Funding Community-Led HIV Prevention
The strength of our nation’s HIV response lies in its reach into local communities. The vast majority of the CDC’s HIV prevention funding—over 80%—is spent in states and local communities across the country.
The CDC’s main HIV prevention grant, PS24-0047 funds state, local, and territorial health departments to reduce new HIV infections and address disparities. Key focus areas include HIV testing, linkage to care, PrEP access, disease monitoring and outbreak response, partner services, and harm reduction. This grant provides the core infrastructure for public HIV prevention nationwide and is central to achieving the goals of the Ending the HIV Epidemic initiative.
Without it, communities would lose essential resources and tools to track, prevent, and treat HIV—making this funding critical to protect, especially amid growing threats to public health budgets.
CDC funding is a direct pipeline to state and local health departments, community-based organizations (CBOs), and clinics. This model ensures that resources are directed to where they are most needed, supporting a wide range of essential, evidence-based services, including:
- HIV testing and diagnosis: Testing and diagnosing people with HIV as early as possible.
- Linkage to care: Connecting people with HIV to lifesaving treatment and care. Early care improves health and reduces the risk of HIV transmission through sustained viral suppression.
- PrEP and PEP navigation and access: Providing powerful biomedical HIV prevention tools to those at greatest risk.
- HIV outbreak detection and response: Monitoring and identifying HIV clusters and outbreaks early so health departments can quickly respond to contain them with targeted HIV prevention and treatment efforts.
- Syringe services programs: Reducing HIV transmission among people who inject drugs.
- Condom distribution and education: Providing access to a fundamental and cost-effective HIV prevention method.
- Community outreach and engagement: Reaching populations most disproportionately affected by HIV with culturally competent information and services.
The Threat of Underfunding: A Burden States Cannot Bear
For many states, federal funding administered by the CDC constitutes the entirety or the vast majority of their HIV prevention budget.
State governments generally do not have the fiscal capacity to absorb a significant reduction in federal support. A substantial cut to the CDC’s HIV prevention budget would create a financial gap that states would be unable to fill, leading to a direct impact on service delivery across the nation.
The consequences of such cuts would be immediate and devastating:
- Reduced access to testing and prevention services, leading to a rise in new HIV infections. The CDC estimates that from 2017 to 2022, its prevention efforts averted approximately 9,000 HIV infections, saving an estimated $5 billion in lifetime medical costs.
- Closure of clinics and community-based organizations, severing life-saving connections to care and prevention for vulnerable populations.
- Loss of a highly specialized and experienced public health workforce, undoing decades of investment in expertise and community trust.
- Exacerbation of health inequities, as the communities most impacted by HIV and with the least resources would bear the brunt of service reductions.
- Growing numbers of HIV outbreaks. The FY26 Congressional Justification for the new Administration for a Healthy America (AHA) reports that over 400 HIV clusters were identified and addressed by 49 health departments between 2022 and 2024. HIV clusters signal rapid transmission, and without swift intervention, they can escalate into costly outbreaks—like the 2014 Scott County, Indiana outbreak, which led to 235 new infections and an estimated $250 million in costs.
The Critical Importance of CDC’s HIV Prevention Branch Core Functions and Funding
Over $1 billion in federal HIV prevention funding for Fiscal Year 2026 is now in jeopardy—critical dollars that have, until recently, been housed under the CDC’s Division of HIV Prevention (DHP).
For decades the Centers for Disease Control and Prevention’s (CDC) Division of HIV Prevention (DHP) has stood as the cornerstone of our nation’s efforts to end the HIV epidemic, providing essential leadership, scientific expertise, and financial resources to empower communities across the nation on the front lines of HIV prevention.
This funding has supported a wide range of essential services that help prevent the spread of HIV across the United States, including access to PrEP, HIV testing, linkage to care and treatment, outbreak detection and response, syringe services programs, and support for state and local health departments. These programs are foundational to the federal Ending the HIV Epidemic initiative, particularly in communities with the greatest unmet need. Without this funding, the infrastructure that helps detect, prevent, and respond to HIV could be severely weakened, threatening the progress made over the last decade.
CDC DHP’s received $1.013 billion in federal FY 2024 funding, which included $220M to support the federal EHE initiative.
However, proposed structural changes and drastic funding cuts in the Administration’s FY 2026 budget threaten to dismantle this vital public health infrastructure, jeopardizing decades of progress and risking a resurgence of the HIV epidemic in the United States.
Protect Core Functions and Full Funding
Regardless of any future organizational restructuring, the core functions of the CDC’s HIV Prevention Branch must be protected and preserved.
- Protect the Size and Scope of Funding: The life-saving work of HIV prevention cannot be accomplished with a fraction of the necessary resources.
- Preserve Core HIV Prevention Functions: The essential activities of direct funding for community-based HIV prevention services, surveillance, research, and technical assistance must continue, regardless of the agency structure.
- Ensure Direct Funding to Communities: The highly effective model of channeling the vast majority of funding to state and local health departments and their grantees must be maintained.
Importance of Core Functions
Regardless of any future organizational restructuring of federal health agencies, the core functions of HIV surveillance, research, technical assistance to all state health departments, and the funding of community-based prevention are vital to maintaining public health.
The preservation of these activities, at their current size and scope, is fundamental to a sustained and effective national response to HIV.
Core Functions of the Nation’s HIV Prevention Response
The federal government’s HIV prevention response is built on a coordinated strategy that integrates data, science, capacity-building, and rapid action to reduce new HIV infections and advance the goals of the Ending the HIV Epidemic (EHE) initiative.
Implementation of the HIV Prevention Pillar under EHE
The federal response leads national efforts to scale up four key prevention pillars:
- Diagnose: Ensure timely HIV testing and diagnosis for all individuals.
- Treat: Rapidly link people diagnosed with HIV to care and antiretroviral treatment.
- Prevent: Expand access to proven prevention methods like PrEP, SSPs, and condoms.
- Respond: Quickly identify and contain HIV clusters with targeted prevention and care.
Surveillance and Monitoring
The foundation of the prevention response is robust data collection and disease monitoring to:
- Track HIV transmission, trends, and deaths over time.
- Identify where prevention efforts are most needed and evaluate their impact.
- Detect HIV clusters and outbreaks early, enabling rapid response and containment.
Research and Evaluation
Ongoing research ensures prevention strategies are effective, equitable, and scalable:
- Evaluate existing interventions, such as PrEP and syringe services programs (SSPs).
- Advance implementation science to expand proven approaches in high-need communities.
- Monitor new prevention technologies and study emerging transmission trends.
- Support community-engaged research to improve cultural relevance and accessibility.
Capacity Building and Community Knowledge
Strengthening the prevention workforce and public understanding through:
- Technical assistance, training, and tools for implementing evidence-based strategies.
- Guidelines to help providers integrate prevention into clinical care.
- Community education on HIV testing, PrEP, treatment, and stigma reduction.