New Data Brief Signals Strain on US HIV Response as
Service Disruptions Worsen for Vulnerable Populations
Washington, DC (April 14, 2026) – The International Association of Providers of AIDS Care (IAPAC), in collaboration with fellow members of the Emergency HIV Clinical Response Task Force, today released a new data brief warning of disruptions to HIV prevention, treatment, and care services across the United States. The findings, based on a national survey of 383 frontline providers across 47 states and Puerto Rico, reveal a system under mounting pressure from funding instability, workforce strain, and deepening social and economic vulnerabilities.
The data brief, “HIV Response in U.S. Experiencing Renewed Strain,” documents that 61% of providers reported at least one HIV service disruption, while 68% reported operational changes such as staffing reductions, service cutbacks, and program closures. These disruptions span the full continuum of care, including HIV testing, mental health services, and access to long-acting injectable antiretroviral therapy (ART) and pre-exposure prophylaxis (PrEP).
Equally concerning are the disproportionate impacts on populations already facing structural inequities. Transgender individuals, migrants and undocumented persons, and people experiencing homelessness were identified as among the most affected groups, but impacts were reported across a wide range of groups, including Latinx/Hispanic, Black/African-American, and lesbian, gay bisexual, and queer (LGBQ) individuals.
“These data confirm what frontline providers have been warning for months: the US HIV response is entering a period of dangerous instability,” said Dr. José M. Zuniga, President/CEO of IAPAC. “We are witnessing the convergence of policy decisions, funding contractions, and social determinants of health that are actively undermining decades of progress. When patients lose housing, insurance, or access to care, HIV does not wait and neither can we.”
The survey also highlights the growing role of social determinants of health in disrupting care continuity. Providers reported that housing instability (65%), food insecurity (62%), and loss of insurance coverage (61%) are among the leading barriers preventing patients from remaining engaged in care. Fear of immigration enforcement was cited as a major factor driving disengagement among migrant populations, with some providers reporting severe consequences, including delayed care leading to death.
In addition, the survey data underscore mounting challenges related to medication access. Insurance lapses, coverage denials, and rising out-of-pocket costs are increasingly preventing people living with and vulnerable to HIV acquisition from accessing life-saving HIV prevention, treatment, and supportive services. In that regard, Dr. Zuniga added that these access barriers are not abstract policy concerns but active risk multipliers, creating the precise conditions under which localized HIV transmission clusters can rapidly escalate into sustained outbreaks if left unaddressed.
“Small HIV transmission clusters do not remain small in the absence of timely intervention; they expand, accelerate, and become exponentially more difficult to contain,” said Dr. Zuniga. “What we are witnessing in the current Bangor, Maine, HIV outbreak is a warning that if we fail to act with urgency to restore access, stabilize services, and re-engage communities in care, we risk allowing preventable clusters of HIV transmission to evolve into widespread outbreaks across multiple jurisdictions.”
The Emergency HIV Clinical Response Task Force – comprising the five leading US-based HIV medical and nursing associations – launched this survey effort to monitor the real-time impacts of evolving federal and state policy changes on HIV service delivery. The first fielding of the survey took place in July 2025, and a second follow-up survey was fielded in November-December 2025, and its data are reported in the current data brief capture the breadth of disruptions and impacts experienced from July to October 2025.
Here is a link to the “HIV Response in U.S. Experiencing Renewed Strain” data brief.
# # #
About IAPAC: The International Association of Providers of AIDS Care is a global association representing healthcare professionals and allied organizations working to improve the quality of and access to HIV prevention, care, and treatment services worldwide. IAPAC supports the global Fast-Track Cities initiative, a network of more than 600 cities and municipalities committed to ending urban HIV epidemics, including 55-plus cities and counties in the United States.
About the Emergency HIV Clinical Response Task Force: In response to reports of HIV clinical and supportive service disruptions, five U.S.-based professional medical and nursing associations – the American Academy of HIV Medicine (AAHIVM), Association of Nurses in AIDS Care (ANAC), GLMA, HIV Medicine Association (HIVMA), and International Association of Providers of AIDS Care (IAPAC) – launched the Emergency HIV Clinical Response Task Force in June 2025.
