By: Al Ballesteros
At a time when Los Angeles County’s HIV testing and prevention system has in place a strong network of agencies working together to curb the spread of HIV, it is now facing drastic reductions in Federal Funding from the Centers for Disease Control. The proposed funding reductions will hurt Los Angeles County, which receives the bulk of its HIV prevention dollars from the CDC which passes through to more than 30 local organizations that provide direct services to residents of the county.
These reductions are a result of DOGE, the “Department of Government Efficiency” implemented by the Trump Administration to cut government programs. These CDC reductions will result in the downsizing of HIV prevention efforts, including significantly less access to HIV testing, Prep and Pep, STD screenings, outreach and other health education and risk reduction programs for at-risk and vulnerable populations. Tragically and because of these CDC cuts, LA County is and will continue to lose its momentum to fight the spread of HIV, leading to more infections and health disparities unless other funding is identified to make up for the loss of federal support.
The funding cuts proposed are nation-wide. In fact, each year there are an estimated 32,000 new HIV infections in the United States. There are also more than 19,000 AIDS-related deaths each year and about 1.2 million people are living with this disease in the US. These proposed cuts will make these statistics much worse. Studies suggest should the CDC cut national funding by 50% this will lead to as many as 75,000 additional HIV infections and 7,500 more AIDS-related deaths by 2030 (source: amfAR). If all CDC HIV prevention funding were ended and not replaced, as many as 143,000 new infections and 15,000 more deaths would occur by 2030.
The 2023 LA County HIV Surveillance Report by the Department of Public Health estimates that 59,400 people are living with HIV in Los Angeles County but only 91% know they have HIV and roughly 6,800 individuals have HIV and don’t know it. It is estimated that approximately 1,400 get infected each year with HIV according to a 2021 statistic provided by the county’s Division of HIV/STD Programs. These federal funding cuts to Los Angeles County mean that there could be between 2,500 – 3,250 new HIV infections annually between 2025 and 2030.
CARLOS VEGA-MATOS of the Men’s Health Foundation says, “routine HIV testing is key to reducing the risk of forward transmission by connecting those who are HIV positive to treatment services, as well as connecting those who are HIV negative to services that can prevent HIV infection such as PREP.”
Adelante: How will the proposed HIV prevention funding cuts affect Los Angeles County?
Vega-Matos: In Los Angeles County, the proposed funding cuts will adversely affect up to 33 clinics and programs conducting HIV testing and STD screenings and treatment. These cuts happen at a time when last year the LA County Department of Public Health reported 9,377 cases of syphilis and neurosyphilis; 126 cases of congenital syphilis (mother-to-newborn transmission); 26,197 cases of gonorrhea and other sexually transmitted infections that are tracked but are not mandated to be reported such as Chlamydia, but which adversely impact health when untreated. Routine STI screenings can help connect people to treatments that can cure infections and prevent forward transmission.
Adelante: What will be the affect on MHF and your operations in WeHo and South LA?
Vega-Matos: As a result of the cuts in HIV and STD prevention services, we will be hard pressed to prevent and treat new HIV and STI infections. We will have to curtail HIV/STD screening services, linkage to care, treatment, and PrEP and PEP navigation for the uninsured and underinsured.
MHF is among the larger providers of HIV, STD testing and treatment in LA County. According to Vega-Matos, in 2024 MHF through its Rapid Results clinics in West Hollywood and in South Los Angeles provided 8,428 HIV screenings with 48 testing HIV positive, of which 23 were new HIV infections and linked or re-engaged in care. MHF also provided 11,196 Chlamydia screenings with 959 testing positive and treated and 11,196 Gonorrhea screenings with 456 testing positive and treated. MHF further provided 9,591 Syphilis screenings, with 191 testing positive and treated.
Adelante: Will MHF have to downsize staff?
Vega-Matos: Yes, absolutely, as well as implement salary reductions across middle and senior management levels.
Adelante: If the federal government does not provide funding as in past years, what other options does LA have to keep programs in place?
Vega-Matos: The options to sustain these services are limited. For example, uninsured and underinsured individuals would have to rely on Medicaid (MediCal in California). But the Federal Government is also proposing drastic cuts to the Medicaid and Medicare Programs, thus further limiting public access to HIV and STD prevention and treatment services.
A second short-term option is for Governor Newsom to assign $71 million from the AIDS Drug Assistance Program to fund HIV/STI prevention and treatment services for one year among the 21 Counties that are being impacting by these budget reductions. It would also help if the administration repaid the millions of dollars borrowed from the fund.
A third option, also short-term, is for the County Board of Supervisors to bridge the gap in prevention funding if the other two do not materialize. We understand that the County has a lot on its plate right now, fire recovery, the Probation Department settlement, reduced revenues, and the upcoming Medicaid cuts, but this bridge funding will help prevent between 2,500 and 3,250 new infections annually.
Adelante: What populations are most affected?
Vega-Matos: The most vulnerable LA county residents who rely on us for accessing screening and treatment will suffer the most adverse health outcomes. And society as whole will suffer the staggering trauma and economic costs associated with undiagnosed and untreated HIV and STD infections. Specific Populations most impacted by these cuts are: Sexually active individuals; Uninsured and underinsured people; Gay men, especially gay men of color; Women, especially women of color; Transgender individuals; Youth of color; and Infants born to women with lack of access to prenatal care, among others.
Adelante: How can the community help?
Vega-Matos: Raise your voice, organize. Call your elected representatives in the county, state and in congress. Tell them “Save Lives, Restore HIV/STD prevention funding.” Remember, SILENCE = DEATH
ROBERT CONTRERAS, President and CEO of Bienestar says the impending reductions would have devastating affects on the Latino community at risk for HIV. This is because Latinos have the largest number of persons living with HIV and new infections in Los Angeles County.
Adelante: How will the proposed HIV prevention funding cuts affect the Latino community at risk?
Robert Contreras: In L.A. County the rates of HIV and STD among Latinos continues to rise. These cuts will impede efforts to prevent and control diseases, as well as reduce the ability to respond effectively and in a holistic manner, which BIENESTAR has done over the past 35+ years, with whole-person care.
The HIV and STD rates for Latinos in Los Angeles County have continued to increase and in fact have never seen a decline in infections. These HIV and STD prevention cuts will negatively impact the Latino community in continuing to receive information and risk reduction strategies to prevent new infections, access to HIV screenings, and guidance on how to access PrEP and other important biomedical strategies that can keep individuals from acquiring HIV. It is well documented, and at BIENESTAR we witness it every day, that stigma and lack of access to these valuable programs are major barriers to having our community engage in prevention strategies that enhance their health and wellbeing.
Adelante: What will be the affect on Bienestar and your operations in East Los Angeles, South LA and other locations?
Contreras: The funding loss that BIENESTAR will experience represents a cut of 32.7% from our Programs & Services budget. The funding loss will have a detrimental impact on the organization by reducing the program capacity to address health promotion and HIV prevention, there will be fewer program activities implemented, fewer people will be reached and linked to PrEP and ART prevention strategies. Our HIV prevention efforts have always been aligned with our efforts to address the barriers that produce poor health outcomes among Latinos such as the lack of information, stigmas, language barriers, and anxiety in understanding and accessing the healthcare system.
Adelante: Is Bienestar having to downsize staff?
Contreras: These funding cuts are negatively impacting our staff morale since some will lose their jobs. We anticipate layoffs of 10 to 16 individuals. Over 50% of our staff are community peers who have similar lived experiences as the population they serve. BIENESTAR currently operates seven community service centers with two (East L.A. and Pomona) with a co-located primary health clinic. We anticipate either closing two service centers or operate them at reduced hours due to the reduction of staff. Our centers are located in communities that are identified as having high levels of poverty, unemployment, poor health access, and high rates of HIV/STDs. The locations are also “safe venues” for the community to access information, services, and support.
Adelante: If the federal government does not provide funding as it has in past years, what other options does Bienestar have to keep programs in place?
Contreras: BIENESTAR has met with foundations and private donors, and while there might be opportunities to obtain their financial support, it is unrealistic to expect that their donation will amount to the $3.9 million funding loss due to the government funding cuts.
BIENESTAR provides other key services that the populations served by the agency need, such as primary care, substance use disorder treatment, and mental health counseling. Our goal is to enhance enrollment in these programs and ensure that through these services, we can continue to provide a comprehensive prevention message about staying healthy.
Adelante: What populations are most affected?
Contreras: These funding cuts will have the most negative impact on populations that historically have poor health outcomes due to having existences that make them vulnerable due to lack of access to healthcare, services, resources, education, and good paying jobs. In addition, they are marginalized by society due to their immigration status, their identification as LGBTQ+, Transgender or Gender Non-conforming, and racial/ethnic identities. These are populations that experience higher levels of isolation, depression, and lack of support networks. In addition, most have had some form of hate incident directed at them, and violence and murder towards our transgender community.
Adelante: How can the community help?
Contreras: The voices of the community are very powerful. Policies being implemented by the federal government hurt the health, economic, and wellbeing of our community, and they do it knowing that there will be no consequences to their actions. We at BIENESTAR encourage everyone to reach out to their elected officials at the federal, state, and county levels and express their concerns about public entities neglecting their duties to address public health. Be informed about what policy changes are occurring because everything has an impact on everyone.
BIENESTAR encourages everyone that believes in the organization’s mission of improving the health and wellbeing of the Latino community and other underserved communities, to become a volunteer and doner. We need these special angels more than ever in order to sustain providing the services facing elimination. We need volunteers with all types of skills, such as helping with communications, event planning, social media, conducting community outreach, mental health counselors, and primary health providers. Everyone is welcome.
Adelante urges its readers to contact their US Senator and demand that HIV prevention funding not be cut. Go to Senate.gov and look up your senator and send them a message to Fully Fund HIV Prevention. The community’s health depends on your action and their support.