U.S. halts anti-HIV drugs for LGBTQ people abroad, risking deadly AIDS rebound
Already an estimated 3,000 new HIV infections because of U.S. aid freeze
Secretary of State Marco Rubio has banned the use of American funds to pay for HIV prevention drugs for LGBTQ people, men who have sex with men (MSM), sex workers and other at-risk people such as fishing communities and truck drivers.
The ban applies to everyone except pregnant women and nursing mothers.
The ban comes as the Trump administration has frozen almost all foreign aid for at least 90 days and is demolishing USAID, the American foreign aid agency.
The U.N. anti-AIDS agency, UNAIDS, estimated this week that more than 3,000 new HIV infections in adults have occurred worldwide as a result of the Trump administration’s aid freeze.
Before Trump intervened, the fight against AIDS was going well. For example, new HIV infections among children aged 0-14 years old have declined by 38% worldwide since 2015 and AIDS-related deaths have fallen by 43%, according to UNAIDS.
In a policy announcement on Feb. 6, the State Department said that life-saving HIV Care & Treatment and Prevention of Mother to Child Transmission (PMTCT) services provided through Pepfar, the huge U.S. anti-AIDS program, should be resumed as soon as possible.
But “Pre-exposure prophylaxis (PrEP) should be offered only to pregnant and breastfeeding women (PBFW),” the policy states.
Donald Trump stops giving PrEP to gay men & sex workers, ensuring HIV outbreaks abroad
The policy change is illegal and will result in easily preventable deaths, experts say.
The U.S. State Department has issued a memo stating that the President’s Emergency Plan for AIDS Relief (PEPFAR), a program to prevent HIV in low- and middle-income foreign countries, can only offer HIV-preventing pre-exposure prophylaxis (PrEP) medications to pregnant and breastfeeding women (PBFW) rather than to LGBTQ+ people, sex workers and other groups at high-risk for contracting HIV.
The memo circulated by the State Department’s Global Health Security and Diplomacy program states, “People other than PBFW who may be at high risk of HIV infection or were previously initiated on a PrEP option cannot be offered PEPFAR-funded PrEP during this pause of U.S. Foreign Assistance or until further notice.”
The “pause” mentioned in the memo refers to a 90-day hold on all foreign aid issued by President Donald Trump’s executive order on “reevaluating and realigning” U.S. foreign aid. The State Department added that Trump’s order is “rooting out waste” and “blocking woke programs” to ensure that funding only benefits efforts “fully aligned” with Trump’s foreign policy.
“We are outraged by the Trump Administration’s puritanical distribution of life-saving medication that brazenly discriminates against anyone not having sex exclusively for procreation,” said Wayne Besen, executive director of the LGBTQ+ advocacy organization Truth Wins Out. “This… could cruelly lead to the infection, and eventual death, of hundreds of thousands of people worldwide.
“There is no other explanation for these guidelines other than cruel, vindictive behavior meant to cause pain and suffering to vulnerable communities disfavored by President Trump’s right-wing base,” Besen continued, adding, “Aren’t conservatives supposed to be pro-life, or do they only care about ‘life’ for those who are just like them?”
Secretary of State Marco Rubio issued a waiver for lifesaving medicines and medical services affected by the pause, but his memo explained that PEPFAR funds will be restricted in various ways. In addition to denying PrEP medications to all but PBFW, Rubio’s restrictions also prohibit surveys and systems tracking the spread of HIV and child abuse in regional populations, as well as any projects scheduled beyond December 31 of this year.
As a result, the program’s HIV-prevention drugs are reportedly still not reaching their intended recipients, many clinics have ceased offering services, and healthcare workers haven’t been paid, the Kaiser Family Foundation (KFF) reported. These all increase the likelihood of rising HIV rates, outbreaks, and HIV-related deaths abroad, KFF and Besen said.
The freeze and restrictions on PEPFAR funding have coincided with the dismantling of USAID – the independent U.S. international development agency that implements most U.S. global health programs – by Trump’s unofficial Department of Government Efficiency (DOGE). DOGE, which is not an official federal department created through required congressional approval, is headed by the world’s richest man, Elon Musk.
Musk has made the elimination of the agency a top DOGE priority, stating, “USAID is a criminal organization. Time for it to die,” without citing any evidence. Although USAID is the primary source of funding for HIV/AIDS relief for over 25 million people in 54 countries, the agency’s website has since been disabled.
A large portion of USAID’s personnel have been furloughed or fired; PEPFAR recipients have been left with no way to reach longtime contacts or access guidance. The Trump administration announced its intention to remove almost all USAID workers from their jobs and out of the field worldwide. Rubio said recipient organizations would have to apply for waivers to restart the funding.
Opponents have called Trump and Musk’s actions against PEPFAR and USAID illegal and unconstitutional. Lawsuits against the dismantling of the agency have been filed by USAID contractors – who say that the Trump administration owes them millions in unpaid bills that had been pledged in the last congressional budget – and also by a pair of nonprofit organizations, including the AIDS Vaccine Advocacy Coalition (AVAC), an HIV-prevention nonprofit.
