Trump Budget Axes CDC HIV Prevention, Shifts Care, Experts Warn of Risks

Details of the fiscal year 2026 Trump administration budget proposal reveal more than $1.5 billion in cuts, including the complete elimination of all Centers for Disease Control and Prevention (CDC) HIV programs. Other HIV programs would be restructured under a new agency, the Administration for Healthy America (AHA).

Although funding for CDC HIV prevention programs—historically responsible for nearly all federally funded HIV prevention efforts—would be cut, the Ending the HIV Epidemic initiative would remain in place. This contrasts with an earlier draft of the budget, which proposed eliminating the initiative.

“While we are reassured that the 576,000 low-income people currently accessing care and treatment through the Ryan White HIV/AIDS Program, along with those using PrEP at community health centers, can maintain their services, the obliteration of CDC HIV prevention and surveillance programs is an absurd proposal that will just increase HIV infections and health costs down the road. We urgently call on Congress to reject these cuts in order to ensure that states and community-based organizations have the resources to prevent HIV, which is still a serious infectious disease and results in about 32,000 new cases each year,” Carl Schmid, executive director of the HIV+Hepatitis Policy Institute in Washington, D.C., said in a news release.

Carl Schmid

The proposal also outlines plans to move the Health Resources and Services Administration’s (HRSA) Ryan White HIV/AIDS Program and Health Center Program under the new AHA. The budget request states that the AHA will “prioritize prevention,” including $165 million for the Ryan White Program and $157 million to fund pre-exposure prophylaxis (PrEP) access in community health centers as part of the Ending the HIV Epidemic effort.

Schmid recently spoke with Managed Healthcare Executive about what these proposed cuts could mean for the future of HIV care and prevention.

This interview has been edited for length and clarity.

MHE: How does the FY2026 budget proposal request compare to last year's in terms of total domestic HIV funding?

Schmid: I'm pleased to report that in the Ryan White Program, the Trump administration is maintaining most of the funding to make sure that people who are living with HIV have access to the care and treatment. With that, there is a $74 million proposed cut to clinical and community-driven training programs and dental reimbursement. We hope that Congress will address that.

We were pleasantly surprised that funding for Ending the HIV Epidemic was maintained in the budget that was released. We saw some drafts of the budget come out and they called for ending the program.

Where we see a real problem, and it is a significant problem, is that they completely zero out the $800 million for the CDC’s HIV prevention and surveillance programs.

The $220 million in funding that was going to the CDC is going to the Ending the HIV Epidemic initiative, which is proposed to be moved to the new Administration for a Healthy America. If Congress goes along with it, that's where the Ryan White program will also be.

MHE: The Ryan White HIV/AIDS Program seems to be spared, but there are other major cuts elsewhere. Why do you think that is?

Schmid: I think the Ryan White program has enjoyed historically bipartisan support. I've also heard that the Ryan White program is in statute.

It touches every community and state around the country. People with HIV need lifetime treatment, so it's very dangerous to pull the plug out. Most of the people [in the program] are below the federal poverty level and they don't have insurance.

Since day one, this administration has gone after, quote, “DEI programs.”

A lot of CDC HIV prevention program work focuses on different communities, and maybe it's not as tangible a prevention program as making sure people have a drug.

There's just been a whole anti-CDC sentiment among certain people the last couple of years due to COVID. I don't agree with it, but I think we've gotten wrapped up in that as well.

MHE: What does this budget tell us about the administration's commitment to Ending the HIV Epidemic by 2030?

Schmid: It seems that they are focused on ending HIV in name. I am glad to see that they're continuing the PREP program for community health centers, and we hope prevention plays into their agenda.

MHE: How does HIV funding fit into the administration’s broader public health priorities for FY2026?

Schmid: We say that HIV is a chronic disease, and [the administration] is interested in stopping and preventing chronic disease. So, let's focus on HIV prevention, on increasing PREP to make sure it gets to the communities that are most impacted. This is a way to prevent chronic disease and to save our government money down the road. HIV treatment is a lifetime commitment and it's expensive.