The present economic downturn, coupled with 20 states and counting, pulling back their government funding for HIV/AIDs assistance programs could not have been untimelier. Economic pressures and potential budgeting shortfalls are forcing states to revise their spending. As a direct result, life-saving medications and preventative care for many living with HIV/AIDs has become more costly than ever. For instance, from 2012-2018, the first-line treatment options for Antiretroviral Therapy (ART) increased by a whopping 30%, which outpaced the inflation rate by 3.5 times,[1] and have only continued to rise.
In an effort to ensure accessibility to comprehensive treatment and support, the Ryan White Care Act was enacted. It is the largest, federally funded program for people with HIV/AIDS in the US. Since its inception, the program has helped over 600,000 people get access to life sustaining care, which is more than half the U.S population living with AIDs. The Act dispenses funds to state programs for uninsured, underinsured, and low-income people living with HIV and higher risk individuals. The funds cover inpatient services, ART medication assistance, counseling and mental health services, case management services and more.[2]
Part B of the program: AIDS Drug Assistance Programs (ADAPs), are responsible for providing HIV treatment and Pre-exposure Prophylaxis (PrEP) to those at the lower income level, or with limited or no health insurance at a significantly less or no cost. ADAPs can also purchase insurance for those who qualify, and provide services to ensure the safety of drug treatments.[3]
What does less funding look like?
Funding has been at stagnant at around $900 million since 2014[4], yet we have seen an increase in enrollments by 30% from 2022-2024. The irrefutable truth of the matter is that thousands will lose access to their life-saving medications and treatment interventions if states continue to cut ADAP funding.
The relationship between poverty levels and HIV diagnoses has always existed— the further someone is below the poverty level, the higher incidence of HIV cases. One the most aggressive cuts so far have come from the state of Florida’s Department of Health. Despite insurance premiums rising nationwide, the Department lowered participant’s income eligibility from 400% to 130% of the federal poverty level. Meaning, only individuals earning $20,345 yearly, or less would be eligible to receive program benefits. Previously, those making $63,840 yearly or less were eligible. This change alone would result in approximately 16,000 individuals losing access to their HIV medications.[5]
Though ADAPs are federally funded, each state determines: how funds are allocated, which medications are part of the program, waitlists for specific medications, and the program eligibility requirements.
Ironically, state cuts in this department don’t actually correlate to money saved in the long run. HIV transmission would rise, as would hospitalizations, emergencies, and complex treatment cases, all of which are more expensive than maintenance medications. Pre-Exposure Prophylaxis (PrEP) medications are used to prevent the transmission of HIV, and are 99% effective when used correctly in those who don’t inject drugs. An economic evaluation study concluded with a modest 3% decline in PrEP coverage yearly, about 8,618 new infections would have failed to be prevented, and would account for $3.6 billion in lifetime costs.[6]
The soaring costs of ART alone is enough to pose a significant barrier for people living with HIV/AIDs to receive life-saving treatment. If these state-implemented cuts continue, much needed resources will be out of reach for the disadvantaged, posing a great risk to several communities. The state-sanctioned rollbacks only add fuel to the fire, and threatens decades of progress that has been made to combat the virus.
How to best navigate these uncertain times?
- Brief yourself with different insurance plans in the market place, and enrollment periods
- Familiarize yourself with your state’s HIV Care and Services
- Ask your healthcare providers and local HIV organizations for assistance programs and resources
[1] https://pubmed.ncbi.nlm.nih.gov/32011622/
[2] https://www.ncbi.nlm.nih.gov/books/NBK216136/
[3] https://ryanwhite.hrsa.gov/about/parts-and-initiatives/part-b-adap
[4] https://stateline.org/2026/03/10/states-are-limiting-hiv-drug-assistance-programs/
[5] https://www.aidshealth.org/2026/02/florida-health-dept-proposes-new-formal-rule-to-slash-hiv-drug-access-for-thousands/
[6] https://pmc.ncbi.nlm.nih.gov/articles/PMC12426795/
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