Statements from the Trump administration that officials are considering cuts to key programs for the prevention of HIV and AIDS are generating outrage among two of the largest LGBTQ+ service organizations in Southern California.
Leaders of the LGBT Center in Los Angeles and DAP Health in the Coachella Valley said that a sharp cut in the Centers for Disease Control and Prevention’s Division of HIV Prevention could endanger many lives and potentially drive up the long-term cost to taxpayers, if incidence of the virus that causes AIDS increases.
When the Wall Street Journal first broke news of the potential cut in mid-March, a spokesman said no “final decision” had been made “on streamlining CDC’s HIV Prevention Division.”
Asked this week for an update, CDC spokesman Nicholas Spinelli referred questions to the agency’s parent organization, the Department of Health and Human Services, which did not respond. The White House also did not respond to a request for comment Friday.
Health agencies across the nation have helped drive down the incidence of HIV, largely through testing, counseling and the distribution of medications that prevent the spread of the disease. Much of the funding for that work came from the Centers for Disease Control and Prevention. The rate of decline was 12% nationally between 2018 and 2022, with an even sharper 21% in the 50 local areas where the CDC focused its prevention efforts.
The LGBT Center in Los Angeles, which provides outreach, testing and HIV-preventative medications, said it has been left in limbo about what will become of its $450,000 CDC grant to support that work.
“We have seen tremendous gains in the fight to end HIV because of the real investments that have been made in prevention and care,” said Joe Hollendoner, CEO of the LGBT Center. “We’ve even been talking about how, in our lifetime, we could end the HIV epidemic and get to zero new cases.”
“But if we are terminating HIV prevention contracts in the way that we anticipate … it is not hyperbole to say it’s going to cost human lives.”
That echoed concerns voiced by DAP Health, which operates 25 clinics in Riverside and San Diego counties, including many in the Coachella Valley, which has a large gay population and where the HIV rate is four times the national average.
“This ‘cost-saving’ strategy of decimating the CDC’s HIV prevention program will only increase costs, both human and financial,” David Brinkman, the CEO of DAP Health, said in a statement.
Brinkman pointed to research that showed the average cost of lifetime treatment for a patient who contracts HIV to be about $500,000 a year. The estimated potential “savings” of $1.8 billion if the federal disease agency eliminates the HIV program would quickly disappear if more than 3,600 Americans were newly infected, Brinkman said, adding: “And we know the toll of lives impacted by HIV with this slashing will be in the tens of thousands.”
An outspoken voice against a possible reduction or elimination of the anti-HIV program is Rep. Raul Ruiz (D-Palm Desert), a former emergency room doctor who represents the Coachella Valley.
“The CDC’s Division of HIV Prevention plays a vital role in reducing new infections, saving billions in preventable health care costs, and ensuring that individuals can access life-saving medication,” Ruiz said in a statement.
Ruiz noted that the CDC program also plays a central role in responding to viral hepatitis and TB. The congressman joined 100 other Democrats in the House and Senate in sending a letter to President Trump, urging him to reconsider any plan to reduce or eliminate the disease prevention program.
The lawmakers reminded Trump that during his first term, in 2019, he declared the goal of ending the HIV epidemic. “One of the pillars of your initiative, as shown on CDC’s website, is prevention,” the letter said. “It is imperative that you uphold this commitment.”
C.J. Tobe, chief transformation officer for DAP Health, said the Trump administration’s potential change of course seemed inexplicable.
“It’s a 180-degree turn, to threaten to take this away,” Tobe said. “It feels personal and it makes zero sense.”
Confusion and turmoil have also enveloped U.S. government-supported research around HIV.
CNN reported this week that the National Institutes of Health had eliminated funding for dozens of HIV-related research grants. The news outlet cited a Department of Health and Human Services database and quoted scientists who said the cuts would also deal a crippling blow to the goal of ending HIV.
Among those on the chopping block were grants related to PrEP, the regimen of drugs that can thwart HIV infection, scientists told the New York Times.
Funding for intervention against the disease overseas also appeared endangered when the Trump administration froze foreign aid and then all but eliminated the U.S. Agency for International Development, the main American agency for delivering assistance to other countries.
A study published in the Lancet said that a reduction in support from the U.S. and other major funding countries could lead to 4.4 million to 10.7 million new HIV infections worldwide by 2030, killing 770,000 to nearly 3 million more people.
“Unmitigated funding reductions could significantly reverse progress in the HIV response by 2030, disproportionately affecting sub-Saharan African countries and key and vulnerable populations,” the study said.
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