A growing coalition of HIV prevention organizations, health experts and Democrats in Congress are sounding the alarm over sweeping Trump administration cuts to HIV/AIDS prevention and surveillance programs nationally, warning they will reverse years of progress combating the disease and cause spikes in new cases — especially in California and among the LGBTQ+ community.

In a letter addressed Friday to Health and Human Services Secretary Robert F. Kennedy Jr., Rep. Laura Friedman (D-Glendale) and 22 of her House colleagues demanded the release of HIV funding allocated by Congress but withheld by the Trump administration. They cited estimates from the Foundation for AIDS Research, known as amfAR, that the cuts could lead to 143,000 additional HIV infections nationwide and 127,000 additional deaths from AIDS-related causes within five years.

Friedman said the effects would be felt in communities small and large across the country but that California would be hit the hardest. She said L.A. County — which stands to lose nearly $20 million in annual federal HIV prevention funding — is being forced to terminate contracts with 39 providers and could see as many as 650 new cases per year as a result.

According to amfAR, that would mark a huge increase, pushing the total number of new infections per year in the county to roughly 2,000.

“South L.A. and communities across California are already feeling the devastating impacts of these withheld HIV prevention funds. These cuts aren’t just numbers — they’re shuttered clinics, canceled programs, and lives lost,” Friedman said in a statement to The Times.

As one example, she said, the Los Angeles LGBT Center — which is headquartered in her district — would likely have to eliminate a range of services including HIV testing, STD screening, community education and assistance for patients using pre-exposure prophylaxis, or PrEP, a medicine taken by pill or shot that can greatly reduce a person’s risk of becoming infected from sex or injection drug use.

A list reviewed by The Times of L.A. County providers facing funding cuts included large and small organizations and medical institutions in a diverse set of communities, from major hospitals and nonprofits to small clinics. The list was provided by a source on the condition of anonymity in order to be candid about the funding of organizations that have not all publicly announced the cuts.

The affected organizations serve a host of communities that already struggle with relatively high rates of HIV infection, including low-income, Spanish speaking, Black and brown and LGBTQ+ communities.

According to L.A. County, the Trump administration’s budget blueprint eliminates or reduces a number of congressionally authorized public health programs, including funding cuts to the domestic HIV prevention program and the Ryan White program, which supports critical care and treatment services for uninsured and underinsured people living with HIV.

The county said the cuts would have “an immediate and long-lasting impact” on community health.

Dozens of organizations and hospitals, such as Children’s Hospital of Los Angeles, are bracing for the disruption and potential vacuum of preventative services they’ve been providing to the community since the 1980s, according to Claudia Borzutzky, the hospital’s Chief of Adolescent and Young Adult Medicine.

Borzutzky said without the funding, programs that provide screening, education, patient navigation and community outreach — especially for at-risk adolescents and young adults — will evaporate. So, too, will free services that help patients enroll in insurance and access HIV prevention medications.

Patients who “face a variety of health barriers” and are often stigmatized will bear the brunt, she said, losing the “role models [and] peer educators that they can relate to and help [them] build confidence to come into a doctor’s office and seek testing and treatment.”

“We are having to sunset these programs really, really quickly, which impacts our patients and staff in really dramatic ways,” she said.

Answers to queries sent to other southern California health departments suggested they are trying to figure out how to cope with budget shortfalls, too. Health officials from Kern, San Bernardino and Riverside counties all said the situation is uncertain, and that they don’t yet know how they will respond.

Friedman and her colleagues — including fellow California representatives Nancy Pelosi, Judy Chu, Gilbert Cisneros Jr., Robert Garcia, Sam Liccardo, Kevin Mullin, Mark Takano, Derek Tran and George Whitesides — said they were concerned not only about funding for programs nationwide being cut, but also about the wholesale dismantling or defunding of important divisions working on HIV prevention within the federal government.

They questioned in their letter staffing cuts to the National Center for HIV, Viral Hepatitis, STD, and Tuberculosis Prevention at the U.S. Centers for Disease Control and Prevention, as well as “the reported elimination” of the Division of HIV Prevention within that center.

In addition to demanding the release of funds already allocated by Congress, the representatives called on Kennedy — and Dr. Debra Houry, deputy director of the CDC — to better communicate the status of ongoing grant funding, and to release “a list of personnel within CDC who can provide timely responses” when those groups to whom Congress had already allocated funding have questions moving forward.

“Although Congress has appropriated funding for HIV prevention in Fiscal Year 2025, several grant recipients have failed to receive adequate communication from CDC regarding the status of their awards,” Friedman and her colleagues wrote. “This ambiguity has caused health departments across the country to pre-emptively terminate HIV and STD prevention contracts with local organizations due to an anticipated lack of funding.”

The letter is just the latest challenge to the Trump administration’s sweeping cuts to federal agencies and to federal funding allocated by Congress to organizations around the country.

Through a series of executive orders and with the help of his billionaire adviser Elon Musk’s “Department of Government Efficiency” and other agency heads, Trump in the first months of his second term has radically altered the federal government’s footprint, laying off thousands of federal workers and attempting to claw back trillions of dollars in federal spending — to be reallocated to projects more aligned with his political agenda, or used to pay for tax cuts that Democrats and independent reviewers have said will disproportionately help wealthy Americans.

California Atty. Gen. Rob Bonta’s office has repeatedly sued the Trump administration over such moves, including cuts and layoffs within Health and Human Services broadly and cuts to grants intended to make states more resistant to infectious disease specifically — calling them unwise, legally unjustifiable and a threat to the health of average Americans.

LGBTQ+ organizations also have sued the Trump administration over orders to preclude health and other organizations from spending federal funding on diversity, equity and inclusion programs geared toward LGBTQ+ populations, including programs designed to decrease new HIV infections and increase healthy management of the disease among transgender people and other vulnerable groups.

“The orders seek to erase transgender people from public life; dismantle diversity, equity, inclusion, and accessibility initiatives; and strip funding from nonprofits providing life-saving health care, housing, and support services,” said Jose Abrigo, the HIV Project Director of Lambda Legal, in a statement. The legal group has filed a number of lawsuits challenging the Trump administration cuts, including one on behalf of the San Francisco AIDS Foundation and other nonprofits.

Trump has defended his cuts to the federal government as necessary to implement his agenda. He and his agency leaders have consistently said that the cuts target waste, fraud and abuse in the government, and that average Americans will be better served following the reshuffling.

Kennedy has consistently defended the changes within Health and Human Services, as well. Agency spokespeople have said the substantial cuts would help it focus on Kennedy’s priorities of “ending America’s epidemic of chronic illness by focusing on safe, wholesome food, clean water, and the elimination of environmental toxins.”

“We aren’t just reducing bureaucratic sprawl. We are realigning the organization with its core mission and our new priorities in reversing the chronic disease epidemic,” Kennedy has said. “This Department will do more — a lot more — at a lower cost to the taxpayer.”

Kennedy has repeatedly spread misinformation about HIV and AIDS in the past, including by giving credence to the false claim that HIV does not cause AIDS.

As recently as June 2023, Kennedy told a reporter for New York Magazine that there “are much better candidates than H.I.V. for what causes AIDS,” and he has previously suggested that environmental toxins and “poppers” — an inhalant drug popular in the gay community — could be causes of AIDS instead.

None of that is supported by science or medicine. Studies from around the world have proven the link between HIV and AIDS, and found it — not drug use or sexual behavior — to be the only common factor in AIDS cases.

Officials in L.A. County said they remained hopeful that the Trump administration would reverse course after considering the effects of the cuts — and the “detrimental impacts on the health and well-being of residents and workers across” the county if they are allowed to stand.