CDC ends $29.2 million in HIV prevention funding for Texas community groups

Outreach testing finds HIV at triple the rate of health department tests

The federal government has cut $29.2 million from Texas health organizations that test thousands of people for HIV directly in their communities, the latest in a series of public health funding cuts statewide. The Centers for Disease Control and Prevention allowed the grant, known as PS21-2102, to expire on Sept. 30.

Texas was the nation’s largest beneficiary of the funding, which supported 11 community-based organizations, most of them in urban areas, over the last five years. Rolled out in 2021, PS21-2102 provided $239 million to community organizations across the country. The federal dollars helped cover the cost of HIV tests, connect Texans to care and pay for HIV prophylaxis, which almost completely protects against infection.

Without the grant, organizations have been left scrambling to find new sources of funding or pare back services. The CDC did not respond to a request for comment.

“The front line in the testing portion of it really are the community-based organizations — they’re the ones that are in their community,” said Philip Keiser, a professor at the University of Texas Medical Branch who studies HIV. “These community groups are critically important in getting out there to reach their community and get people tested.”

The elimination comes as President Donald Trump’s administration has targeted HIV-eradication efforts both domestically and abroad. “From the start of this administration, we heard that HIV prevention was … under attack,” said Philip Huang, director of Dallas County Health and Human Services and the vice chair of the state’s Public Health Funding and Policy Committee.

Beyond HIV prevention, the federal government has cut public health funding to Texas more broadly, including pandemic-era grant money for immunization efforts, laboratory capacity and the investigation of infectious disease outbreaks. Job cuts at the federal level have wiped out both the administrative support and the technical expertise local health departments rely on, Huang said, and the uncertainty about funding has been incredibly disruptive. “It’s been chaotic, uncertain, so they’re all making our job of trying to protect the public … much more difficult,” he said.

Unlike other HIV-related grants, PS21-2102 channeled money directly to community organizations. The federal government is now giving state health departments a one-time pot of money through May 2027, and the CDC awarded the Texas Department of State Health Services just over $5.2 million. Almost a quarter of that award — $1.2 million — will flow to community organizations, while the rest will go to “projects that support the HIV prevention and surveillance efforts funded through” another program, DSHS spokesperson Lara Anton wrote in an email.

The sum is a fraction of the more than $3 million Texas community organizations had been receiving annually from the CDC. State health departments are encouraged, but not required, to send 10% of the new funds to community organizations, and advocates worry states will prioritize testing in clinical settings at the expense of the groups. While both clinics and community organizations are key parts of an effective HIV prevention strategy, Keiser said, siphoning funding from community organizations to support clinics is like “robbing Peter to pay Paul.”

In Houston, Allies in Hope has provided HIV-related care for more than four decades. Starting in 2021, the organization received about $441,000 annually under the grant, which funded outreach and a mobile unit, said CEO William Jeffrey Campbell. The money covered more than a quarter of the 2,000 tests the organization administers yearly, and unless it finds new sources of funding, it will have to reduce testing. “That $441,000, with all that it encompasses, that takes out a good chunk of the number of people that we are able to test,” Campbell said.

In Austin, Vivent Health used its award to fund outreach HIV testing and awareness, and the grant made up 30% of the organization’s funding for HIV prevention, said Emma Sinnott, its vice president of health center operations. Much of the organization’s clientele may not trust clinics or worry that a clinic visit could out them, she said. “There’s a lot of stigma in the community, and they don’t want people to know their sexuality,” Sinnott said. “Outreach allows access, testing and meeting people where they’re at.”

As one of the state’s larger organizations, Vivent Health can better absorb the initial shock of losing the grant, Sinnott said, but the cut will limit its outreach events and reduce access to newer post-exposure prophylaxis medications such as injectables. The organization will try to keep testing panels for sexually transmitted diseases free for as long as possible, but Sinnott said she worries it will eventually need to charge for them.

Vivent Health meets a particular need by focusing on the populations most affected by HIV and with the least access to testing, said Laura La Fuente, assistant director of Austin Public Health, which also provides HIV testing. “We want to ensure that there are access points across a public health system with various partners to ensure that individuals can get tested and can get treatment,” she said.

Texas ranks fifth in the nation for new HIV diagnoses per capita, according to 2024 data from AIDSVu, a mapping tool developed at Emory University in partnership with Gilead Sciences. People can get tested at clinics or at a doctor’s office, but the onus typically falls on the patient to seek out care. Community organizations reach vulnerable groups directly — setting up testing stations at bars or nightclubs, for instance — so they find more positive cases for each test administered. Between 2012 and 2017, community organizations diagnosed a new case of HIV in 1.4% of CDC-funded tests, compared with 0.5% for tests administered by local health departments — a rate of new diagnoses three times as high.

The first Trump administration made eradicating HIV a pillar of its public health strategy, setting a goal of ending the HIV epidemic by 2030. The last two years have brought repeated cuts to HIV prevention efforts: in the wake of the COVID-19 pandemic, the administration has tightened its oversight of the CDC, and many public health programs were cut under the Department of Government Efficiency’s push to reduce federal spending. In 2025, the National Institutes of Health eliminated at least $759 million in grants for HIV research, and the administration has sought to cut or alter numerous HIV-related programs, including the Ending the HIV Epidemic initiative, part of the Ryan White HIV/AIDS Program and a program supporting housing for people living with AIDS.

“The first year the Trump administration was back, they zeroed budget proposals on HIV prevention programs,” said Carl Schmid, executive director of the HIV+Hepatitis Policy Institute. “We’ve been on the defensive, and this is not where we were in the last administration with President Trump.”

Experts said HIV prevention is economically advantageous regardless of the administration’s ideological stance. A single case of HIV can cost up to $1 million in treatment over a patient’s lifetime, said Anthony Fojo, a medicine professor at Johns Hopkins Medicine. The more positive cases are found and treated, the fewer transmissions occur, meaning that running 1,000 tests to find a single positive case still saves hundreds of thousands of dollars in the long run, he said. “It’s kind of penny wise and pound foolish to cut funding for testing, because it’s a lot cheaper to test and screen things than to treat additional infections down the road,” Fojo said.

In San Antonio, Black Efforts Against the Threat of AIDS was the nation’s largest recipient of the grant’s money. Last year, the grant covered 20% of the approximately 5,000 HIV tests the organization administered. It is now writing more grant applications, educating local leaders and seeking more support from the city. Each year, 300 to 400 people are newly diagnosed with HIV in San Antonio, Executive Director Michele Durham said. Reduced funding means reduced testing capacity, translating to more people living with HIV without knowing it and who could unwittingly pass on the disease. “For us to let up off the gas right now is just not our smartest move as a community and as a nation,” Durham said.

Going into the next legislative session, Texas lawmakers have started considering replacement funding at the state level, said state Rep. Venton Jones, a Dallas Democrat who is the first openly HIV-positive lawmaker to serve in the Legislature. Jones vowed to do everything he can to replace the eliminated federal dollars but warned that state funding is not a permanent solution. “This is a huge hit to our ability to respond to the epidemic,” Jones said. “Ultimately, we want to make sure that those funds are put back by the federal government, by the CDC, because those are critical.”