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‘This represents hope’

WASHINGTON — The U.S. is purchasing enough doses of a new twice-a-year HIV prevention shot to share with up to 2 million people in poor countries by 2028, the State Department announced Thursday.

Gilead Sciences had already announced it would sell that supply of the protective drug lenacapvir at no profit for use in low- and middle-income countries that are hard-hit by HIV. The question was who would buy and distribute it after the Trump administration slashed foreign aid earlier this year — forcing closures of health clinics and disrupting HIV testing and care in many countries.

Under Thursday’s move, the U.S. will purchase the doses under the PEPFAR program and work with governments in hard-hit countries on how to distribute them. The priority will be to protect pregnant or breastfeeding women, said Jeremy Lewin, a State Department senior official.

Lewin said the program will be a collaboration with the Global Fund, another international program that funds HIV treatment and prevention efforts, but wouldn’t disclose how much the U.S. was investing.

“We’re hoping, with the Global Fund, to help 2 million people get on the medication over the next three years but could potentially see more,” he said.

There are more than 30,000 new HIV infections in the U.S. every year and 1.2 million people are living with the virus. Worldwide there are 1.3 million new infections annually and nearly 40 million people living with the virus.

Many experts say lenacapavir is the most powerful option yet for what’s called PrEP — using preventive medicines to guard against sexually transmitted HIV. Unlike daily pills that people may forget, each lenacapavir shot offers protection for six months. In two groundbreaking studies with people at high risk, it nearly eliminated new infections.

The drug already has been approved for use in the U.S. and Europe.

In March, the head of the U.N. AIDS agency urged the Trump administration and Gilead to make the preventive shots available worldwide for millions.

Gilead has signed agreements with generic drugmakers to produce low-cost versions of the shot for poor countries, mostly in Africa, Southeast Asia and the Caribbean. The doses provided at-cost for up to 2 million people in those countries were intended to be a stopgap until the generics are available.

Neergaard writes for the Associated Press.

Gareth Thomas has opened up about some of the horrific abuse he has faced from strangers on the street. 

Back in 2019, the former Welsh rugby captain revealed that he was HIV-positive after a tabloid threatened to out his status.

“Now that you have that information, it makes me extremely vulnerable, but it does not make me weak,” he said in a video uploaded on X/Twitter. “I choose to fight to educate and break the stigma around this subject.”

Since that fateful day, Thomas has fervently used his platform to shatter misconceptions and debunk harmful myths about the condition, earning praise from fans, LGBTQIA+ organisations and other advocacy groups.

But despite his incredible contributions to the rugby world, queer community and HIV/AIDS awareness, the 51-year-old has continued to experience hate from bigoted trolls.

During a recent appearance on Bryony Gordon’s The Life of Bryony podcast, Thomas recalled a harrowing interaction he had with “two young lads” who spat on him on the street.

“I won’t sit here and be big guy and say it doesn’t hurt. So the two young lads who walked past spat at me and called me an AIDS spreader,” he recalled.

However, instead of hurling his own set of insults or getting physical, Thomas killed the two individuals with kindness.

“I just stopped, and I opened up my arms. So they walked past me. One spat at my chest, one spat at my feet. They walked past me, they waited for a reaction, and I just opened up my arms, and it kind of put them off because that was completely different,” he continued.

“And then they started calling me names. I was like, ‘Do you want a hug?’ And they were like, ‘We’re not going to have a hug off you. You got effing AIDS.’ And I’m like, ‘Do you want to hug, boys? Do you want to hug?’”

The talented athlete went on to say that he walked away from the interaction feeling that he had won, adding that they wanted an angry reaction from him.

“They wanted confirmation that I was a bad person. And I refused to give the confirmation that I was a bad person,” he continued. 

Elsewhere in his interview, Thomas opened up about the discrimination his loved ones and friends have faced, simply because they are associated with him.

“[My husband] Steve is HIV negative, but he’s a teacher in college, right? He’s a brilliant teacher. It’s difficult for him at times because he’s afraid of the stigma that might come from the students within the college,” he revealed.

Thomas also revealed that his parents have faced pushback, stating that people once knew them as the parents of ‘Gareth, the Welsh rugby player.” However, now they are known as “the mother and father of the guy who’s got HIV.”

“So, the stigma that comes with the association of being open and wanting to be authentic in a certain way, but thinking that will last. Will that stigma disappear for me the day after I talk about my HIV virus because I got nothing to hide anymore,” he said.

“The reality is the day after is when the shit begins, right? It’s when it starts because you’ve opened yourself up, you’ve made yourself vulnerable.”

In addition to his status, the legendary talent discussed being an ‘agony aunt’ for closeted sports players and gushed about his husband’s longstanding support.

Check out Thomas’ full podcast interview here.

PRINCE Harry is considering starting a new humanitarian charity.

It comes after the Duke of Sussex stepped down as patron of Sentebale, the African charity he co-founded, after a bullying row.

Yesterday, Harry’s spokesman said: “The duke remains committed to continuing his support for the children and young people of Lesotho and Botswana — work he started nearly 20 years ago.

“In what form that support takes, no decisions have been made.

“All options remain on the table, whether that be starting a new charity or working to support pre-existing charities.”

Sentebale works in southern Africa supporting young people, especially those with HIV and Aids.

But Harry stood aside in March amid bullying claims by the board chairwoman.

Sentebale said in a statement: “The Charity Commission is explicitly clear, including in its public guidance, that it is not the commission’s responsibility to adjudicate or mediate internal disputes.

“This would include individual allegations of bullying, harassment, misogyny, misogynoir etc.

“As a result, the commission has not investigated any individual allegations and therefore has not made any findings in relation to individuals, including Prince Harry.

“The issues not investigated by the commission can and may be dealt with through avenues more appropriate than the commission.”

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State lawmakers are considering a bill meant to protect access to HIV prevention drugs for insured Californians as threats from the federal government continue.

Assembly Bill 554 would require health plans and insurers to cover all antiretroviral drugs used for PrEP and PEP regimens. The drugs just have to be approved by the Food and Drug Administration, and would not require prior authorization. The bill would also prevent health plans from forcing patients to first try a less expensive drug before choosing a more expensive, specialty option.

The bill requires insurance providers to cover these drugs without cost-sharing with patients, and it limits the ability of insurers and employers to review treatments to determine medical necessity. To streamline reimbursements and expand the range of PrEP medications doctors can pick for their patients, the legislation allows providers to directly bill insured patients’ pharmaceutical benefit plans.

LGBTQ+ public health advocates worry that the Trump administration’s recent attempt to slash $1.5 billion in HIV prevention funding from the federal budget — along with its decisions to stop offering suicide-prevention counseling for LGBTQ+ individuals through the national 988 lifeline and to restrict gender-affirming care for transgender Americans — amounts to an assault on the queer community.

The state bill would act “as a shield against this administration’s cruelty,” said California Assemblymember Mark González (D-Los Angeles) who co-sponsored AB 554 with Assemblymember Matt Haney (D-San Francisco).

A recent cause for alarm among LGBTQ+ health advocates, first reported in the Wall Street Journal, is news that Health and Human Services Secretary Robert F. Kennedy Jr. plans to replace the entire U.S. Preventive Services Task Force because its 16 appointed members are too “woke,” according to unnamed individuals cited by the Journal.

At a news conference Monday, Kennedy confirmed that he is reviewing the makeup of the panel, adding that he hasn’t made a final decision.

The bill was introduced earlier in the year out of fear that Kennedy’s skepticism about vaccines might spill over into HIV/PrEP drug coverage and because of worries that President Trump would dismantle the task force, González said.

The task force wields immense influence, making recommendations about which cancer screenings, tests for chronic diseases and preventive medications are beneficial for Americans and therefore should be covered by insurers — including drugs for HIV/AIDS prevention.

Drugs prescribed in a PrEP regimen — short for pre-exposure prophylaxis — block the virus that causes AIDS from multiplying in a person’s body. They can be taken in either pill or injection form on an ongoing basis. PEP refers to post-exposure prophylaxis and involves taking medication within 72 hours of potential exposure and for a short period of time, in order to prevent infection and transmission of the virus. Both regimens are recommended by the Centers for Disease Control and Prevention as effective ways to reduce the spread of HIV/AIDS when used correctly.

The U.S. Preventive Services Task Force was created in 1984 by congressional authorization to issue evidence-based advice to physicians on which screenings and preventive medicines are worth considering for their healthy patients. The panel’s recommendations are closely watched by professional societies when adopting guidelines for their clinician members. In many cases, when insurers are on the fence about whether to cover a given screening or diagnostic test, they’ll turn to the panel’s recommendations.

The panel, made up of doctors, nurses, health psychologists, epidemiologists and statisticians who are experts in primary care and preventive medicine and who serve four-year terms on a voluntary basis, is meant to be free from conflicts of interest and outside influences.

Some of its past recommendations, however, such as its advice on prostate cancer screenings, have been met with criticism.

When it comes to HIV prevention, the U.S. Supreme Court appeared to back up the task force with its July 11 ruling in Kennedy vs. Braidwood Management, which upheld a key mandate in the Affordable Care Act requiring insurers to cover preventive care, including for HIV.

However, in the same ruling, the court also declared that the Secretary of Health and Human Services has the power to review decisions made by the task force, and to remove members at his or her discretion.

Kennedy abruptly postponed the task force’s July meeting, sparking concern among public health advocates and Democratic leaders.

“The task force has done very little over the past five years,” Kennedy said at Monday’s news conference. “We want to make sure that it is performing, that it is approving interventions that are actually going to prevent the health decline of the American public.”

González said he worries that the Supreme Court gave the administration a new way to meddle in the healthcare decisions of LGBTQ+ people.

“The Braidwood decision was both a relief and a wake-up call,” González said. “While it upheld the Preventive Services Task Force’s existing recommendations — keeping protections for PrEP, cancer screenings, and vaccines intact — it handed unprecedented authority to RFK Jr. to reshape that very task force and place existing protections under direct threat once again.”

González described AB 554 as “a measure to protect LGBTQ+ Californians and ensure we never return to the neglect and devastation of the HIV/AIDS crisis.” The state Senate Appropriations Committee is expected to vote on whether to advance the bill on Aug. 29.

“These attacks aren’t isolated,” the lawmaker said. “They are coordinated, deliberate, and aimed squarely at our most vulnerable communities.”

Living with HIV has changed significantly over the years, thanks to improved treatment options, greater public education, and the gradual dismantling of discriminatory laws — including outdated restrictions on blood and organ donation, barriers to IVF and sperm donation, and the criminalisation of HIV transmission. HIV research and science is continuing to evolve, so it is always important to keep updated on any new developments from novel treatment options to innovative ways to manage living with HIV.

However, it can be hard to know where to start in terms of research and reliable resources and information. That’s why, in collaboration with ViiV Healthcare, we sat down with Dr Tristan Barber and Tom Hayes-Isaacs. Tristan is a consultant physician focussing in the field of HIV, who has more than twenty year’s experience and is the new chair of the British HIV Association (BHIVA). Tom is an awareness activist who began blogging about their experiences of living with HIV when they were diagnosed in 2011, and who now continues this mission of battling misinformation and raising awareness with the charity Saving Lives UK.

Below, Tristan and Tom engage in an in-depth conversation around key topics for people and communities living with HIV, as well as allies looking to get better informed. From changing HIV treatment options to advice for people or communities living with HIV at different stages of diagnosis, navigating the patient/healthcare practitioner relationship, and battling stigma, here are key points you need to know, spoken through by experts with lived experience. 

How HIV has changed

“Compared to the 80s when life expectancy was short and there was no successful treatment, the changes in the management of HIV have been incredible” – Tristan Barber

Tristan, as a doctor and researcher, what do you think has changed in the management of HIV and people living with HIV since the 80s? 

Tristan: Many people living with HIV can now live their lives normally. Treatment can be as simple as one pill once a day or different formulations and modalities to suit each individual’s need. They can have children, and work in almost every career. They cannot transmit the virus sexually if on treatment with an undetectable viral load on a blood test. Compared to the 80s when life expectancy was short and there was no successful treatment, the changes have been incredible.

We have gone from having regimens where tablets need to be taken multiple times per day to now having regimens which allow for medication to be taken much less frequently. What new treatment options have become available during your career?

Tristan: I have worked in the HIV field for over 20 years. When I started, we had limited treatment options, many with lots of side effects and toxicities. I have worked on and seen the development of new drug classes, particularly the integrase inhibitors which are now in first line treatment options around the world in all major guidelines. I have also seen the development of PrEP, an antiretroviral that can be taken daily or as needed to prevent someone acquiring HIV through condomless sex. 

Tom, you were diagnosed 14 years ago, in 2011. How has treatment changed recently since your diagnosis?

Tom: HIV treatment has changed dramatically over the past forty years, but even in the fourteen years I’ve been diagnosed the pace of change hasn’t slowed down.

Back in 2011, I was taking one pill once a day – something that was very important to me to aid with my adherence (taking treatment at the same time each day). Unfortunately, that older medication had some pretty unpleasant side-effects. I’ve changed a couple of times since then, and now I’m very happy and not experiencing side effects on a newer combination pill.

The patient/doctor relationship

“Your quality of life is more important than starting an awkward conversation” – Tom Hayes-Isaacs

From your medical perspective, Tristan, how has the relationship with your patients changed over time? 

Tristan: The community has always been at the forefront of advocating for HIV treatment and care. Some key slogans support this particularly ‘nothing about us without us’. To be honest I don’t even use the term ‘patient’ anymore. These are people, people with HIV, and they are experts by experience. I think in many ways HIV has led on person-centred care, placing people and their loved ones in the centre. In many ways this hasn’t changed, as it was true in the early days also, where HIV services stood up for people experiencing stigma, and provided care in a unique way. Now that HIV is more manageable we continue to strive for this despite funding restrictions that may make it difficult for us to always provide everything we would like to.

And what does a good patient/HCP relationship look like in your opinion? 

Tristan: It should be open, honest, trustworthy, and never complacent! As HIV is a lifelong condition it needs to be a partnership, with both people working together to achieve the best outcome for the person with HIV.

Tom, with the above in mind, how is your relationship with your current doctor and what do you think makes a good patient/doctor relationship?

Tom: I’m very lucky to have a doctor that is both one of the best in her field, as well as a truly wonderful human being. Although I may only see her a couple of times a year, we chat for ages about what’s been going on in both our lives. The actual time spent on HIV is probably in the minority compared to the amount of gossiping! Regrettably, not everyone has the same relationship with their HIV care team. One of the first doctors I had was a very grumpy gentleman who treated the patients like numbers – not people. 

A good patient-doctor relationship must be grounded in honesty and mutual respect. As our doctor you’re asking us to share very personal information about ourselves, our sex lives and more – people aren’t going to do that if they don’t feel safe and respected. As patients we need to recognise that our doctors need us to be onboard and engaged so that we can pick the right treatments and care for the best outcomes.

To both of you, how can people with HIV advocate for their needs? 

Tristan: I think the best way is to be prepared! Keep notes between appointments – what isn’t working for you, what problems have you had, what do you need from the appointment at your clinics? If something isn’t working, say so. Feedback always shows that people like seeing the same doctor, who knows their story, but sometimes I think seeing someone new, even if only for one visit, may give a different perspective, result in different questions or referrals, and can be a way to get a different opinion, even if you then revert back to your long standing and trusted clinician. We all work as a team and want the best thing for those we care for.

Tom: Sometimes we all need to be our own advocate and that can often seem daunting, but no-one knows your needs like you do. Understanding more about your condition, your care and your treatment goes a long way towards making you feel empowered to advocate for yourself. You don’t need to be an expert, but knowing the basics will help you and your doctor have a more constructive conversation and hopefully build a treatment plan that fits all your needs.

If you don’t feel you’re getting the level of care and support that you need from your HIV care team it’s important to know that you have options. You can ask to see another doctor or nurse. You can move your care to another HIV clinic. Don’t be afraid to speak out. Your quality of life is more important than starting an awkward conversation. 

Rep. Robert Garcia (D-Long Beach) is calling on Health and Human Services Secretary Robert F. Kennedy Jr. to explain why the Trump administration has repeatedly ordered cuts to HIV/AIDS programs both at home and abroad.

In a letter to Kennedy dated Thursday, Garcia asserted that the cabinet secretary has a history of peddling misinformation about the virus and disease, and that the planned cuts — which he called “alarming and unprecedented” — would cost lives.

“We are concerned that your motivations for disrupting HIV funding and delaying preventative services and research are grounded not in sound science, but in misinformation and disinformation you have spread previously about HIV and AIDS, including your repeated claim that HIV does not cause AIDS,” wrote Garcia, the ranking Democrat on the House Oversight Committee.

A Health and Human Services spokesperson said Kennedy remains committed to science-based public health, that critical HIV/AIDS programs will continue under his leadership, and that ongoing investments in such work demonstrate that commitment.

Both President Trump and Kennedy have previously defended the sweeping cuts to Health and Human Services programs and staff under Kennedy’s leadership. Agency spokespeople have said they would allow for a greater focus on Kennedy’s priorities of “ending America’s epidemic of chronic illness by focusing on safe, wholesome food, clean water, and the elimination of environmental toxins.”

Kennedy has said the department under his watch “will do more — a lot more — at a lower cost to the taxpayer.”

Garcia’s letter — which he co-wrote with Rep. Raja Krishnamoorthi (D-Ill.), the ranking Democrat on the Health Care and Financial Services subcommittee — requested that the health department produce a list of all HIV/AIDS-related funding it has cut and an explanation for how those funds were identified for elimination, as well as other documentation and communications around several of the largest cuts.

The letter is the latest attempt by Democrats, in coordination with health experts and LGBTQ+ organizations, to challenge what they see as an inexplicable yet coordinated effort by the Trump administration to dismantle public health initiatives aimed at controlling and ultimately ending one of the most devastating and deadly epidemics in human history.

It comes the same day that Senate Republicans agreed to a Trump administration request to claw back billions of dollars in funding for public media and foreign aid, but declined an earlier White House request to include in those cuts about $400 million in HIV/AIDS funding for the President’s Emergency Plan for AIDS Relief, or PEPFAR, which is credited with saving millions of lives in some of the poorest nations around the world.

The House had previously voted for an earlier version of the measure that did cut the funding for PEPFAR, which was started by President George W. Bush in 2003. However, senators pushed for the restoration of the funding before agreeing to sign the broader rescission package.

The House must now approve the Senate version of the measure by Friday for it to take effect.

In an interview with The Times, Garcia said he has long viewed Kennedy as a dangerous “conspiracy theorist” who has “peddled in all sorts of lies” about HIV, vaccines and other medical science. Now that Kennedy is Health secretary, he said, the American people deserve to know whether national and international health decisions are being driven by his baseless personal beliefs.

“Folks need to understand what he’s trying to do, and I think that he has to be responsible and be held accountable for his actions,” Garcia said.

In their letter, Garcia and Krishnamoorthi noted that recent scientific advancements — including the creation of new preventative drugs — are making the eradication of HIV more attainable than ever. And yet Kennedy and the Trump administration are pushing the nation and the world in the opposite direction, they said.

“Since taking office, the Trump Administration has systematically attacked HIV-related funding and blocked critical HIV-related services and care for those who need it most,” Garcia and Krishnamoorthi wrote. “These disruptions would threaten Americans most at risk of contracting HIV, and many people living with HIV will get sicker or infect others without programs they rely on for treatment.”

The letter outlines a number of examples of such cuts, including:

• The elimination of the HIV prevention division of the Centers for Disease Control and Prevention and termination or delay of billions of dollars in HIV prevention grants from that office.
• The termination of a $258-million program within the National Institutes of Health to find a vaccine to prevent new HIV infections.
• The termination of dozens of NIH grants for HIV research, particularly around preventing new infections among Black and Latino gay men who are disproportionately at risk of contracting the virus.
• The targeting of HIV prevention initiatives abroad, including PEPFAR.
• The U.S. drawing back from the Global Fund to Fight AIDS, Tuberculosis and Malaria.

Many in the medical and foreign aid community expressed grave concerns about Kennedy being appointed as Health secretary, in part because of his past remarks about HIV/AIDS. Kennedy told a reporter for New York Magazine as recently as June 2023 that there “are much better candidates than H.I.V. for what causes AIDS.”

In their letter, Garcia and Krishnamoorthi called out a specific theory shared by Kennedy that the recreational drug known as “poppers” may cause AIDS, rather than the HIV virus, writing, “We are deeply concerned that the Trump Administration’s HIV-related funding cuts are indiscriminate, rooted in a political agenda, and not at all in the interest of public health.”

Kennedy’s skepticism about the link between HIV and AIDS conflicts with well established science that has long been accepted by the medical establishment, and by the federal government. Studies around the world have proved the link, and found that HIV is the only common factor in AIDS cases.

In August 2023, about a week before Kennedy threw his support behind Trump, his presidential campaign addressed the controversy surrounding his “poppers” comment, stating that Kennedy did not believe poppers were “the sole cause” of AIDS, but contended they were “a significant factor in the disease progression” of early patients in the 1980s.

Garcia and Krishnamoorthi also noted a successful effort by local officials and advocates in Los Angeles County to get about $20 million in HIV/AIDS funding restored last month, after it and similar funding nationwide was frozen by the Trump administration.

The restoration of those funds followed another letter sent to Kennedy by Rep. Laura Friedman (D-Glendale) and other House members, who cited estimates from the Foundation for AIDS Research, known as amfAR, that the nationwide cuts could lead to 127,000 additional deaths from AIDS-related causes within five years.

Garcia and Krishnamoorthi cited the same statistics in their letter.

In his interview with The Times, Garcia, who is gay, also said the LGBTQ+ community “is rightly outraged” at Kennedy’s actions to date and deserves to know if Kennedy “is using his own conspiracy theories and his own warped view of what the facts are” to dismantle public health infrastructure around HIV and AIDS that they fought for decades to build.

The United Nations AIDS agency is warning that severe international funding cuts could lead to an additional 4 million deaths related to the disease by 2029.

The United States was the single biggest donor to the global response to HIV/AIDS before the administration of President Donald Trump abruptly halted foreign development assistance in January.

UNAIDS says the withdrawal of assistance will have catastrophic consequences for the fight against the pandemic.

So, what can countries do to reduce the impact of the funding cuts?

And why did wealthy nations end support for AIDS prevention and treatment programmes?

Presenter: Adrian Finighan

Guests:

Dr Helen Rees – director of the Reproductive Health and HIV Institute at the University of the Witwatersrand

Dr Krishna Udayakumar – founding director of the Duke Global Health Innovation Center

Nidhi Bouri – former deputy assistant administrator for Global Health at USAID

The Trump administration has lifted a freeze on federal funds for HIV prevention and surveillance programs, officials said, following an outcry from HIV prevention organizations, health experts and Democrats in Congress.

The Los Angeles County Department of Public Health received notice from the U.S. Centers for Disease Control and Prevention on Thursday that it had been awarded nearly $20 million for HIV prevention for the 12-month period that began June 1 — an increase of $338,019 from the previous year.

“Let’s be clear — the Trump administration’s move to freeze HIV prevention funding was reckless, illegal and put lives at risk,” said Rep. Laura Friedman (D-Glendale) in a statement. “I’m relieved the CDC finally did the right thing — but this never should have happened.”

The CDC didn’t immediately respond to a request for comment.

Friedman and other advocates for HIV prevention funding sent a letter to Health and Human Services Secretary Robert F. Kennedy Jr. last month, warning that proposed cuts to these programs would reverse years of progress combating the disease and cause spikes in new cases — especially in California and among the LGBTQ+ community.

The letter cited estimates from the Foundation for AIDS Research, known as amfAR, suggesting the cuts could lead to 143,000 additional HIV infections nationwide and 127,000 additional deaths from AIDS-related causes within five years.

Los Angeles County, which stood to lose nearly $20 million in annual federal HIV prevention funding, was looking at terminating contracts with 39 providers. Experts said the dissolution of that network could result in as many as 650 new cases per year — pushing the total number of new infections per year in the county to roughly 2,000.

“Public Health is grateful for the support and advocacy from the Board of Supervisors, the Los Angeles County Congressional delegation, and all of our community based providers in pushing CDC to restore this Congressionally approved funding,” a spokeswoman for the county’s health department said.

“Looking forward, it is important to note that the President’s FY26 budget proposes to eliminate this funding entirely, and we urge our federal partners to support this critical lifesaving funding,” she said.

June 18 (UPI) — The Food and Drug Administration has approved a new drug that could prevent HIV infections with just two shots every year and possibly eradicate the disease.

The drug’s scientific name is lenacapavir and it will be marketed as Yeztugo, which requires one injection every six months to maintain its effectiveness in preventing HIV infections.

Other drugs exist that also prevent HIV, but they require daily dosages in pill form and have not significantly affected the disease on a global level.

“We’re on the precipice of now being able to deliver the greatest prevention option we’ve had in 44 years of this epidemic,” AVAC executive director Mitchell Warren told the New York Times. AVAC is an anti-HIV organization.

He said recent funding cuts by the Trump administration will make it hard to distribute the drug globally.

“It’s as if that opportunity is being snatched from out of our hands by the policies of the last five months,” Warren said.

Gilead Sciences is producing the drug, which is the second long-lasting HIV prevention drug available.

The other option is cabotegravir, which is sold under the brand name Apretude and requires an injection every two months.

About 21,000 Americans use Apretude, while about 500,000 use daily oral medications to prevent HIV.

Clinical trials showed most participants who received two shots of lenacapavir every year had nearly full protection against HIV.

More than 39,000 people in the United States contracted HIV in 2023, which carries an estimated lifetime treatment cost of $1.1 million per patient, Gilead Chairman and Chief Executive Officer Daniel O’Day told the New York Times.

Lenacapavir already is being prescribed to treat people with HIV infections that resist other medications and at an annual cost of $42,000 per patient, but most patients don’t pay the full cost.

Health insurance coverage and patient-assistance programs would cover the cost for most people using lenacapavir, according to Gilead.

The cost for oral pills taken daily is just $1 per pill, while Apretude carries an annual cost of about $24,000.

Proposed funding reductions for Medicaid and the President’s Emergency Program for AIDs Relief, commonly called PEPFAR, might greatly reduce access to the drug, according to advocacy groups.

The PrEP oral treatment still would be available, but it does not work for many people, Health Gap Executive Director Asia Russell told the New York Times.

PORT-AU-PRINCE, Haiti — A video showing dozens of people marching toward the office of Haiti’s prime minister elicited gasps from some viewers as it circulated recently on social media. The protesters, who are HIV-positive, did not conceal their faces — a rare occurrence in a country where the virus is still heavily stigmatized.

“Call the minister of health! We are dying!” the group chanted.

The protesters risked being shunned by society to warn that Haiti is running out of HIV medication just months after the Trump administration slashed more than 90% of the United States Agency for International Development’s foreign aid contracts and $60 billion in overall aid across the globe.

At a hospital near the northern city of Cap-Haitien, Dr. Eugene Maklin said he struggles to share that reality with his more than 550 HIV patients.

“It’s hard to explain to them, to tell them that they’re not going to find medication,” he said. “It’s like a suicide.”

‘We can’t stay silent’

More than 150,000 people in Haiti have HIV or AIDS, according to official estimates, although nonprofits believe the number is much higher.

David Jeune, a 46-year-old hospital community worker, is among them. He became infected 19 years ago after having unprotected sex.

“I was scared to let people know because they would point their finger at you, saying you are infecting others with AIDS,” he said.

His fear was so great that he didn’t tell anyone, not even his mother. But that fear dissipated with the support Jeune said he received from nonprofit groups. His confidence grew to the point where he participated in last week’s protest.

“I hope Trump will change his mind,” he said, noting that his medication will run out in November. “Let the poor people get the medication they need.”

Patrick Jean Noel, a representative of Haiti’s Federation of Assns. of HIV, said that at least five clinics, including one that served 2,500 patients, were forced to close after the USAID funding cuts.

“We can’t stay silent,” he said. “More people need to come out.”

But most people with HIV in Haiti are reluctant to do so, said Dr. Sabine Lustin, executive director of the Haiti-based nonprofit Promoters of Zero AIDS Goal.

The stigma is so strong that many patients are reluctant to pick up their medication in person. Instead, it is sent in packages wrapped as gifts so as to not arouse suspicion, she said.

Lustin’s organization, which helps some 2,000 people across Haiti, receives funding from the U.S. Centers for Disease Control and Prevention. Though its funding hasn’t been cut, she said that shortly after President Trump took office in January, the agency banned HIV prevention activities because they targeted a group that is not a priority — which she understood to be referring to gay men.

That means the organization can no longer distribute up to 200,000 free condoms a year or educate people about the disease.

“You risk an increase in infections,” she said. “You have a young population who is sexually active who can’t receive the prevention message and don’t have access to condoms.”

‘That can’t be silenced’

On the sunny morning of May 19, a chorus of voices drowned out the din of traffic in Haiti’s capital, Port-au-Prince, growing louder as protesters with HIV marched defiantly toward the prime minister’s office.

“We are here to tell the government that we exist, and we are people like any other person,” one woman told reporters.

Another marching alongside her said, “Without medication, we are dying. This needs to change.”

Three days after the protest, the leader of Haiti’s transitional presidential council, Louis Gérald Gilles, announced that he had met with activists and would try to secure funding.

Meanwhile, nonprofit organizations across Haiti are fretting.

“I don’t know what we’re going to do,” said Marie Denis-Luque, founder and executive director of CHOAIDS, a nonprofit that cares for Haitian orphans with HIV/AIDS. “We only have medication until July.”

Her voice broke as she described her frantic search for donations for the orphans, who are cared for by HIV-positive women in Cap-Haitien after gang violence forced them to leave Port-au-Prince.

Denis-Luque said she has long advocated for the orphans’ visibility.

“We can’t keep hiding these children. They are part of society,” she said, adding that she smiled when she saw the video of last week’s protest. “I was like, whoa, things have changed tremendously. The stigma is real, but I think what I saw … was very encouraging to me. They can’t be silenced.”

A dangerous combination

Experts say Haiti could see a rise in HIV infections because medications are dwindling at a time that gang violence and poverty are surging.

Dr. Alain Casseus, infectious-disease division chief at Zanmi Lasante, the largest nongovernmental healthcare provider in Haiti, said he expected to see a surge in patients given the funding cuts, but that hasn’t happened because traveling by land in Haiti is dangerous since violent gangs control main roads and randomly open fire on vehicles.

He warned that abruptly stopping medication is dangerous, especially because many Haitians do not have access or cannot afford nutritious food to strengthen their immune system.

“It wouldn’t take long, especially given the situation in Haiti, to enter a very bad phase,” he said of HIV infections. And even if some funding becomes available, a lapse in medication could cause resistance to it, he said.

Casseus said gang violence also could accelerate the rates of infection by rapes or other physical violence as medication runs out.

At the New Hope Hospital run by Maklin in Haiti’s northern region, shelves are running empty. He used to receive more than $165,000 a year to help HIV/AIDS patients. But that funding has dried up.

“Those people are going to die,” he said. “We don’t know how or where we’re going to get more medication.”

The medication controls the infection and allows many to have an average life expectancy. Without it, the virus attacks a person’s immune system and they develop AIDS, the late stage of an HIV infection.

Reaction is swift when Maklin tells his patients that in two months, the hospital won’t have any HIV medication left.

“They say, ‘No, no, no, no!’” he said. “They want to keep living.”

Coto and Sanon write for the Associated Press and reported from San Juan, Puerto Rico, and Port-au-Prince, respectively.

A growing coalition of HIV prevention organizations, health experts and Democrats in Congress are sounding the alarm over sweeping Trump administration cuts to HIV/AIDS prevention and surveillance programs nationally, warning they will reverse years of progress combating the disease and cause spikes in new cases — especially in California and among the LGBTQ+ community.

In a letter addressed Friday to Health and Human Services Secretary Robert F. Kennedy Jr., Rep. Laura Friedman (D-Glendale) and 22 of her House colleagues demanded the release of HIV funding allocated by Congress but withheld by the Trump administration. They cited estimates from the Foundation for AIDS Research, known as amfAR, that the cuts could lead to 143,000 additional HIV infections nationwide and 127,000 additional deaths from AIDS-related causes within five years.

Friedman said the effects would be felt in communities small and large across the country but that California would be hit the hardest. She said L.A. County — which stands to lose nearly $20 million in annual federal HIV prevention funding — is being forced to terminate contracts with 39 providers and could see as many as 650 new cases per year as a result.

According to amfAR, that would mark a huge increase, pushing the total number of new infections per year in the county to roughly 2,000.

“South L.A. and communities across California are already feeling the devastating impacts of these withheld HIV prevention funds. These cuts aren’t just numbers — they’re shuttered clinics, canceled programs, and lives lost,” Friedman said in a statement to The Times.

As one example, she said, the Los Angeles LGBT Center — which is headquartered in her district — would likely have to eliminate a range of services including HIV testing, STD screening, community education and assistance for patients using pre-exposure prophylaxis, or PrEP, a medicine taken by pill or shot that can greatly reduce a person’s risk of becoming infected from sex or injection drug use.

A list reviewed by The Times of L.A. County providers facing funding cuts included large and small organizations and medical institutions in a diverse set of communities, from major hospitals and nonprofits to small clinics. The list was provided by a source on the condition of anonymity in order to be candid about the funding of organizations that have not all publicly announced the cuts.

The affected organizations serve a host of communities that already struggle with relatively high rates of HIV infection, including low-income, Spanish speaking, Black and brown and LGBTQ+ communities.

According to L.A. County, the Trump administration’s budget blueprint eliminates or reduces a number of congressionally authorized public health programs, including funding cuts to the domestic HIV prevention program and the Ryan White program, which supports critical care and treatment services for uninsured and underinsured people living with HIV.

The county said the cuts would have “an immediate and long-lasting impact” on community health.

Dozens of organizations and hospitals, such as Children’s Hospital of Los Angeles, are bracing for the disruption and potential vacuum of preventative services they’ve been providing to the community since the 1980s, according to Claudia Borzutzky, the hospital’s Chief of Adolescent and Young Adult Medicine.

Borzutzky said without the funding, programs that provide screening, education, patient navigation and community outreach — especially for at-risk adolescents and young adults — will evaporate. So, too, will free services that help patients enroll in insurance and access HIV prevention medications.

Patients who “face a variety of health barriers” and are often stigmatized will bear the brunt, she said, losing the “role models [and] peer educators that they can relate to and help [them] build confidence to come into a doctor’s office and seek testing and treatment.”

“We are having to sunset these programs really, really quickly, which impacts our patients and staff in really dramatic ways,” she said.

Answers to queries sent to other southern California health departments suggested they are trying to figure out how to cope with budget shortfalls, too. Health officials from Kern, San Bernardino and Riverside counties all said the situation is uncertain, and that they don’t yet know how they will respond.

Friedman and her colleagues — including fellow California representatives Nancy Pelosi, Judy Chu, Gilbert Cisneros Jr., Robert Garcia, Sam Liccardo, Kevin Mullin, Mark Takano, Derek Tran and George Whitesides — said they were concerned not only about funding for programs nationwide being cut, but also about the wholesale dismantling or defunding of important divisions working on HIV prevention within the federal government.

They questioned in their letter staffing cuts to the National Center for HIV, Viral Hepatitis, STD, and Tuberculosis Prevention at the U.S. Centers for Disease Control and Prevention, as well as “the reported elimination” of the Division of HIV Prevention within that center.

In addition to demanding the release of funds already allocated by Congress, the representatives called on Kennedy — and Dr. Debra Houry, deputy director of the CDC — to better communicate the status of ongoing grant funding, and to release “a list of personnel within CDC who can provide timely responses” when those groups to whom Congress had already allocated funding have questions moving forward.

“Although Congress has appropriated funding for HIV prevention in Fiscal Year 2025, several grant recipients have failed to receive adequate communication from CDC regarding the status of their awards,” Friedman and her colleagues wrote. “This ambiguity has caused health departments across the country to pre-emptively terminate HIV and STD prevention contracts with local organizations due to an anticipated lack of funding.”

The letter is just the latest challenge to the Trump administration’s sweeping cuts to federal agencies and to federal funding allocated by Congress to organizations around the country.

Through a series of executive orders and with the help of his billionaire adviser Elon Musk’s “Department of Government Efficiency” and other agency heads, Trump in the first months of his second term has radically altered the federal government’s footprint, laying off thousands of federal workers and attempting to claw back trillions of dollars in federal spending — to be reallocated to projects more aligned with his political agenda, or used to pay for tax cuts that Democrats and independent reviewers have said will disproportionately help wealthy Americans.

California Atty. Gen. Rob Bonta’s office has repeatedly sued the Trump administration over such moves, including cuts and layoffs within Health and Human Services broadly and cuts to grants intended to make states more resistant to infectious disease specifically — calling them unwise, legally unjustifiable and a threat to the health of average Americans.

LGBTQ+ organizations also have sued the Trump administration over orders to preclude health and other organizations from spending federal funding on diversity, equity and inclusion programs geared toward LGBTQ+ populations, including programs designed to decrease new HIV infections and increase healthy management of the disease among transgender people and other vulnerable groups.

“The orders seek to erase transgender people from public life; dismantle diversity, equity, inclusion, and accessibility initiatives; and strip funding from nonprofits providing life-saving health care, housing, and support services,” said Jose Abrigo, the HIV Project Director of Lambda Legal, in a statement. The legal group has filed a number of lawsuits challenging the Trump administration cuts, including one on behalf of the San Francisco AIDS Foundation and other nonprofits.

Trump has defended his cuts to the federal government as necessary to implement his agenda. He and his agency leaders have consistently said that the cuts target waste, fraud and abuse in the government, and that average Americans will be better served following the reshuffling.

Kennedy has consistently defended the changes within Health and Human Services, as well. Agency spokespeople have said the substantial cuts would help it focus on Kennedy’s priorities of “ending America’s epidemic of chronic illness by focusing on safe, wholesome food, clean water, and the elimination of environmental toxins.”

“We aren’t just reducing bureaucratic sprawl. We are realigning the organization with its core mission and our new priorities in reversing the chronic disease epidemic,” Kennedy has said. “This Department will do more — a lot more — at a lower cost to the taxpayer.”

Kennedy has repeatedly spread misinformation about HIV and AIDS in the past, including by giving credence to the false claim that HIV does not cause AIDS.

As recently as June 2023, Kennedy told a reporter for New York Magazine that there “are much better candidates than H.I.V. for what causes AIDS,” and he has previously suggested that environmental toxins and “poppers” — an inhalant drug popular in the gay community — could be causes of AIDS instead.

None of that is supported by science or medicine. Studies from around the world have proven the link between HIV and AIDS, and found it — not drug use or sexual behavior — to be the only common factor in AIDS cases.

Officials in L.A. County said they remained hopeful that the Trump administration would reverse course after considering the effects of the cuts — and the “detrimental impacts on the health and well-being of residents and workers across” the county if they are allowed to stand.