Federal cuts for HIV research, prevention and treatment impacting South Florida

Just in the first few months of 2025, Robert Boo’s Pride Center discovered four people in Broward County who had HIV through its free testing at churches, festivals, pharmacies and nightclubs.

“If we weren’t testing, those four people could spread to four more, and it could quickly start spreading out of control,” Boo said. “The people spreading it aren’t even going to know they are doing it.”

The Pride Center’s $350,000 grant for HIV testing runs through June and funding hasn’t been renewed yet. With so many federal cuts, it may not be.

“If it isn’t renewed, there will be an impact in South Florida,” Boo said, adding that he fears a surge of new cases in Broward County.

South Florida, an area with the highest rate of HIV/AIDS in the country, is already starting to feel the effects of the Trump Administration’s federal cuts to funding for research, prevention, and access to treatment for the disease.

Since January, the state’s large universities have lost nearly $30 million remaining on terminated federal research grants for studies that include scaling interventions locally to end HIV, reducing risk among Hispanic youth, and increasing prevention (PrEP) enrollment in Latino gay men.

The Florida Department of Health has eliminated positions in its HIV program, including the statewide AIDS drug assistance program patient care director.

Disease surveillance at the state level also is threatened.

“These are the people who oversee statistical reporting of HIV,” said Dr. Elizabeth Sherman, a member of HIV Medicine Association’s board of directors and an associate professor of pharmacy practice at Nova Southeastern University. “It’s important to know what populations are seeing upticks of HIV rates so we can focus interventions to those folks. When they cut people who oversee surveillance, it hampers our ability to limit transmission before it starts to spread.”

As of March 24, the Florida Department of Health had been slated to lose $495 million in budgeted funds provided to the state to detect, prevent, and respond to infectious disease outbreaks, including HIV. A federal judge on Thursday temporarily blocked the Trump administration’s move to cut that public health funding after 23 states and the District of Columbia sued to keep the funding intact.

Local clinic directors say it’s not just funding cuts affecting HIV care: Their foreign-born patients are asking for 90-day prescriptions, telehealth calls, and postponements of blood tests to avoid coming in out of fear of being deported — even when they are in the U.S. legally.

“What is going on with deporting people and making people afraid already has impacts that we are seeing in the clinic,” said Sherman, who helps at a Broward clinic. “People are not picking up their medications. They are not coming to get their labs drawn. That is how HIV becomes uncontrolled and how it spreads.”

Every day, Sherman talks to people living with HIV who are worried that they will lose access to their life-sustaining medications or insurance should the Ryan White HIV/AIDS Program or Medicaid experience funding cuts. People who have been living with HIV for decades are afraid of returning to the 1980s era when they saw friends dying of AIDS, which occurs at the most advanced stages of infection.

“There’s a lot of panic and confusion,” she said. “Once you break any link in the chain, cut any funding for doctor visits, lab appointments, medications, the whole chain becomes undone and now you have uncontrolled transmission.”

Meanwhile, federal actions do not bode well for eradicating HIV/AIDS or curbing new diagnoses. As of early 2024, more than 128,000 people in Florida are living with HIV — about 59,000 of them in Miami-Dade, Broward, and Palm Beach counties.

On Tuesday, the Trump administration laid off thousands of federal health workers, including teams leading HIV surveillance, prevention, and research and a group of global health researchers working to prevent transmission of HIV from mother to child.

Days earlier, the Administration dismissed the entire staff of the Office of Infectious Disease and HIV Policy, which directed initiatives within the U.S. Department of Health and Human Services, such as the initiative to end the HIV/AIDS epidemic.

The loss of staff and initiatives will trickle down to states like Florida that rely heavily on federal funding for public health initiatives. Florida is one of six states awarded CDC funding dedicated to lowering HIV infections, which helps pay for medicine like pre-exposure prophylactics (PrEP) for at-risk patients.

“Right now, we don’t know what cuts will occur at the state level, but I’m sure that’s coming soon,” said Joey Wynn, chairman of the South Florida AIDS Network. “It has everyone on edge.”

A deadline looms

Many community programs with HIV services in South Florida are funded through June 30, the end of their fiscal year. Boo at the Pride Center is just one of the organizations uncertain of their future source of funding.

“For now, we are all still operating on money allocated a year ago,” Wynn said. “The first wave of what we feel here will be in July with the loss of new money.”

Von Biggs, Holy Cross Health Community Health & Well-Being Community Outreach coordinator, said Broward advocates who work to curb HIV transmission regularly battle a lack of education about prevention, the stigma associated with getting tested, and the red tape required to see a doctor and access medication. He still sees young people with new HIV diagnoses, sometimes advanced HIV.

“Our goal is 95-95-95,” he said. “That means 95% of people who are living with HIV knowing their HIV status, 95% of these people on antiretroviral treatment, and 95% of those on treatment being virally suppressed. We haven’t attained our goal yet.”

Biggs believes that private funders and nonprofits will need to step in to fill the void created by any loss of public grants. “We just need to figure out how to get information into their hands,” he said. “It has to be a multifaceted approach, and we have to work it from all angles.”

Some promising research is still underway

Even with turmoil at the federal level, Biggs is hopeful that pharmaceutical companies will continue to progress in their trials to eliminate the symptoms of HIV or find a cure.

“I hope in my lifetime to see the end of the HIV epidemic,” he said.

Trials for long-acting injectable medications are promising, including Gilead Sciences’ lenacapavir, an injectable drug that protects people for six months with each shot.

In addition, seven people had been cured of AIDS following a stem-cell transplant from a donor carrying genes that are partially resistant to HIV.

In Boca Raton, progress in HIV detection is advancing. Despite federal cutbacks, researchers at Florida Atlantic University received phase 2 of a $1.3 million federal grant in February to develop a low-cost, at-home disposable HIV test.

FAU researcher Waseem Asghar said a challenge in combating HIV is the lack of a self-test that can detect new infections during the first two weeks or identify a rebound in patients on antiviral drugs.

“If the test is easy to do at home, we might be able to fight back and limit transmission,” Asghar said. “It could be particularly helpful in communities far from a doctor’s office.”

Unlike expensive HIV tests today, FAU researchers expect theirs to cost less than $5 each.

Asghar said one in four people in Florida infected with HIV is not on suppressive treatment, so the test could play a significant role in helping them learn their status.

Acknowledging the recent cuts to federal research funding, Asghar said his grant shows HIV is still an important area of study.

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