In the past year, Americans encountered more barriers to HIV care—including testing, prevention and treatment—according to findings of an annual survey by the Human Rights Campaign (HRC) Foundation. What’s more, the difficulties in accessing HIV care are largely due to the Trump administration, which has slashed health care funding and derailed the stability of Medicaid, Medicare and other providers and insurers.

 

In a top-line finding, one in five (20.9%) surveyed U.S. adults said the federal government’s policies have made accessing HIV prevention and treatment care more difficult in the last year. The percentage was higher among LGBTQ adults—30% reported a harder time accessing HIV care because of federal policies. (The HRC Foundation aims to improve LGBTQ equality through policy, research and education; however, the HIV survey includes non-LGBTQ Americans.)

 

Released on World AIDS Day, which is marked each December 1, HRC’s annual HIV Care Access in the U.S. Community Survey report includes updated statistics on barriers to HIV care and resources, including household income, federal policies and health insurance coverage.

 

Despite advances in biomedical prevention, such as pre-exposure prophylaxis (PrEP), and a 12% decline in new HIV cases from 2018 to 2022, about 31,800 people acquired HIV in 2022, according to the Centers for Disease Control and Prevention. About 1.2 million people in the United States are living with HIV. While most populations saw a decrease in new diagnoses, Black and Latino men who have sex with men remain disproportionately affected by the epidemic.

 

According to the report, half (51.3%) of LGBTQ adults on Medicare or Medicaid said it has been more difficult to access HIV prevention and care treatment in the last 12 months. What’s more, LGBTQ respondents who rely on publicly supported plans like Medicare and Medicaid have twice the odds of reporting difficulty accessing HIV prevention and treatment services due to recent federal policies.

 

“For many LGBTQ+ adults, Medicare or Medicaid is not just a form of coverage but a lifeline,” authors of the report wrote. “Shifts in federal policy place that lifeline under significant strain.”

 

Indeed, federal funding cuts under the Trump administration have driven HIV prevention and treatment resources to historic lows. In addition, the administration has eliminated tens of thousands of federal jobs and restructured operations in critical agencies at the Department of Health and Human Services, including the Centers for Disease Control and Prevention and the Centers for Medicaid and Medicare. As Stateline reports, Medicaid provides health coverage for 72 million people—a fifth of the population. Nonetheless, the Trump White House and Republican lawmakers plan to cut $1 trillion from the vital program in the next decade.

 

Earlier this year, the administration terminated billions of dollars in grants to the National Institutes of Health. Since then, over 74,000 people enrolled in medical studies and clinical trials have been impacted. What’s more, the cuts disproportionately hampered research into infectious diseases, including HIV, pneumonia and COVID-19.

 

Looking to the near future, the Trump administration’s proposed budget for fiscal year 2026 slashes HIV funds, including HIV prevention and much of the Ryan White HIV/AIDS Program. (For more about this lifesaving program, see “If Congress Ends Ryan White HIV Services, How Many Americans Will Contract HIV?” The answer: researchers predict a 49% spike in cases—or 75,000 excess HIV diagnoses—by 2030.)

 

The financial situations for health care facilities and individuals alike may become even more precarious—and that affects access to care. As the HRC survey points out, LGBTQ individuals in households with annual incomes below $75,000 reported both a higher likelihood and a higher intensity of barriers when navigating HIV prevention and treatment under current policies compared with adults earning $75,000 or more annually.

 

“This challenge transcends income alone, extending even to those who rely on public assistance programs, including publicly supported health insurance plans,” the report reads.

 

In response to government rollbacks, HRC is organizing harm reduction events nationwide and leading storytelling trainings that amplify the voices of people living with HIV.

 

This World AIDS Day theme is the thought-provoking “Collective Action: Sustain and Accelerate HIV Progress,” a call to action with the directions in the title itself.

 

To learn more, click #World AIDS Day or #Access to Care. There, you’ll see headlines such as “World AIDS Day 2025: A Look Back—A Look Forward,” “World AIDS Day Through The Years” and “UNAIDS Releases 2025 World AIDS Day Report: Overcoming Disruption, Transforming the AIDS Response.”