversal: A Global Crisis Unfolds on world AIDS Day 2025
On World AIDS Day 2025, the global community should be celebrating a breakthrough: a new injectable treatment offering six months of HIV protection. Instead, public health officials are grappling with a stark reality – President Donald Trump’s policies have demonstrably worsened the HIV epidemic, reversing decades of progress and endangering vulnerable populations worldwide.
The consequences of a January 20, 2025, “stop-work order” on foreign aid and targeted cuts to health programs are now painfully clear. Thes actions, impacting both domestic and international initiatives, have jeopardized the health and economic stability of LGBTQ+ individuals, immigrants, sex workers, and people living with HIV/AIDS, with repercussions expected to last for years, if not decades.
The Trump governance’s cuts were sweeping yet precise, slashing funding for vital health research conducted by the Centers for Disease Control and Prevention (CDC), universities, and community organizations. Critically,the administration gutted the United States Agency for International Advancement (USAID),curtailing or eliminating programs like the President’s Emergency Plan For AIDS Relief (PEPFAR),a cornerstone of global HIV prevention and treatment.
These cuts have had a disproportionate impact on already marginalized communities.In the U.S., over $125 million in National Institutes of Health grants for LGBTQ-focused health research were canceled.Globally, USAID cuts have forced the closure of community organizations and disrupted life-saving services. In South Africa, transgender individuals instantly lost access to gender-affirming care, leading to devastating consequences including forced detransitioning, body dysmorphia, depression, and suicide. In Lebanon, cuts have resulted in job losses for humanitarian aid workers, impacting medical care and development programs. Uganda has seen people living with HIV lose access to essential resources like condoms, lubricants, medication, and even food – a crucial support system now crumbling. Many former healthcare workers, now unemployed, “will see many of my former colleagues offering services,” highlighting the desperate measures taken by those left without options.
The crisis extends beyond U.S. borders.In Europe, HIV organizations are struggling with cuts from both USAID and European Union funding, as resources are diverted to NATO and Frontex. In Lebanon, an organization supporting 600 people monthly can now only plan eight months ahead. In Uganda, a clinic serving “key populations” (a euphemism for LGBTQ+ individuals) has seen its staff reduced from 15 to just four, while a similar organization in South Africa has experienced an even more drastic reduction, from 86 to four staff members.
The timing of these cuts is particularly tragic, coinciding with the development of lenacapavir, an injectable drug offering six months of HIV prevention.Hailed as a potential game-changer, lenacapavir could substantially diminish or even eradicate HIV if widely implemented. Though, Gregg gonsalves, an epidemiologist at the Yale School of Public health, described the administration’s limited rollout of the drug – approximately 500 doses each to Zambia and Eswatini – as “a hollow promise,” noting that the drug could be manufactured for just $40 a year and requires a robust infrastructure of prevention programs that Trump dismantled.
The cuts have decimated outreach efforts in critical locations – sex work “hotspots,” gay saunas, immigration processing centers, prisons, and food banks – where HIV often takes root among marginalized populations. In Uganda,a recent free STI clinic run by Universal Love Alliance,while providing vital services,highlighted the dwindling supplies marked “USAID: From the American People,” signaling the end of a crucial lifeline. The clinic’s staff also noted that the six-month injectable PrEP offered by lenacapavir would be a significant improvement over the 30-day supply of daily medication they were currently providing, reducing the burden on both patients and healthcare workers.
On World AIDS Day, the devastating consequences of Trump’s policies are undeniable. The cuts have not only harmed individuals and communities directly affected by HIV but have also put the entire human race at increased risk. Viruses travel, and the dismantling of global health infrastructure has created a dangerous vulnerability.
This essay is part of the series Global Stop Work Order, which will feature reporting about how the trump administration’s cuts are affecting LGBTQ+ health and HIV/AIDS in Africa, Europe, the Middle East, and North America. The series is supported by a Pulitzer Center Global Reporting Grant and the Fund for Investigative Journalism.
