In a sweeping and sudden move, the Trump administration dismantled several key offices within the Centers for Disease Control and Prevention that were dedicated to HIV prevention. The cuts include entire teams focused on public health communication campaigns, behavioral surveillance, capacity building, and non-laboratory research. Public health experts warn that this decision will have devastating consequences, reversing years of progress in preventing new HIV infections and increasing the burden on an already strained healthcare system.

Among the most shocking changes is the reassignment of Dr. Jonathan Mermin, a long-time and widely respected leader in public health, to the Indian Health Service. Dr. Mermin previously served as the director of the National Center for HIV, Viral Hepatitis, STD, and TB Prevention, a role in which he played a critical part in shaping the nation’s response to infectious diseases. His abrupt transfer is widely seen as part of a broader restructuring that has resulted in thousands of staff layoffs across the Department of Health and Human Services (HHS).

The administration also reassigned Dr. Jeanne Marrazzo, Director of the NIH’s National Institute of Allergy and Infectious Diseases, to the Indian Health Service. This move comes on top of last week’s announcement that eliminated entire offices within HHS, including the Office of Infectious Disease & HIV Policy and the Office of Minority Health—two entities that have played pivotal roles in addressing health disparities and coordinating nationwide infectious disease policy.

Adding to the devastation, the National Institutes of Health terminated at least 145 grants related to HIV research, amounting to nearly $450 million in lost federal funding. Scientists warn that these terminations will decimate progress toward eliminating the epidemic in the United States. The cuts have been made in phases over the last month, leaving researchers scrambling to salvage their work and find alternative funding sources.

Carl Schmid, executive director of the HIV+Hepatitis Policy Institute, expressed deep concern over the implications of these actions. In a statement, he warned:

“In a matter of just a couple days, we are losing our nation’s ability to prevent HIV. The expertise of the staff, along with their decades of leadership, has now been destroyed and cannot be replaced. We will feel the impacts of these decisions for years to come, and it will certainly, sadly, translate into an increase in new HIV infections and higher medical costs.

“We are still learning the full extent of the staff cuts and do not know how the administration’s announced reorganization of HHS will impact all HIV treatment, prevention, and research programs, including President Trump’s Ending the HIV Epidemic initiative. At the moment, it seems that we are in the middle of a hurricane and just waiting for the next shoe to drop. Hopefully, soon the dust will settle, and we can focus on providing the critically needed HIV treatment and preventive services our country requires. But make no doubt about it, we will be in a much-weakened position, and it will be harder to achieve our goals.”

Many researchers were left stunned by the scale of the cancellations, particularly since in 2019, Donald Trump announced a commitment to eliminate the HIV epidemic within ten years. However, the abrupt policy reversal has shattered confidence in the administration’s approach, leaving public health experts and activists questioning the sincerity of past promises.

The terminated research projects largely focused on increasing access to life-saving HIV prevention treatments, including pre-exposure prophylaxis (PrEP), in communities most at risk—such as transgender individuals and Black men. Harvard Medical School professor Julia Marcus, who had two grants canceled, warned that the loss of funding could lead to a resurgence of HIV in the U.S.

“The loss of this research could very well result in a resurgence of HIV that becomes more generalized in this country,” Marcus said. “These drastic cuts are rapidly destroying the infrastructure of scientific research in this country, and we are going to lose a generation of scientists.”

Additionally, some termination letters cited concerns over “diversity, equity, and inclusion (DEI) studies,” suggesting that research aimed at addressing racial and social health disparities was being specifically targeted for defunding. The justification given was that such studies could “support unlawful discrimination,” a claim widely refuted by health equity experts.

The funding cuts have already had ripple effects, with research teams shutting down, clinic staff facing layoffs, and scientists struggling to secure alternative funding. Dr. Pamina Gorbach, an epidemiologist at UCLA, had been following hundreds of men living with HIV for over a decade to identify their treatment needs. Her NIH grant was abruptly terminated, putting both her research and patient care services at risk.

“It’s really devastating,” said Gorbach. “If you’re living with HIV and you’re not on meds, you know what happens? You get sick and you die.”

As the public health community scrambles to assess the full impact of these decisions, many are calling for immediate congressional oversight and intervention to restore funding and staffing for HIV prevention efforts. Whether these demands will be met remains to be seen, but one thing is certain: the stakes have never been higher for the future of HIV prevention in America.