By Julie Steenhuysen
CHICAGO, April 17 (Reuters) – The U.S. State Department on Friday said it had supported HIV treatment for 20.6 million people as of September last year, including 3 million people whose care was provided by their own governments rather than the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), while testing rates dropped sharply due to funding cutbacks.
The report suggests that support for HIV treatment and services through PEPFAR overall was about the same as last year. However, the Trump administration did not provide data from earlier in 2025 that would show the impact of HIV funding disruptions, AIDS advocates said on Friday.
In one of his first acts in office in January 2025, President Donald Trump put almost all U.S. foreign aid on a 90-day hold. Days later, the State Department said life-saving HIV work under PEPFAR, the world’s leading HIV/AIDS initiative, would continue. Most prevention efforts, including testing and pre-exposure prophylaxis – in which HIV-blocking drugs are given to people at risk of infection – were curtailed.
“We have seen this big drop in testing, and that’s problematic, because if people aren’t tested, they can’t know if they’re positive. If we don’t know they’re positive, they cannot be put on drugs,” said Charles Kenny, a senior fellow at the Center for Global Development who has been tracking the data.
“We’re building up problems for the future.”
In September, the Trump administration released an America First Global Health Strategy in which the U.S. would negotiate multi-year agreements with countries receiving PEPFAR assistance to steer them toward self-reliance for HIV care.
As a result, the number of people receiving antiretroviral therapy from PEPFAR fell to 17.4 million in the fourth quarter of fiscal 2025, down from 19.4 million in the prior year quarter, according to the state department’s PEPFAR website.
Testing in that period fell to 17.2 million people in the fourth quarter of 2025, down from 21.9 million in the year-ago quarter. New HIV diagnoses fell to 307,000 in the fourth quarter of 2025, from 385,000 in the year-ago quarter.
The PEPFAR website said that data for the first three quarters of fiscal 2025 were not available because of program interruptions, reporting challenges and programmatic shifts. The federal government said it has greater confidence that fourth-quarter figures represent a complete tally after the State Department took ownership of the program.
“We have been in an unprecedented period of a 16-month data blackout,” said Asia Russell, executive director of Health GAP, a global AIDS advocacy, noting that typically PEPFAR data are reported every quarter.
Preliminary drafts of quarterly data from early in 2025 had “suggested a big drop off” in HIV care, said Kenny.
“The program interruptions bit really matters here,” Kenny said. “That means, quite plausibly, hundreds of thousands of people lost access to lifesaving medicine for a while at least.
The PEPFAR program has been credited with saving 26 million lives and preventing HIV infections in 7.8 million babies born to HIV-infected mothers since its start in 2003 under President George W. Bush.
(Reporting by Julie Steenhuysen and Christy Santhosh; Editing by Maju Samuel and Alistair Bell)
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