CDC redirects HIV prevention funding from community groups to state health departments

The Trump administration will not reauthorize millions of dollars in HIV prevention funding that previously went directly to community-based organizations (CBOs), instead redirecting that money to state and local health departments.

The Centers for Disease Control and Prevention (CDC) will now distribute funds previously allocated to community-based HIV prevention organizations to states, which will decide whether to fund the CBOs. Roll Call first reported on these changes in federal HIV grants.

Key Details

• CDC's National Center for HIV, Viral Hepatitis, STD, and Tuberculosis Prevention (NCHHSTP) informed staff via email Tuesday that it will not renew a federal cooperative agreement supporting "Ending the HIV Epidemic in the U.S. through Community-Based Partnerships."
• This funding stream currently supports dozens of organizations.
• CDC employees and nonprofit groups said these changes will increase administrative costs and delay federal funds reaching community-based groups conducting HIV prevention work.

Background on CBO Role

In a related funding announcement from December 2020, the CDC wrote that "CBOs are uniquely positioned to complement and extend the reach of HIV prevention efforts implemented by state and local health departments and education agencies."

The agency further stated that CBOs "support the optimization of services across public, private, and other community-based organizations to achieve objectives of increased identification of HIV diagnoses, referral for pre-exposure prophylaxis (PrEP) and non-occupational post-exposure prophylaxis (nPEP) services, earlier entry to HIV care, and increased consistency of care."

Official Response

Department of Health and Human Services Press Secretary Emily Hilliard said in a statement:

"CDC remains committed to supporting HIV prevention efforts nationwide, including the critical work of community-based organizations. As CDC streamlines HIV prevention funding through health departments, local decision-making will remain central to combatting HIV, ensuring that local data inform local strategies and interventions. CDC will continue to support HIV testing, diagnosis, and linkage to care, expand access to PrEP, and help people living with HIV achieve and maintain viral suppression."

Employee Concerns

A CDC employee told Government Executive that the agency is reverting to an old grant model that was less effective at getting funding to communities hardest hit by HIV.

"The result is more overhead cost for the states, which means less money that ultimately ends up with the CBOs for HIV prevention," the employee said. "A lot of money gets lost going down to the CBOs, and it helped with CDC being able to coordinate directly with them."

A second CDC employee said that under the new funding model, state health departments would subcontract these community-based organizations, "leaving gaps in oversight and the loss of technical support provided directly from CDC to CBOs."

"This is a serious attack on communities, as CBOs are on the boots on the ground for HIV work and losing them would be a major loss," the second employee said. "Many of the CBOs are run by folks with not only expertise but lived experience – which is critical in the HIV space given trust and stigma."

The second employee added that in the interim, "many CBOs will either be shut down completely or have to lay off staff," and that "local politics will play a much larger role in what happens with the CBOs [and] if they get funding."

Impact on Organizations

CDC employees said the agency had previously planned to renew this federal grant funding for another five-year cycle starting in fiscal 2027.

Save HIV Funding, a coalition of over 150 organizations and advocates, said in a statement Monday that community-based organizations currently receiving these awards were provided a three-month extension through September 2026, but have now been informed that a new funding opportunity will not be released.

Jeremiah Johnson, executive director of PrEP4All and co-founder of the Save HIV Funding campaign, said that some impacted organizations that have spent decades building relationships with communities hardest hit by HIV may have to lay off staff or shut down "if this critical funding stream is discontinued or altered beyond recognition."

"As we have already seen too many times in the past year, when we lose critical CDC..."