Domestic HIV Funding in the White House FY2026 Budget Request

Lindsey Dawson
Published: Jun 05, 2025

President Trump released the FY 2026 budget request, the first of his second term, on May 30, 2025, following a preliminary release with topline information earlier this month. A budget request lays out presidential administration priorities both in terms of the policy issues identified and the level of funding requested (or proposed for elimination). Congress then considers the request but ultimately has “the power of the purse” and is responsible for appropriating funding for discretionary programs. Congress may also pass temporary “continuing resolutions” rather than a full budget. Those appropriations can differ from levels proposed by the administration. At the same time, since taking office in January, the Trump administration has taken several executive actions to terminate or limit already appropriated funding – – including delaying and cancelling HIV-related grants – leading to litigation and creating some uncertainty regarding future spending even if funds continue to be appropriated. In addition, the administration has plans to use the recission process, whereby the president asks Congress to rescind appropriated funds, which, if approved by Congress, would reduce funding.

The FY 2026 request marks a significant change in approach for domestic HIV programs and funding levels. It eliminates or transforms several core programs, while maintaining others. Additionally, past proposals to bolster PrEP uptake were not included in this request. Notably, an OMB document leaked earlier this year indicated that the administration was considering eliminating the “Ending the HIV Epidemic” (EHE) initiative, an effort created by the first Trump administration, but the final budget request retains funding for EHE (at least for accounts where funding levels are available). While detailed funding information is not available for all accounts, where levels are known for both years, the FY 2026 budget request for domestic HIV programs represents a $1.5 billion (35%) decline compared to FY 2025 levels.

If these cuts are enacted, it could make addressing HIV more challenging at a time when Congress debates other changes to the health policy landscape, changes that could also have an impact on how people with, and at increased risk for, HIV receive access to care and prevention services.

A summary of the request for domestic HIV programs is below.

Overview

The request includes discretionary funding for key programs aimed at addressing the domestic HIV epidemic, including for the Health Resources and Services Administration’s (HRSA) Ryan White HIV/AIDS and Health Center Programs, programs that the budget moves to the new Administration for Healthy America (AHA). The request states that AHA “will prioritize prevention” and includes HIV/AIDS, among other named areas, as a focus. Funding previously provided to other departments/agencies for HIV activities is moved to AHA. This includes funding previously at the Office of Infectious Disease and HIV/AIDS Policy (OIDP) for HIV and other infectious disease related activities, as well as all EHE funding previously allocated to CDC. At the same time, the request eliminates a range of historical HIV programs including funding for domestic HIV prevention at the Center for Disease Control and Prevention’s (CDC), the Housing Opportunities for People with AIDS (HOPWA) program, Part F of the Ryan White HIV/AIDS Program, and at least some parts of the Minority AIDS Initiative (MAI). Additionally, large cuts are proposed for the National Institute of Allergy and Infectious Diseases (NIAID) at the National Institutes of Health, which has been the largest source of HIV research funding in the world.

Specific, known funding levels are as follows:

Centers for Disease Control and Prevention (CDC)- Domestic HIV Prevention

Funding for core HIV prevention programs at the CDC is eliminated in the budget request and funding previously provided to the CDC for EHE activities ($220 million) is moved to AHA. Historically, CDC has accounted for almost all (91%) federal funding for domestic HIV prevention. This cut would represent a $794 million decrease (78%) over FY25 level ($1 billion, including the EHE) in HIV funding, but a total elimination of funding for the division.

While CDC’s HIV prevention funds are eliminated in the proposal, some funding for infectious diseases has been retained and combined into one account. Previously, CDC funding for viral hepatitis, sexually transmitted infections, and tuberculosis prevention had separate funding lines. The request proposes to group those accounts into a single $300 million line. The $300 million funding level is $77 million below the sum of these individual accounts in FY 2025. These accounts were not traditionally part of the HIV prevention budget and it is unclear whether HIV activities would be allowable activities in the reorganized account.

Ryan White HIV/AIDS Program

The Ryan White HIV/AIDS Program, the nation’s safety net for HIV care and treatment (formerly housed at HRSA, now at AHA), receives $2.5 billion in the FY 2026 request, a $74 million (3%) decrease over the FY 2025 enacted level. The request includes $165 million for EHE activities within Ryan White, the same as in FY 2025. The overall program decrease of $74 million is attributed to the elimination of funding for Part F of the program which has included the following components:

AIDS Education and Training Centers (AETCs) which provide education and training for health care providers who treat people with HIV.
Dental Programs: The “Dental Reimbursement Program” reimburses dental schools and providers for oral health services. The “Community-Based Dental Partnership Program” supports dental provider education and expands access to oral care for people with HIV.
Minority AIDS Initiative (MAI): Created in 1998 to address the impact of HIV on racial and ethnic minorities, MAI provides funding to strengthen organizational capacity and expand HIV services in minority communities.

Community Health Center HIV Funding

The FY 2026 budget request includes $157 million in HIV funding for the Health Center Program (formerly housed at HRSA, now at AHA), all of which is for the EHE initiative, and is the same amount as the FY 2025 level.

Administration for Healthy America (AHA) – EHE Coordination

The budget provides funding to support coordination and leadership of “EHE and other HIV/AIDS related activities, formerly carried out by OASH’s Office of Infectious Disease and HIV/AIDS Policy” (OIDP). It appears this is accompanied by $8 million in funding and may inlcude funding to support work related to other infectious diseases. Previously, these funds resided at OIDP for HIV and other activities.

Housing Opportunities for Persons with AIDS (HOPWA)

The Department of Housing and Urban Development’s HOPWA Program is eliminated in the budget. In FY 2025, HOPWA was funded at $505 million. HOPWA, which was established in 1992, has provided housing assistance and supportive services to low-income people with HIV facing housing insecurity and is the only federal program centered on the housing needs of people with HIV. Its funding supports grants to localities, states, and community-based organizations.

National Institutes of Health – Domestic HIV Research.

Historically, the National Institutes of Health (NIH) has carried out almost all federally funded HIV research activities. However, the budget proposes significant cuts to NIH overall, including to the National Institute of Allergy and Infectious Disease (NIAID) which would be cut by $2.4 billion (36%), from approximately $6.6. billion to $4.2 billion. While the amount of funding for domestic HIV research at NIH is not yet known, in FY 2025, it was $2.7 billion (amount provided to KFF via data request). The Office of AIDS Research, which sits in the Office of the NIH Director is mentioned in the budget’s technical appendix, although a specific funding amount is not provided. suggesting some level of funding may be retained. Notably though, the administration has reportedly decided not to renew core NIH funded HIV vaccine research.

Indian Health Service (IHS)

In the IHS budget justification, EHE is mentioned but no funding level is provided, nor is it described as eliminated. In FY 2025, IHS received $5 million for EHE activities to support ending HIV and hepatitis C in Indian Country.

The Minority AIDS Initiative (MAI)

As noted above, the MAI was created in 1998 to address the disparate impact of HIV on racial and ethnic minority communities and to build resources and organizational capacity within these communities. The status of the Minority AIDS Initiative is unclear. Funding that has been provided for MAI activities at the Substance Abuse and Mental Health Services Administration (SAMHSA), aimed at “improving the health of people of color who have or are at risk for HIV” is eliminated in the proposal. In FY 2025 SAMHSA received $119 million for the MAI. Another $60 in MAI funding is eliminated from the Secretary’s Minority HIV/AIDS. In addition, as noted, MAI Ryan White funding in Part F is also eliminated in the proposal.

The tables below compare federal funding levels for domestic HIV, where specified, in the FY 2026 request to the FY 2025 continuing resolution (CR) levels. EHE funding is included in the overall table (Table 1) and in a dedicated table (Table 2).