Trump FY27 Budget Request: Domestic HIV Funding Overview

President Trump released a Fiscal Year 2027 discretionary budget request on April 3, 2026, that proposes reducing funding for domestic HIV programs by more than $1.5 billion. The proposal targets HIV prevention, housing and substance use programs, while maintaining support for existing HIV care, treatment, and certain PrEP initiatives.

According to analysis from KFF and reports from public health advocacy groups, the budget request reflects a significant shift in federal priorities for the second year in a row. The proposal seeks to eliminate or transform several core HIV programs, echoing similar requests made for Fiscal Year 2026.

Proposed Reductions in HIV Prevention

The most substantial cuts are directed toward HIV prevention infrastructure. Current federal funding for HIV prevention exceeds $1 billion, but the FY 2027 proposal would reduce this amount to $220 million.

A significant portion of these reductions targets the Centers for Disease Control and Prevention’s National Center for HIV, Viral Hepatitis, STD, and Tuberculosis Prevention. The budget proposes cuts of more than $1 billion for this center, including the total elimination of core HIV prevention funding.

AIDS United stated on April 3, 2026, that these cuts would devastate our nation’s HIV prevention infrastructure and leave states without the necessary resources to reduce new transmissions or connect undiagnosed individuals to medical care.

Maintained Services and Structural Changes

Despite the proposed cuts to prevention, the administration’s budget maintains funding for several critical areas of care. This includes existing domestic HIV treatment and care programs, as well as PrEP programs operating within community health centers.

Carl Schmid, executive director of the HIV+Hepatitis Policy Institute, noted that over 600,000 low-income people accessing care through the Ryan White HIV/AIDS Program would be able to maintain their services under the proposal.

However, the budget proposes a major structural reorganization. All domestic HIV treatment and prevention programs would be consolidated into the Administration for a Healthy America (AHA), though they would operate at dramatically reduced funding levels.

Administrative Actions and Personnel Shifts

The budget request follows a series of executive actions taken by the Trump administration to limit the use of already appropriated funds. These actions have included delaying or cancelling grants related to HIV, some of which have resulted in litigation and the subsequent reinstatement of grants.

The administration has also utilized the recission process to ask Congress to rescind appropriated funds, although these requests have not yet impacted domestic HIV accounts. The administration has laid off thousands of federal employees at the Department of Health and Human Services who supported public health infrastructure.

The FY27 President’s Budget doubles down on these massive and devastating cuts, repeating many of the same disastrous proposals that were just rejected by Congress in their FY26 spending bills and undermining our nation’s—and the first Trump Administration’s—efforts to end the HIV epidemic.

AIDS United

Legislative Context and Future Outlook

The final funding levels for these programs will be determined by Congress, which holds the power to appropriate discretionary funds. This dynamic was evident during the FY 2026 budget process, where Congress rejected the administration’s calls for reduced HIV funding and instead appropriated funds at levels similar to previous years.

Public health advocates emphasize the gap between the administration’s budget request and the statements of its leadership. Carl Schmid highlighted that NIH Director and CDC leader Jay Bhattacharya has repeatedly emphasized the success of HIV prevention, including long-acting PrEP, and the necessity of ending HIV in the United States.

Advocacy groups continue to urge Congress to reject the proposed cuts, arguing that the dismantling of surveillance, testing, and outreach programs will lead to an increase in new HIV infections and higher long-term health costs.