Organizations working to combat HIV in Louisiana are bracing for potential funding cuts and warning of a possible resurgence of the virus, after the Trump administration eliminated staff at the Centers for Disease Control and Prevention’s office for HIV prevention.
“There's going to be a lot of people who don't know they have HIV, who have a high risk of transmitting it. They're going to get sicker,” said Dr. Jennifer Avegno, the director of the New Orleans Health Department.
Louisiana is among the states with the highest rate of new HIV cases, but a network of outreach, testing, and treatment organizations have partnered with the Louisiana Department of Health to bring down the rate of new diagnoses in recent years.
A memo from LDH lays out in stark detail how nearly $12 million in CDC grant funding could now be at risk. This money is used to fund testing, track new HIV cases, connect people who test positive with health care providers and reduce stigma.
The grants help pay the salaries of 49 LDH staff members and 239 employees at contracted partner organizations, according to the memo, which was sent to partner organizations earlier this month following sweeping cuts to HIV prevention programs at the CDC.
The largest grant—totaling $6 million—funds testing, connecting people to care, education and community engagement work. Without CDC funding, more than 100,000 Louisiana residents at the highest risk for HIV would lose access to essential testing, the memo states.
“Over 200 people living with undiagnosed HIV would not become aware of their infection, which would lead to unintentional transmission of the virus to others, including unborn and new born babies” if that grant was cut, the memo added.
“More residents would become infected with HIV… many unborn babies would acquire HIV from their mothers” if another $1 million grant used to collect data on HIV testing was cut, according to the memo.
Louisiana organizations that rely on the CDC funding — through direct grants and money distributed by LDH to support HIV patients and prevention efforts — said they are facing unprecedented uncertainty.
“We’re waiting for the shoe to drop,” said Dr. Isolde Butler, the chief medical officer at CrescentCare.
“These are frightening times,” said Donnisha Patterson Hayes, the executive director of Brotherhood Inc.
The loss of HIV prevention and care funding wouldn’t just impact her organization’s budget, “it costs lives,” she said.
The federal cuts, including the elimination of dozens of HIV studies, have sparked outrage among public health officials and organizations working to help people living with HIV and end the epidemic.
Louisiana groups have good reason to fear for their funding, said Carl Baloney Jr., CEO-elect of the advocacy group AIDS United.
“I think that the folks making these cuts think that everything's on the table, nothing is off limits, including programs that save lives,” he said.
HIV staff gutted at the federal level
The unexpected cuts at the CDC last month eliminated five of 10 branches within the Division of HIV Prevention, according to an email obtained by WWNO/WRKF and sent to LDH on April 3.
In the email, Dr. Robyn Neblett Fanfair, the CDC’s Director of the Division of HIV Prevention, said the HIV Prevention Capacity Development Branch, HIV Research Branch, Prevention Communication Branch, Quantitative Sciences Branch and Behavioral and Clinical Surveillance Branch were all axed. The staff fired from those branches were “central” to the effort to fight HIV, Fanfair wrote, but she added that there had been no changes to CDC grants “at this point.”
Butler’s biggest fear is the impact of those cuts and the potential loss of grant funding on HIV testing and prevention.
Louisiana has the fourth highest rate of new HIV cases in the country, with Baton Rouge and New Orleans leading the state in new cases, according to Louisiana Department of Health data from 2022. Over 23,000 people in the state are living with HIV, roughly half of whom have been diagnosed with AIDS.
There were 869 people newly diagnosed with HIV in Louisiana in 2023 – but that number has been declining since 2018. That’s in part thanks to HIV medications that can reduce the amount of HIV in a person’s blood so that it’s untraceable and thus unspreadable, letting that person live a normal life without exposing others to the virus. Another medication, Pre-exposure Prophylaxis, or PrEP, can be taken by people at higher risk of contracting HIV to reduce their chance of acquiring the virus by between 92% to 99%.
But both those innovations rely on education and reaching the people who need those treatments. Every organization interviewed by WWNO/WRKF said testing and immediately linking people who test positive to HIV treatment has been vital to stemming the virus’s spread.
“My big concern is that all these really wonderful gains that we've had in the last decade, we're going to start seeing those go in the wrong direction,” Butler said.
Tim Young, president and CEO of Open Health Care Clinic in Baton Rouge, said cuts to surveillance efforts and tracking of new HIV infections would make it hard to know where HIV is emerging, and thus harder to respond quickly to the parts of the state that most need testing and treatment.
Louisiana’s ongoing high rates of new HIV cases show there is a need to continue to test people, get out into communities and fight stigma against HIV, Patterson Hayes said.
“If these are our numbers, what state will we be in if we didn’t have the funding at all?” she said.
Patterson Hayes said she’s never seen Louisiana’s health department lay out its funding so clearly to its partners in a memo — or outline the stakes of losing that funding. It shows the department itself thinks this funding could be at risk, she said.
The health department did not immediately respond to a request for comment.
Cuts could impact the entire state
The cuts at the CDC are part of Elon Musk’s Department of Government Efficiency, or DOGE, dramatic slashing of federal agencies. The Trump administration said in late March that it will create a new Administration for a Healthy America, and that “HIV/AIDS” will be one of its new divisions.
Young said it’s possible the federal grants that his clinic receives — both directly and through LDH — could be moved to the new administration.
“It remains to be seen. It's still unclear,” he said.
If the funding were to disappear, Louisiana organizations said they would not be able to make up the cost of either replacing that funding or treating the spike in new cases of HIV that would result. The cost of treating people with HIV is far higher than the cost of testing and prevention, said Baloney Jr.
“The money is critical. Louisiana cannot fill the gap,” he said.
Women With A Vision is a reproductive justice group that has held contracts for HIV work with LDH in the past, but the organization decided not to take $250,000 in federal funding through LDH earlier this year in the wake of the Trump administration’s attack on DEI, said Jennifer Holl, who leads the organization’s efforts to end the HIV epidemic. That’s meant reenvisioning how they do their work with less money, she said.
“A lot of these organizations are already stretching their dollars,” Holl said. “I have not seen the excess and waste that the federal government is claiming to be there.”
The stigma around HIV means that organizations would not be able to privately raise the money they stand to lose from the federal government, Patterson Hayes said.
Young estimated that it would take less than 400 new cases of HIV to reach the $12 million in federal funding the state currently receives, “and then those numbers would spread exponentially.”
Butler urged Louisiana politicians to look at the downstream effects that could result from stepping back in the fight against HIV, which she said extend far beyond New Orleans and Baton Rouge.
“If you look at maps of HIV incidents throughout the state of Louisiana, we see very high rates in central Louisiana, rural areas,” she said. “So this is something that affects the entire state.”
