World AIDS Day, observed every year on December 1, encourages us to remember those we've lost, recognize the resilience of people living with HIV, and renew our commitment to ending the epidemic through prevention, treatment, and public health efforts. Started in 1988, the observance began amid widespread fear and misinformation. It quickly grew into a global event to highlight the scale of the crisis, the communities most affected, and the urgent need for coordinated action. Since the first cases were identified in 1981, HIV has claimed over 44 million lives worldwide. Today, about 40 million people are living with the virus, including around 150,000 Californians. Nearly 100,000 Californians have died from HIV, highlighting how deeply the epidemic has affected the state. World AIDS Day urges us to challenge stigma, support access to care, and strengthen efforts to prevent new infections. It is both a day of remembrance and a reminder that the fight to end HIV is far from over.
This year, World AIDS Day arrives with concerning instructions from the US government. According to a recent report in The New York Times, the State Department has told employees and grantees not to use federal funds to recognize or commemorate the day. An internal email explained that this is part of a broader policy to avoid messaging about all commemorative events. Staff can still highlight work supported by US global health programs or attend external events, but they have been instructed not to publicly mention World AIDS Day on social media, in speeches, or through other public communication channels. This guidance sharply contrasts with other observances recognized by the White House this year, including World Autism Awareness Day and National Manufacturing Day. For many activists, the instruction echoes the early years of the epidemic when silence and neglect worsened the crisis. The long-standing message from HIV advocates still resonates: silence equals death.
World AIDS Day has also traditionally been the day when the State Department submits its annual report to Congress on the President's Emergency Plan for AIDS Relief, or PEPFAR, which is the main source of US funding for HIV programs abroad. Earlier this year, PEPFAR's budget was sharply cut, and the administration is reportedly considering ending the program altogether. In its place, UNAIDS released a detailed report this week showing how recent cuts have already disrupted lifesaving prevention and treatment services. According to UNAIDS, the global AIDS response went into "crisis mode" when the United States, responsible for 75 percent of all international HIV funding, halted its HIV-related spending. Over the past decade, AIDS-related deaths decreased by 54 percent, reaching 630,000 last year, and new infections dropped by 40 percent. That progress is now at risk. UNAIDS estimates that by October 2025, about 2.5 million people had already lost access to PrEP because of donor funding cuts. Modeling studies in the report warn that if PEPFAR ends, the world could see 6.6 million additional HIV infections by 2030, including 660,000 among children, and over 4.2 million additional AIDS-related deaths, with 300,000 of those deaths in children. An estimated 3 million more children could be orphaned by AIDS.
A similar pattern of budget cuts is developing in the US. The FY 2026 budget request and related House bills propose eliminating the Domestic HIV and AIDS Prevention and Research Program and removing all essential HIV prevention funding from the CDC. Since the CDC has traditionally managed about 90 percent of federal domestic HIV prevention funding, this would result in a 78 percent reduction (around $794 million) compared to FY 2025 and would shut down the division responsible for national surveillance, prevention efforts, and grants to communities and health departments nationwide. Several key HIV care programs are also at risk. The proposals aim to end Part F of the Ryan White Program, which supports dental care, clinical training, and community research; terminate the Minority AIDS Initiative at HRSA and SAMHSA; and restructure or cut major housing supports. Additionally, HHS has announced plans to phase out its role in maintaining federal HIV clinical guidelines by June 2026. Advocates and clinicians are concerned that, under an administration that has closed key HIV policy offices and cut prevention funding, these guidelines may be updated less frequently, lose scientific independence, or become vulnerable to political pressure. Such changes could weaken standards of care and affect insurance coverage for over a million people living with HIV in the US.
HIV research in the US has also encountered significant setbacks. The federal government has canceled dozens of grants aimed at preventing new infections and increasing access to care, slowing progress toward ending the epidemic. Since January 2025, the NIH has terminated at least 191 HIV-specific grants, cutting more than $200 million in funding. Ninety-one of these grants were tied to 113 active clinical trials. Earlier this week, JAMA Internal Medicine reported that between late February and August, funding disruptions led to the termination of 383 clinical trials nationwide, impacting over 74,000 participants. Trials focused on infectious disease and behavioral health were among the most severely affected.
In this challenging environment, the School of Behavioral Health's mission has become even more important. The school has received three major HIV prevention grants, led by Dr. Alex Dubov. Two of these are federally funded, totaling ~$3.5 million over the next four years. Thanks to this support, our research teams are expanding community outreach, increasing access to HIV testing and PrEP, and enhancing behavioral health services for populations most affected by HIV. Over the past two years, our team has already engaged more than 2,400 people through community events and in the Emergency Department. Our outreach uses the SBIRT model (screening, brief intervention, and referral to treatment) to identify needs early and connect individuals with appropriate care. We have distributed over 500 harm reduction kits and now operate two community clinics in Riverside and Redlands that offer HIV, hepatitis C, and syphilis testing to unhoused individuals and link them to treatment and prevention services. Each clinic serves about 50 clients weekly and includes mental health screenings for anxiety and depression, with referrals to care when necessary. Through additional grants focused on empowering pharmacies to serve as community prevention hubs, we have established a coalition of 15 pharmacies equipped to provide point-of-care testing and HIV prevention services. More than 100 people have already started HIV prevention medication (PrEP) through these pharmacy partners—most of them younger, low-income Hispanic men who are often underserved or missed entirely by traditional clinic-based systems.
As we observe the importance of World AIDS Day and consider the challenges mentioned earlier, this moment calls for renewed dedication from everyone in the behavioral health community. HIV, hepatitis C, and substance use remain highly stigmatized conditions that often affect individuals with the least access to care. Cuts to prevention, treatment, research, and public health infrastructure threaten to widen these disparities. We encourage our community to stay engaged by supporting outreach efforts and advocating for evidence-based services. Consider volunteering at our community events or partnering with organizations that serve people at risk for HIV. Improve your knowledge by learning more about PrEP, harm reduction, trauma-informed care, and the mental health needs of those living with chronic infectious diseases. And most importantly, use your voice. Stand with communities that depend on stable, well-funded prevention and treatment systems. Speak out when science is dismissed or when stigma silences voices. Urge local and national leaders to protect programs that save lives.
Written by Dr. Alex Dubov, Associate Professor, Interdisciplinary Studies