City Reports Fourth Consecutive Year of Increasing Diagnoses While Trump Administration Proposes $755 Million in National HIV Program Cuts
Concerning Reversal of Decades-Long Progress
New York City documented 1,791 new HIV diagnoses in 2024, representing a 5.4 percent increase from the previous year and marking the fourth consecutive year of rising or stagnant case numbers. This troubling trend reverses more than two decades of consistent progress that had reduced new infections by over 70 percent since 2001. The uptick coincides with proposed federal budget cuts that threaten to eliminate more than $755 million in nationwide HIV prevention funding, including over $41 million allocated specifically to New York City’s prevention, treatment, and support programs. Acting Health Commissioner Dr. Michelle Morse emphasized the timing of these developments during a World AIDS Day 2025 event at the LGBT Center in Manhattan. The simultaneous rise in cases and threats to funding create what public health officials describe as a potential crisis for HIV prevention efforts. According to the city’s 2024 HIV Surveillance Annual Report, estimated new infections rose even more sharply than diagnoses, climbing 17 percent year over year.
Federal Funding Under Threat
The Trump administration’s 2026 budget proposal seeks to eliminate the Centers for Disease Control and Prevention’s Division of HIV Prevention entirely. This move would eradicate $755.6 million in annual federal funding for HIV prevention programs nationwide. For New York City specifically, the cuts would eliminate $41 million currently used for critical services including identifying newly diagnosed individuals, connecting them to treatment, tracking linkage to care and viral suppression, expanding HIV testing in hospitals and clinics, and supporting sexual health services. The House of Representatives’ September appropriations bill aligned with the administration’s proposal, seeking nearly $2 billion in HIV-related reductions. However, the Senate’s corresponding proposal maintains HIV funding at current levels, creating uncertainty about the ultimate outcome. Any funding legislation must pass both chambers of Congress and receive presidential approval to become law. The proposed cuts extend beyond CDC prevention programs. The administration also seeks to eliminate Ryan White Part F funding, which specifically expands HIV services in minority communities and supports oral care for people with HIV. New York City received approximately $9 million through this program in 2024. Additional threats include elimination of the Housing Opportunities for Persons With AIDS program, from which New York has consistently received over $40 million annually.
Stark Health Disparities Persist
The 2024 surveillance data revealed continuing racial and socioeconomic disparities in HIV transmission. Eighty-six percent of newly diagnosed individuals were Black or Latino, with 42 percent living in high-poverty neighborhoods. Among those interviewed by health officials, 48 percent reported lacking health insurance, 37 percent experienced housing insecurity, and 13 percent struggled with food insecurity. These findings underscore how social determinants of health drive HIV transmission rates. Poverty, unstable housing, inadequate health insurance, unemployment, and unmet social support needs all heighten vulnerability to HIV infection. The interconnection of these factors means that addressing the epidemic requires comprehensive approaches extending far beyond medical interventions. Public health experts emphasize that economic instability and lack of access to basic necessities create conditions where individuals struggle to prioritize preventive care or maintain treatment regimens. The CDC’s HIV prevention resources provide additional context on effective intervention strategies.
Multiple Contributing Factors
Health officials identify numerous reasons for the post-2020 increase in HIV cases. Increasing homelessness rates, gaps in health coverage, economic stress, and interruptions in preventive care during and after the pandemic all contributed to rising transmission. Stigma and fear surrounding HIV testing continue delaying diagnoses, allowing the virus to spread to additional individuals before infected persons receive treatment. The COVID-19 pandemic disrupted HIV prevention and treatment services in multiple ways. Testing sites closed or reduced hours, routine medical appointments were cancelled, and many individuals avoided healthcare facilities due to infection concerns. These disruptions occurred precisely as social and economic conditions that increase HIV vulnerability were worsening. Increasing mistrust of public health institutions following the pandemic has complicated efforts to rebuild prevention programs. Misconceptions about HIV risk persist despite decades of public education efforts. Unequal access to PrEPa medication that reduces HIV transmission risk by approximately 99 percent when taken consistentlycontributes to continuing new infections, particularly in communities facing economic and healthcare access challenges.
City Services at Risk
The $41 million in threatened federal funding supports extensive city operations. These resources enable the Health Department to identify people newly diagnosed with HIV and connect them to treatment promptly. The funding supports partner services that notify and test individuals who may have been exposed. It underwrites tracking systems monitoring whether newly diagnosed individuals successfully link to care and achieve viral suppression. Prevention funding supports routine HIV testing in hospitals and clinics while expanding testing in nontraditional settings to reach individuals who might not otherwise be screened. The money provides HIV testing and navigation support for PrEP, emergency PEP, and treatment at the city’s Sexual Health Clinics. It enables the PlaySure Network 2.0 to deliver comprehensive HIV and sexual health services. The program also distributes free safer sex products throughout the city.
Additional Policy Threats
Beyond the immediate funding cuts, several other federal policy changes threaten HIV prevention and treatment efforts. Proposed reductions to Medicaid spending combined with stricter eligibility requirements could result in loss of coverage for many New Yorkers, including those living with HIV or at high risk of infection. Medicaid currently covers approximately 40 percent of people with HIV in the United States. Potential expiration of Affordable Care Act subsidies would increase health insurance costs, potentially pricing many individuals out of coverage. Reduced funding for public health research would hamper development of new prevention and treatment approaches. Changes to housing support programs at the federal level jeopardize stability for thousands of vulnerable New Yorkers, including many living with HIV for whom stable housing is crucial for maintaining treatment adherence.
Community Response and Advocacy
Health care providers, social service organizations, and community advocates gathered at the World AIDS Day event to strategize responses to the dual challenges of rising cases and funding threats. Participants emphasized the importance of community-based organizations building trust and effectively communicating the value of HIV testing, treatment, and prevention services. Advocates stressed that prevention efforts can succeed only if adequately resourced and accompanied by increased access to safe, affordable housing, health insurance, gainful employment, and supportive services. These broader social supports enable individuals to prioritize their health and maintain consistent engagement with prevention and treatment programs. Organizations serving communities disproportionately affected by HIV are preparing contingency plans should federal cuts materialize. However, they warn that any significant federal funding reduction would severely weaken testing programs, outreach in high-risk communities, and access to preventive medication. The Planning Services Resource Administration, which manages Ryan White Part A funding for New York City, is developing contingency plans for an 11 percent funding reductionup to $10 million of the city’s $92 million allocation. This represents a significant increase from previous years when contingency planning anticipated only 5 percent reductions.
Call for State and Local Action
Community health centers like Callen-Lorde, serving Chelsea, Brooklyn, and the Bronx, have called on New York City and State leadership to fight for HIV prevention and treatment funding at all governmental levels. Executive Vice President Kimberleigh Smith emphasized that progress against the HIV epidemic cannot afford retreat at this critical moment. The city included $232 million for HIV programs in its adopted 2026 budget across the Health Department and Department of Social Services. However, this funding cannot fully replace lost federal resources, particularly for prevention activities that federal grants have historically supported. Looking ahead, public health officials emphasize that ending the HIV epidemic in New York City remains achievable despite current challenges, but success requires sustained commitment and adequate resources from all levels of government alongside continued community engagement and support.
