The Trump administration continues to make cuts that threaten people living with, or at risk for, HIV and sexually transmitted infections, including cancellation of National Institutes of Health research grants. Scientists who lost funding and advocates have filed a lawsuit challenging the cuts.
“Over 400 NIH grants have been terminated since [President Donald] Trump took office, with an intensification over the past two weeks,” Dr. Monica Gandhi, medical director of the Ward 86 HIV clinic at Zuckerberg San Francisco General Hospital, told the Bay Area Reporter. “Many of these grants involve HIV research, since the stated reason [for cancellation] is diversity, transgender research or even sexual minority research – all topics disproportionally represented in HIV research.”
NIH is part of the Department of Health and Human Services, along with the Centers for Disease Control and Prevention, the Food and Drug Administration, and other federal health agencies. Without a formal announcement of the cuts from NIH or DHHS, journalists and advocates have had to rely on reports from defunded researchers and sporadically updated government listings. The Washington Post estimates that total NIH funding has fallen by more than $3 billion compared with the amount issued during the same period last year.
Even without knowing the full scope of the cuts, it’s clear that HIV and STI research has been heavily impacted as the federal government implements new DHHS Secretary Robert F. Kennedy Jr.’s desired shift from infectious diseases to chronic health conditions.
Many grants were canceled as part of the administration’s push to eliminate “gender ideology” and DEI (diversity, equity, and inclusion). HIV disproportionately affects gay and bisexual men, transgender people, Black and Latino people, and people who use drugs, so much of the HIV research focuses on these populations.
In addition, grants awarded to specific universities have been canceled across the board, including Columbia, due to its handling of pro-Palestinian protests, and the University of Pennsylvania, because it allowed transgender swimmer Lia Thomas to compete in women’s sports. Funding for research in South Africa, the country with the highest number of HIV cases, is also under fire.
6 UCSF grants terminated
Six NIH grants to UCSF have been terminated so far, according to Gandhi. She also noted that the notice of award for the AIDS Clinical Trials Group – the major funder of HIV research worldwide – has been delayed. Funding for the HIV Prevention Trials Network and the HIV Vaccine Trials Network has also been suspended, STAT reported this week.
“In the history of the NIH, it is rare to terminate grants, and they are only terminated if there is fraud or any other demonstrated abnormality,” Gandhi said. “These cuts will have a negative effect on our ability to prevent HIV, to prevent sexually transmitted infections through the highly successful strategy of doxyPEP, and to help address important topics in HIV. I hope these terminated grants are refunded and these policies affecting LGBTQ+ health especially are reversed.”
In March, the NIH canceled $18 million in funding for the Adolescent Medicine Trials Network for HIV/AIDS Intervention, which aims to prevent and treat HIV in adolescents and young adults. One of the largest single grants on the chopping block funds a study of HIV prevention and hepatitis C care for people who use drugs, coordinated by Columbia. The Fenway Institute in Boston, which focuses on LGBTQ health and HIV, reportedly lost five NIH grants in one day. Funding for several studies of doxyPEP – taking a single dose of doxycycline after sex to prevent gonorrhea, chlamydia, and syphilis – have also been axed.
About 7% of the NIH budget is devoted to HIV, a disproportionate share of funding given that less than 1% of the U.S. population is living with the virus. But funding for HIV research has paid off in advances for other diseases. The rapid development of COVID vaccines, for example, was possible thanks to HIV immunology and vaccine research.
“I've been involved in HIV research since 1993, and NIH has been very generous to us,” Dr. Steven Deeks of UCSF said at a March 10 “Save Our Sciences” rally coinciding with the annual Conference on Retroviruses and Opportunistic Infections, held this year in San Francisco. “We collectively have received billions of dollars over the decades, and everybody in the United States who contributed as taxpayers to NIH needs to know that the return on the investment goes well beyond HIV.”
HIV Medicine Association chair Dr. Colleen Kelley made a similar argument for continued HIV funding.
“The National Institutes of Health’s abrupt termination of hundreds of HIV research grants threatens to halt decades of progress,” Kelley said in a statement. “The return on investment in HIV research goes well beyond HIV with the discoveries laying the foundation for curative therapies for hepatitis C and treatments for cancer. Turning our back on HIV research – before we have reached all who need it with HIV treatment or prevention and discovered a cure – will leave us all more vulnerable to HIV and other infectious diseases and have serious consequences for global health security here at home and around the world.”
The depth of the cuts has left researchers and advocates both concerned and somewhat surprised, as they seem contrary to the goals of the Ending the HIV Epidemic in the U.S. initiative, which Trump himself launched during his first term.
Lawsuit
On April 2, the American Civil Liberties Union filed a lawsuit aiming to halt the grant cancellations on behalf of the American Public Health Association, unions representing scientists, and individual researchers who lost funding. The plaintiffs argue that the NIH actions are part of an “ideological purge” and a violation of the First Amendment.
“The NIH’s efforts to shut down research that so much as references LGBTQ people or racial minorities is a direct attack on public health,” Olga Akselrod, senior counsel for the ACLU Racial Justice Program, said in a statement. “By censoring studies that include these populations, they are also undermining critical research on cancer, HIV, and Alzheimer’s – diseases that affect us all.”
