The major HIV conference in San Francisco this week coincides with growing fears that budget cuts being pushed by Republicans will gut essential health care services in the United States and worldwide. Advocates have been growing more vocal that the funding reductions will result in potentially catastrophic consequences, as people in treatment for the virus that causes AIDS are cut off from their life-saving medications.
A Save Our Sciences rally March 10 at the Yerba Buena Gardens in the city's South of Market neighborhood – adjacent to the Moscone Center, where the Conference on Retroviruses and Opportunistic Infections, or CROI, took place March 9 to 12 – attracted hundreds of attendees. One participant was Richard Jefferys, a gay man who is the basic science, vaccines and cure project director with the Treatment Action Group.
In an interview with the Bay Area Reporter post-protest, Jefferys explained how people who can no longer access antiretroviral medications due to the abrupt cuts in the United States President's Emergency Plan for AIDS Relief, or PEPFAR, are at risk.
"For someone with HIV, their load count would rebound and they'd be more susceptible to opportunistic infections," Jeffreys said.
And it's not just PEPFAR. The United States Agency for International Development, or USAID, was "one of the main funders of tuberculosis prevention around the world," noted Jefferys, adding that, "TB remains the largest killer of people with HIV globally. This administration has made the American people complicit in one of the worst acts of mass murder ever in our history. ... Everyone alive today has benefited from scientific research."
The U.S. Congress reauthorized PEPFAR last year through March 25, 2025; however, after President Donald Trump signed a day one executive order after his January inauguration pausing foreign aid, there've been work stop orders for existing grants and contracts, leading to clinic closures, Jefferys claimed.
On February 27, the Trump administration also cut off the Joint United Nations Programme on HIV/AIDS, or UNAIDS.
Billionaire Elon Musk, senior advisor to Trump, who the president claims is the head of the Department of Government Efficiency (its official head is Amy Gleason, a health care tech professional), announced his intention to shut down USAID citing false and misleading allegations of waste, fraud and abuse. Last week, the U.S. Supreme Court in a 5-4 decision decided to side with a lower court's order that the foreign aid funding that was paused be unfrozen and disbursed by the state department and USAID.
A federal judge also granted a restraining order temporarily preventing mass USAID layoffs. (USAID was established by executive order but its programs are authorized by Congress.)
Vincent Crisostomo, a gay AIDS activist based in San Francisco who is the HIV Caucus Co-Chair for the Harvey Milk LGBTQ Democratic Club and has been living with the virus since 1987, told the B.A.R. that "that's the checks and balances of our country."
He spoke at the March 10 rally held on CROI's second day.
"They're [the Trump administration] trying everything they can to see what sticks, and it's to overwhelm everyone," Crisostomo said. "People should be calling their congressperson every day, every hour. ... People should find out where they could make the biggest difference."
Jefferys also encouraged people to call their congressional representatives, who have the power of the purse and oversight powers over the executive. People can locate their congressmember at www.house.gov/representatives/find-your-representative by entering their zip code and then clicking on the link to their individual website with contact info.
"I just don't think a lot of people understand the role UNAIDS has to play in this and how they coordinate," Crisostomo said. "By excluding ourselves from UNAIDS, we go from a high influence country to almost no influence – and I do think it sets us back."
Craig Bowers, a gay man who is the chief marketing and external affairs officer for APLA Health in Los Angeles, told the B.A.R. during a March 11 phone call that his group, which provides domestic HIV services, hasn't been affected yet by the executive orders.
Nonetheless, "we have contracts up for renewal in the short term we expect may not be renewed," said Bowers, whose nonprofit did not attend this year's CROI.
Calling your congressperson might make little impact, too, if they're a Democrat from a blue state, Bowers said. Nonetheless, Senate Democrats have the power to vote against a continuing resolution for funding the government (which passed the House of Representatives March 11), Bowers said, and people might want to consider opposing that, though, "a lot of federal workers would be out of a good job," he said, concluding that there is "no good scenario."
The San Francisco AIDS Foundation is one of several groups that sued the Trump administration after they received stop-work orders or termination notices for federal funds as a result of Trump's executive orders attacking DEI initiatives and the erasure of transgender people. Tyler TerMeer, a gay, HIV-positive man, was one of the speakers at the March 10 event.
"We are deeply concerned by the current federal administration's cuts to HIV research, science, programs, and services, both here in the U.S. and globally," he stated to the B.A.R. before the rally. "It is abundantly clear that lives are at stake and people will die as a result from the Trump administration's decisions to cut vital initiatives, including PEPFAR and UNAIDS."
TerMeer stated that the abrupt cuts signal a catastrophe for progress against AIDS.
"Scientific progress will stall and gains made in HIV cure research, and medication and vaccine development, may be lost," he warned. "Agencies that rely on federal funding to provide HIV prevention, treatment, and support services may be forced to reduce their services and even close their doors. At this moment, we must come together to demand continued investment in science, public health, research, and evidence-based programs. Our lives, and our health, are at stake."
Trump's abrupt moves since returning to the White House stand in contrast to his first term that began in 2017. Mentored by his personal attorney Roy Cohn, who died of AIDS in the 1980s, Trump during his previous administration started the Ending the HIV Epidemic in the US with the goals of reducing new HIV infections by 75% by 2025 and 90% by 2030.
"In recent years, we have made remarkable progress in the fight against HIV and AIDS. Scientific breakthroughs have brought a once-distant dream within reach," Trump had said in 2019 during his State of the Union address to Congress. "My budget will ask Democrats and Republicans to make the needed commitment to eliminate the HIV epidemic in the United States within 10 years. Together, we will defeat AIDS in America."
Now, congressional Republicans have set the initiative in their crosshairs at the same time that the White House has scrubbed HIV-related content from its website.
Outside CROI on March 11, a B.A.R. reporter attempted to speak with 15 conference attendees (identified by lanyards) to discuss PEPFAR and other cuts. Thirteen either expressed they didn't want to give a statement, or ignored the reporter's question, while two did speak to the reporter.
Dr. Douglas Brust, a gay man who is the medical director for Los Angeles-based AIDS Healthcare Foundation's Healthcare Centers: Coconut Grove, was in town for the conference.
"Literally, it's chaos, and cutting off life-saving treatment and prevention mid-therapy without alternate funding," he noted of the Trump administration's actions.
CROI attendee Frank Post, a straight man who is a professor of HIV medicine at King's College London, said, "PEPFAR has been absolutely amazing."
He told the B.A.R. that, "This week at the conference everyone has expressed their gratitude to the American people's contribution to HIV scientific research, particularly with respect to marginalized populations."
Post said he understood if people wanted to "do things differently," but stressed that "the way to do that is not to cut overnight."
Longtime activist Crisostomo told the B.A.R. that activists need to "find common ground, so we don't completely fall apart as a country." He noted "there's a reason" for why the "other 50%" of the country that support Trump "feels the way they do."
"How well has it worked out for us so far, where we are just fighting with everybody?" he asked. "All the things I've fought for my whole life – are they still worth fighting for? I think that they are."
Update, March 12, 2025: Post-publication, Jefferys clarified the risk posed by PEPFAR cuts, and a sentence was removed.
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