How U.S. HIV Funding Cuts Quickly Affected Care in East Africa

The U.S. government’s withdrawal of funding for global HIV programs in January 2025 sharply reduced the number of people entering HIV care across East Africa within weeks, according to findings led by UC San Francisco researchers.

The results, considered the first to use patient-level data to measure the immediate, real-world effects of the funding cuts, were drawn from HIV clinics in Kenya, Uganda, and Tanzania during the first five weeks after the funding withdrawal. Compared with the same period in 2024, new patient enrollment fell 59% and viral load testing dropped by 33%.

HIV programs within the East Africa IeDEA consortium managed to continue providing care and treatment during the funding pause, thanks to dedicated providers, many of whom volunteered their services.

Hong-Ha M. Truong, PhD, MPH

UCSF researchers presented the data on July 28, 2026, at the International AIDS Society Conference in Rio de Janeiro, Brazil, one of the world’s leading scientific meetings on HIV research.

For more than two decades, the President’s Emergency Plan for AIDS Relief (PEPFAR), implemented through agencies including the U.S. Agency for International Development (USAID) and the U.S. Centers for Disease Control and Prevention (CDC), has funded HIV testing, treatment, and prevention programs around the world.

In January 2025, the Trump administration paused most U.S. foreign assistance, disrupting many HIV programs and forcing clinics and partner organizations to reduce staff or scale back services.

To assess the disruption’s immediate impact, UCSF researchers partnered with colleagues in Kenya, Uganda, and Tanzania through the National Institutes of Health-funded East Africa regional consortium of the International epidemiology Databases to Evaluate AIDS (EA-IeDEA). The network, which has tracked HIV care across East Africa for nearly two decades, provided patient-level data from nearly 103,000 people at 189 HIV clinics in those three countries for this analysis.

The researchers found the funding cuts did not immediately unravel treatment for existing patients, but they did create a bottleneck for new HIV patients, preventing them from enrolling in care.

Young people and men, who were already less likely to get HIV care, experienced the steepest declines. Women, especially those who are pregnant, typically have more opportunities to access HIV services.

“HIV programs within the East Africa IeDEA consortium managed to continue providing care and treatment during the funding pause, thanks to dedicated providers, many of whom volunteered their services,” said Hong-Ha M. Truong, PhD, MPH, UCSF professor of medicine and the study’s lead author.

The Trump administration eventually exempted some lifesaving HIV care from the pause, but many prevention and support services remain restricted. The UCSF team is now investigating the longer-term effects of the funding disruption.

Authors: Additional UCSF authors include Craig R. Cohen, MD, MPH, and Jayne Lewis-Kulzer, MPH. Other authors are Aggrey Semeere, MBChB, MMed, MAS, FCP (ECSA), Infectious Diseases Institute, Kampala, Uganda; Constantin T. Ylannoutsos, PhD, City University of New York; Kara Wools-Kaloustian, MD, and Beverly Musick, MS, Indiana University, Indianapolis, Ind.; Francesca Odhiambo, MBChB, MMED, Kenya Medical Research Institute, Kisumu, Kenya; Lameck Diero, MBChB, MMed, Moi University, Eldoret, Kenya; Charles Kasozi, MBChB, Masaka Regional Referral Hospital, Masaka, Uganda; Denna Michael Mkwashapi, MSc, PhD, National Institute for Medical Research, Mwanza, Tanzania.

Funding: National Institute of Allergy and Infectious Diseases (U01AI069911).