TRUMP GUTTED AIDS HEALTH CARE AT THE WORST POSSIBLE TIME. By Steven W. Thrasher and Afeef Nessouli for The Intercept.
On World AIDS Day 2025, humanity should be celebrating that there is a new shot available which offers six months of protection against the transmission of HIV, the virus which has already infected approximately 40 million living people and taken the lives of 44 million more.
Instead, public health workers are reeling from how President Donald Trump has helped HIV to circulate in more humans this year than last. The lethal ways the current U.S. health policy is harming the health and wealth of LGBTQ+ people worldwide will be felt for years, if not decades.
That’s because on the first day of his second term, Trump issued a stop-work order for all foreign aid and several orders that jeopardized the health outcomes of minority groups within the U.S.
The cuts were far-reaching yet highly specific. They reduced resources for short- and long-term health research conducted by the Centers for Disease Control and Prevention, universities, and community groups in the U.S. and around the world. Through the so-called Department of Government Efficiency’s gutting of the United States Agency for International Development, or USAID, the administration curtailed or ended funding for programs like the President’s Emergency Plan For AIDS Relief, also known as PEPFAR.
These cuts disparately harmed several distinct but often overlapping populations: LGBTQ+ people, immigrants, sex workers, and people living with HIV/AIDS. They were swift, halting scientific trials and critical services within days (or even mere hours) of their posting on January 20, 2025. And they were significant, contributing to acute medical crises, hunger, homelessness, or even death.
In the U.S., cuts to federal spending resulted in the cancellation of over $125 million in National Institutes of Health grants for LGBTQ-focused health research.
Across the globe, cuts to USAID are disrupting life-saving services and forced community organizations to close across the globe. In South Africa, transgender people immediately lost access to gender-affirming care, leading to forced detransitioning, body dysmorphia, depression, and even suicide. In Lebanon, USAID cuts are causing job losses among humanitarian aid workers, impacting medical care and disrupting development programs. In Uganda, people living with HIV have lost access to condoms, lubricants, medication, and even to the food that USAID once provided to people living with the virus (as those who are starving simply cannot take antiretroviral medication).
While there are lethal exceptions, often, the effects of these cuts are unfolding gradually over time. HIV is a slow-acting virus, and the deadliness of halting its prevention and treatment now will take years or even more than a decade to manifest.
But it’s possible to take a toll of the damage nearly 11 months later today on World AIDS Day, to better understand the damage done and the suffering and death still to come. By early 2025, Politico reported that the administration canceled 86 percent of all USAID awards. One analysis found that 71 percent of HIV-related activities globally were terminated, including several HIV treatment awards and most HIV prevention programs. Overall, there has been a huge drop in the number of people starting antiretroviral medication and a decrease in viral load testing, which is crucial for monitoring the virus and preventing transmission. Without the infrastructure of monitoring, documentation, and care, HIV is transmitting unchecked in the dark.
And it’s also possible to get a pattern of HIV’s rise by talking to people doing the work on the ground (or who recently returned from it), people living with HIV, and people who are both. In the United States, Europe, Africa, and the Middle East, Trump’s cuts are not merely harming these populations by reducing or eliminating services they receive; it is also harming them by taking away their jobs.
For instance, at one large university hospital we visited in the Midwestern United States, every single trans Black outreach worker — who had been integral in addressing high rates of HIV among Black LGBTQ+ Americans — had lost their job by May. In Europe, we found HIV nongovernmental organizations struggling not just with cuts from USAID, but cuts also dictated from Brussels and their own governments, as EU countries shifted money away from immigrants and foreign aid and toward NATO and Frontex, the ICE of the European Union.
In Lebanon, the executive director of an organization that helps some 600 people per month access HIV services and other care — including financial aid or case management for queer people experiencing violence — said they can no longer plan beyond eight months.
At a clinic in Uganda for “key populations” (the euphemism for LGBTQ+ people in a country where “aggravated homosexuality” is a capital offense), a medical assistant said the staff was cut from 15 to just four. When told that staff at a similar organization in South Africa had also been reduced to just four people — but from an original staff of 86 — one of the workers in Uganda could only laugh: “Wow, I thought we had it bad.”