Studies Link Trump Administration Aid Cuts to 77,000 Fewer Children Receiving U.S.-Supported HIV Treatment and 1,700 Service-Site Closures

Two studies documented major disruptions to U.S.-supported HIV services following Trump administration foreign-aid cuts. An analysis of PEPFAR data found that approximately 77,000 fewer children received U.S.-supported HIV treatment in the year ending October 2025, a 14% decline, while noting that some children may have received care through governments or other donors. Separately, an amfAR survey of 166 organizations in 46 countries reported more than 1,700 service-site closures and over 16,000 full-time job losses. It also found that 43% of respondents permanently ended at least one prevention activity and that nearly three-quarters of organizations serving key populations ended at least one service for those groups. The State Department disputed the pediatric-treatment study’s methodology and argued that the decline reflected fewer child infections.

PEPFAR funding cuts

• ▪South Africa experienced the largest absolute decline in U.S.-supported pediatric HIV treatment, with approximately 30,000 fewer supported children, representing a 45 percent drop.
• ▪A study of PEPFAR data found that approximately 77,000 fewer children globally received U.S.-supported HIV treatment in the year ending October 2025 than in the previous fiscal year, following Trump administration cuts and changes to foreign aid.
• ▪Data from the President’s Emergency Plan for AIDS Relief (PEPFAR) showed a 14 percent year-on-year decline in U.S.-supported pediatric HIV treatment, affecting 20 of the 21 countries analyzed.

HIV clinic closures worldwide

• ▪An amfAR survey of 166 PEPFAR-funded organizations in 46 countries reported that more than 1,700 clinics, drop-in centers, and other service sites closed after awards were terminated or delayed.
• ▪The amFAR survey reported that more than 16,000 full-time staff lost their jobs after PEPFAR awards were terminated or delayed.

Trump administration foreign aid policy

• ▪The U.S. State Department said it had not reviewed the pediatric-treatment study in detail but considered its methodology flawed, arguing that the decline reflected a four-year trend of fewer children becoming infected with HIV.
• ▪The Trump administration dismantled the U.S. Agency for International Development (USAID) in July 2025, terminating thousands of overseas aid awards.

Prevention program disruptions

• ▪PEPFAR spending on HIV prevention programs fell by more than half in one year, and funding for condoms and lubricants was almost entirely eliminated.
• ▪Forty-three percent of surveyed organizations permanently stopped at least one HIV prevention activity due to the funding cuts.

Key populations service loss

• ▪Organizations altered their programming to comply with Trump administration executive orders targeting diversity, equity, and inclusion (DEI) initiatives, reproductive rights, and gender-affirming care.
• ▪Nearly three-quarters of surveyed organizations serving populations at the highest risk of HIV ended at least one service for those groups, including sex workers, transgender people, gay men, and people who inject drugs.

Local organization funding elimination

• ▪Locally-based organizations were significantly more likely than international organizations to lose funding and close service sites, despite historical U.S. efforts to transition HIV programs to local ownership.
• ▪In eastern and southern Africa, governments prioritized maintaining HIV treatment but scaled back community testing, prevention programs, and peer support systems.