Funding cuts under the Trump administration are causing major disruption to one of the world’s most important HIV/AIDS programs, according to new research warning that progress against the disease could be reversed in dozens of countries.
The report focuses on the President’s Emergency Plan for AIDS Relief, known as PEPFAR, a U.S.-funded global health program launched in 2003 under President George W. Bush. Over the past two decades, PEPFAR has been credited with saving more than 26 million lives by supporting HIV testing, treatment, prevention and care around the world.
But researchers say recent U.S. funding cuts, the dismantling of USAID and new political restrictions on health programming have sharply weakened the system that delivers those services.
The findings, prepared by the AIDS research foundation amfAR and scheduled for presentation at the 26th International AIDS Conference in Rio de Janeiro, describe the disruption as widespread and severe. Researchers surveyed 166 organizations across 46 countries that had expected to receive PEPFAR funding in 2025.
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More than half said at least one of their funding awards had been terminated. The result, according to the report, included more than 1,700 closed clinics, drop-in centers or service sites and more than 16,000 full-time workers losing their jobs.
The cuts appear to have hit prevention services especially hard. Those programs often provide HIV testing, condoms, medication that reduces the risk of infection and outreach to people most at risk. Researchers warned that when prevention programs shut down, infections can rise silently before health systems recognize the full impact.
Even programs that were supposed to be protected have reportedly faced disruptions. The Trump administration issued a waiver earlier in 2025 intended to allow life-saving HIV treatment and prevention of mother-to-child transmission to continue. But researchers said the structure of global health funding means cuts in one area can damage the entire system.
For example, a clinic may technically still have permission to provide antiretroviral treatment, but if its outreach staff are laid off, laboratory supplies run out, or transport funding disappears, patients may still lose access to care.
Nearly two-thirds of organizations providing services to prevent mother-to-child HIV transmission reported disruption, according to the survey. About one-fifth said they had ended those services entirely.
The report also found that many organizations changed their work to comply with Trump administration policies targeting diversity, equity and inclusion programs, reproductive-rights services and gender-affirming care. Some groups reportedly stopped services tailored to vulnerable populations, including gay and transgender people, people who inject drugs and sex workers.
Those populations are often at higher risk of HIV infection and may already face stigma, violence or legal barriers to care. Public health experts warn that removing targeted services does not make risk disappear; it can push people away from clinics and make outbreaks harder to detect.
The administration has argued that U.S. foreign assistance requires stronger oversight and should reflect American policy priorities. Supporters of cuts may also argue that global health programs should be more financially sustainable and less dependent on U.S. funding.
Critics, however, say the abrupt nature of the cuts has damaged systems that took years to build. PEPFAR does not operate simply as a single check to foreign governments. It funds networks of local clinics, health workers, community organizations, laboratories and supply chains. When those networks are interrupted, restarting them can be slow and expensive.
The report’s authors also warned that the number of closures may be an undercount because organizations that shut down completely may no longer have staff or email access to respond to surveys.
The impact could be especially serious in countries where U.S. support makes up a large share of HIV services. If patients lose access to medication, their health can worsen and the virus can become more likely to spread. Interruptions in treatment can also increase the risk of drug resistance.
PEPFAR has long been considered one of the most successful bipartisan U.S. global health initiatives. Its future has now become part of a broader fight over foreign aid, public health, reproductive policy and the role of the United States in global humanitarian programs.
Why It Matters
PEPFAR has helped keep millions of people alive and has played a major role in reducing HIV deaths worldwide. If clinics close, staff disappear and prevention programs are cut, communities could see new infections rise and patients could lose access to medication they need every day.
The issue is also bigger than one disease. It raises questions about whether sudden political changes in Washington can destabilize health systems across the world, especially in poorer countries that rely heavily on U.S. support.
What Comes Next
Researchers will present the findings at the International AIDS Conference in Rio de Janeiro, where global health leaders are expected to pressure the U.S. government to restore stable funding and protect core services.
Advocacy groups will also likely push Congress to preserve PEPFAR funding and limit restrictions that prevent organizations from serving vulnerable communities. Without new funding or policy changes, more clinics and prevention programs could close in the coming months.
New research found that Trump administration aid cuts have forced hundreds of HIV treatment and prevention sites to close worldwide.
1,700 H.I.V. Treatment Sites Closed After Trump Aid Cuts, a Study Finds
New research also shows that children and high-risk adult populations have been particularly affected.
The Trump administration’s cuts to the largest global H.I.V. program last year resulted in sharp drops… pic.twitter.com/EHGopxTEOZ
— Benjamin Ryan (@benryanwriter) July 21, 2026
