Trump once promised to end HIV in America. His deep funding cuts are rolling back progress in the South.

[Pelican Press 0]

This is the hidden content, please

• Sign In
• or
• Sign Up

Trump once promised to end **** in America. His deep funding cuts are rolling back progress in the South.

JACKSON, Miss. — Storm clouds hung low above a community center in Jackson, where pastor Andre Devine invited people inside for lunch. Hoagies with smoked turkey and ham drew the crowd, but several people lingered for free preventive health care: tests for **** and other diseases, flu shots, and blood pressure and glucose monitoring.

Between greetings, Devine, executive director of the nonprofit group

This is the hidden content, please

• Sign In
• or
• Sign Up

, commiserated with his colleagues about the hundreds of thousands of dollars their groups had lost within a couple of weeks, swept up in the Trump administration’s termination of research dollars and clawback of more than $11 billion from health departments across the country.

Devine would have to scale back food distribution for people in need. And his colleagues at the nonprofit health care group

This is the hidden content, please

• Sign In
• or
• Sign Up

were worried they’d have to shutter the group’s mobile clinic — an RV offering **** tests, parked beside the community center that morning. Several employees had already been furloughed and the cuts kept coming, said June Gipson, CEO of My Brother’s Keeper.

“People can’t work without being paid,” she said.

This is the hidden content, please

• Sign In
• or
• Sign Up

/applications/core/interface/js/spacer.png">

A mobile clinic run by the nonprofit My Brother’s Keeper provides free tests for **** and other diseases in Jackson, Mississippi. The group is curbing its services because of cuts to federal funding.

Amy Maxmen / KFF Health News

The directors of other community-based groups in Mississippi, Alabama, Louisiana, and Tennessee told KFF Health News they too had reduced their spending on **** testing and outreach because of delayed or slashed federal funds — or they were making plans to do so, anticipating cuts to come.

Scaling back these efforts could prove tragic, Gipson said. Without an extra boost of support to get tested or stay on treatment, many people living with **** will grow sicker and stand a greater chance of infecting others.

President Trump, in his first term, promised to end America’s **** epidemic — and he put the resources of the federal government behind the effort. This time, he has deployed the powers of his office to gut funding, abandoning those communities at highest risk of ****.

Mr. Trump’s earlier efforts targeted seven Southern states, including Mississippi, where funds went to community groups and health departments that tailor interventions to historically

This is the hidden content, please

• Sign In
• or
• Sign Up

that face discrimination and have

This is the hidden content, please

• Sign In
• or
• Sign Up

to quality education, health care, stable income, and generational wealth. Such factors help explain why ****** people accounted for

This is the hidden content, please

• Sign In
• or
• Sign Up

in the United States in 2023, despite representing only 14% of the population,

This is the hidden content, please

• Sign In
• or
• Sign Up

half of the country’s new **** infections occur in the South.

Now, Mr. Trump is undermining **** efforts by barring funds from programs built around diversity, equity, and inclusion. A Day One executive order said they represent “immense public waste and shameful discrimination.”

Since then, his administration has

This is the hidden content, please

• Sign In
• or
• Sign Up

to health departments, universities, and nonprofit organizations that do **** work. And in April, it eliminated half of the Centers for Disease Control and Prevention’s 10 **** branch offices, according to an email to grant recipients, reviewed by KFF Health News, from the director of the CDC’s Division of **** Prevention. The layoffs included staff who had overseen the rollout of **** grants to health departments and community-based groups, like My Brother’s Keeper.

The CDC provides

This is the hidden content, please

• Sign In
• or
• Sign Up

of all federal funding for **** prevention — about $1 billion annually. The Trump administration’s May 2 budget proposal for fiscal 2026 takes aim at DEI initiatives, including in its explanation for cutting $3.59 billion from the CDC. Although the proposal doesn’t mention **** prevention specifically, the administration’s drafted plan for HHS, released mid-April, eliminates all prevention funding at the CDC, as well as funding for Mr. Trump’s initiative to end the epidemic.

Eliminating federal funds for **** prevention would lead to more than 143,000 additional people in the U.S. becoming infected with **** within five years, and about 127,000 additional people who die of AIDS-related causes, according to

This is the hidden content, please

• Sign In
• or
• Sign Up

, a nonprofit known as amfAR. Excess medical costs would exceed $60 billion, it said.

Eldridge Dwayne Ellis, the coordinator of the mobile testing clinic at My Brother’s Keeper, said curbing the group’s services goes beyond ****.

“People see us as their only outlet, not just for testing but for confidential conversations, for a shoulder to cry on,” he said. “I don’t understand how someone, with the stroke of a pen, could just haphazardly write off the health of millions.”

This is the hidden content, please

• Sign In
• or
• Sign Up

/applications/core/interface/js/spacer.png">

Eldridge Dwayne Ellis (right) and a nurse work inside a mobile clinic run by My Brother’s Keeper that offers free tests for **** and other diseases. 

Amy Maxmen / KFF Health News

Quiet tears

Ellis came into his role in the mobile clinic haphazardly, when he worked as a construction worker. Suddenly dizzy and unwell on a job, a co-worker suggested he visit the organization’s brick-and-mortar clinic nearby. He later applied for a position with My Brother’s Keeper, inspired by its efforts to give people support to help themselves.

For example, Ellis described a young man who visited the mobile clinic recently who had been kicked out of his home and was sleeping on couches or on the street. Ellis thought of friends he’d known in similar situations that put them at risk of **** by increasing the likelihood of transactional sex or substance use disorders.

When a rapid test revealed ****, the young man fell silent. “The quiet tears hurt worse — it’s the dread of mortality,” Ellis said. “I tried to be as strong as possible to let him know his life is not over, that this wasn’t a death sentence.”

Ellis and his team enrolled the man into **** care that day and stayed in touch. Otherwise, Ellis said, he might not have had the means or fortitude to seek treatment on his own and adhere to daily **** pills. Not only is that deadly for people with ****, it’s bad for public health. **** experts use the phrase “treatment as prevention” because most new infections derive from people who aren’t adhering to treatment well enough to be considered virally suppressed — which keeps the disease from spreading.

Only

This is the hidden content, please

• Sign In
• or
• Sign Up

living with **** in Mississippi were virally suppressed in 2022. Nationally, that number is

This is the hidden content, please

• Sign In
• or
• Sign Up

. That’s worse than in eastern and southern Africa, where

This is the hidden content, please

• Sign In
• or
• Sign Up

with **** aren’t spreading the virus because they’re on steady treatment.

My Brother’s Keeper is one of many groups improving such numbers by helping people get tested and stay on medication. But the funding cuts in Washington have curtailed their work. The first loss was a $12 million grant from the National Institutes of Health, not even two years into a 10-year project. “Programs based primarily on artificial and non-scientific categories, including amorphous equity objectives, are antithetical to the scientific inquiry,” the NIH said in a letter reviewed by KFF Health News.

My Brother’s Keeper then lost a CDC award to reduce health disparities — a grant channeled through the Mississippi state health department — that began with the group’s work during the covid pandemic but had broadened to screening and care for ****, heart disease, and diabetes. These are some of the maladies that account for why low-income ****** people in the Deep South

This is the hidden content, please

• Sign In
• or
• Sign Up

, on average, than those who are white. According to a

This is the hidden content, please

• Sign In
• or
• Sign Up

, the former’s life expectancy was just 68 years in 2021, on par with the average in impoverished nations like Rwanda and Myanmar.

The group then lost CDC funding that covered the cost of laboratory work to detect ****, chlamydia, gonorrhea, and ********* in patients’ blood samples. Mississippi has the

This is the hidden content, please

• Sign In
• or
• Sign Up

of ********* transmitted diseases among states, in part because people spread infections when they aren’t tested and treated.

“The labs are $200 to $600 per person,” Gipson said, “so now we can’t do that without passing the cost to the patient, and some can’t pay.”

Two other CDC grants on **** prevention, together worth $841,000, were unusually delayed.

Public health specialists close to the CDC, who spoke on condition of anonymity because they fear retaliation, said they were aware of delays in **** prevention funding, despite court orders to unfreeze payments for federal grants in

This is the hidden content, please

• Sign In
• or
• Sign Up

and

This is the hidden content, please

• Sign In
• or
• Sign Up

“The faucet was being turned off at a higher level than at the CDC,” one specialist said. The delays have now been compounded, they said, by the gutting of that agency’s **** workforce in April.

“I know of many organizations reliant on subcontracted federal funds who have not been paid for the work they’ve done, or whose funding has been terminated,” said Dafina Ward, executive director of the Southern AIDS Coalition. 

To reach the underserved, these groups offer food, housing assistance, bus passes, disease screening, and a sense of community. A network of the groups was fostered, in part, by Mr. Trump’s initiative to end the epidemic. And it showed promise: From 2017 to 2022, new **** infections

This is the hidden content, please

• Sign In
• or
• Sign Up

in the cities and the Southern states it targeted.

Disparities in infections were still massive, with the rate of **** diagnoses about

This is the hidden content, please

• Sign In
• or
• Sign Up

for ****** people as White people, and the South remained hardest hit. Ward was hopeful at the start of this year, however, as testing became more widespread and **** prevention drugs — called preexposure prophylaxis, or PrEP — slowly gained popularity. But her

This is the hidden content, please

• Sign In
• or
• Sign Up

has shifted and she fears that grassroots organizations might not weather the funding turmoil.

“We’re seeing an about-face of what it means to truly work towards ending **** in this country,” she said.

A closed clinic

Southeast of Jackson, in Hattiesburg, Sean Fortenberry tears up as he walks into a small room used until recently for **** testing. He has kept his job at Mississippi’s

This is the hidden content, please

• Sign In
• or
• Sign Up

by shifting his role but agonizes about the outcome. When Fortenberry tested positive for **** in 2007, he said, his family and doctor saved his life.

“I never felt that I was alone, and that was really, really important,” he said. “Other people don’t have that, so when I came across this position, I was gung-ho. I wanted to help.”

But the coalition froze its **** testing clinic and paused mobile testing at homeless shelters, colleges, and churches late last year. Kathy Garner, the group’s executive director, said the Mississippi health department — which funds the coalition with CDC’s **** prevention dollars — told her to pause outreach in October before the state renewed the group’s annual **** contract.

This is the hidden content, please

• Sign In
• or
• Sign Up

/applications/core/interface/js/spacer.png">

Sean Fortenberry and Kathy Garner, of the AIDS Services Coalition, work inside the group’s **** testing clinic, whose operation has been suspended because of delayed federal funds for **** prevention.

Amy Maxmen / KFF Health News

Kendra Johnson, communicable diseases director at Mississippi’s health department, said that delays in **** prevention funds were initially on the department’s end because it was short on administrative staff. Then Mr. Trump took office. “We were working with our federal partners to ensure that our new objectives were in line with new **** prevention activities,” Johnson said. “And we ran into additional delays due to paused communications at the federal level.”

The AIDS coalition remains afloat largely because of money from the Ryan White ****/AIDS Program for treatment and from the Department of Housing and Urban Development. “If most of these federal dollars are cut, we would have to close,” Garner said.

The group provides housing or housing assistance to roughly 400 people each year. Research shows that people in stable housing adhere

This is the hidden content, please

• Sign In
• or
• Sign Up

to **** treatment and are far

This is the hidden content, please

• Sign In
• or
• Sign Up

to die than unhoused people with ****.

Funding cuts have shaken every state, but the South is acutely vulnerable when it comes to ****, said Gregorio Millett, director of public policy at amfAR. Southern states have the highest level of poverty and a severe shortage of rural clinics, and several haven’t expanded Medicaid so that more low-income adults have health insurance. 

Further, Southern states aren’t poised to make up the difference. Alabama, Louisiana, Kentucky, Mississippi, and Missouri put zero state funds into **** prevention last year, according to NASTAD, an association of public health officials who administer **** and hepatitis programs. In contrast, about 40% of Michigan’s **** prevention budget is provided by the state, 50% of Colorado’s **** prevention budget, and 88% of New York’s.

“When you are in the South, you need the federal government,” said Gipson, from My Brother’s Keeper. “When we had slavery, we needed the federal government. When we had the push for civil rights, we needed the federal government. And we still need the federal government for health care,” she said. “The red states are going to suffer, and we’re going to start suffering sooner than anyone else.”

“So goes Mississippi”

When asked about cuts and delays to **** prevention funding, the CDC directed queries to HHS. The department’s director of communications, Andrew Nixon, replied in an email: “Critical ****/AIDS programs will continue under the Administration for a Healthy America (AHA) as a part of Secretary [Robert F.] Kennedy’s vision to streamline HHS to better serve the American people.”

Nixon did not reply to a follow-up question on whether the Trump administration considers **** prevention critical.

On April 4, Gipson received a fraction of her delayed **** prevention funds from the CDC. But Gipson said she was afraid to hire back staff amid the turmoil.

Like the directors of many other community organizations, Gipson is going after grants from foundations and companies. Pharmaceutical firms such as Gilead and GSK that produce **** drugs are among the largest contributors of non-governmental funds for **** testing, prevention, and care, but private funding for **** has never come close to the roughly

This is the hidden content, please

• Sign In
• or
• Sign Up

that the federal government allocated to **** annually. 

“If the federal government withdraws some or all of its support, the whole thing will collapse,” said Alice Riener, CEO of the community-based organization CrescentCare in Louisiana. “What you see in Mississippi is the beginning of that, and what’s so concerning is the infrastructure we’ve built will collapse quickly but take decades to rebuild.”

Southern health officials are reeling from cuts because state budgets are already tight. Mississippi’s state health officer, Daniel Edney, spoke with KFF Health News on the day the Trump administration terminated $11 billion in COVID-era funds intended to help states improve their public health operations. “There’s not a lot of ****, and we’re cutting it to the bone right now,” Edney said.

Mississippi needed this boost, Edney said, because the state ranks among

This is the hidden content, please

• Sign In
• or
• Sign Up

in health metrics including premature death, access to clinical care, and teen births. But Edney noted hopeful trends: The state had recently moved from 50th to 49th worst in health rankings, and its rate of new **** cases was dropping.

“The science tells us what we need to do to identify and care for patients, and we’re improving,” he said. “But trends can change very quickly on us, so we can’t take our foot off the gas pedal.”

If that happens, researchers say, the comeback of **** will go unnoticed at first, as people at the margins of society are infected silently before they’re hospitalized. As untreated infections spread, the rise will eventually grow large enough to make a dent in national statistics, a resurgence that will cost lives and take years, if not decades, to reverse.

Outside the community center on that stormy March morning, pastor Devine lamented not just the loss of his grant from the health department, but a $1 billion cut to food distribution programs at the U.S. Department of Agriculture. He rattled off consequences he feared: People relying on food assistance would be forced to decide between buying groceries, paying bills, or seeing a doctor, driving them further into poverty, into emergency rooms, into crime.

Deja Abdul-Haqq, a program director at My Brother’s Keeper, nodded along as he spoke. “So goes Mississippi, so goes the rest of the United States,” Abdul-Haqq said. “Struggles may start here, but they spread.”

This is the hidden content, please

• Sign In
• or
• Sign Up

is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at

This is the hidden content, please

• Sign In
• or
• Sign Up

— the independent source for health policy research, polling, and journalism.

This is the hidden content, please

• Sign In
• or
• Sign Up

#Trump #promised #**** #America #deep #funding #cuts #rolling #progress #South

This is the hidden content, please

• Sign In
• or
• Sign Up

This is the hidden content, please

• Sign In
• or
• Sign Up