HIV and STD grants have been in the news recently, with renewed threats of being cut or terminated. This is challenging not only because of the financial impact, but because losing these grants can also put an organization’s access to the 340B drug pricing program at risk.
Right now there are two immediate funding risks:
- First, the Administration has proposed $600M in cuts primarily affecting HIV and STD prevention and surveillance programs. These proposed cuts would affect 66 grants across four states: California, Colorado, Illinois, and Minnesota. The states have challenged the cuts, which are currently blocked in the courts and have not been terminated.
- Second, PS21-2102 is set to expire in June 2026. This Notice of Funding Opportunity (NOFO), “Comprehensive High Impact HIV Prevention Programs for Community-Based Organizations,” supports more than 60 CBOs across the country. It funds HIV testing, linkage to care, and PrEP services that are foundational to local prevention efforts.
While Congress appropriated roughly the same level of funding for HIV Prevention and Ending the HIV Epidemic (EHE) as last year, it’s still unclear how that funding will be distributed and whether existing programs, including PS 21-2102, will continue. There are a few potential paths forward for PS21-2102:
- The NOFO is extended, ideally for a year or more. This would be the least disruptive and would allow funding to continue under the current structure, with the same eligibility criteria, and would let grantees keep operating without gaps
- The NOFO is allowed to expire, and a new one is issued. That process typically takes 6-8 months and could introduce changes to eligibility or priorities, and leaves existing grantees without funding in the interim.
- The NOFO is allowed to expire, and the funding is reallocated. The funds would still be spent by the CDC, but not through PS21-2102 or with the same recipients.
CBOs supported under PS21-2102 are the ones doing the work on the ground. They are essential to how public health objectives are actually met. Extending the NOFO will preserve programs that are effective, targeted, and critical to HIV prevention and control. We are actively advocating for that outcome.
How Risky Is Your Grant, Really
While these two groups of grantees face the most immediate risk, it’s important for every clinic to understand how secure its STD grant is and to think through contingency plans if needed. The first step is to know what specific STD grant you have and where it comes from. You can find this information by searching your entity’s name on www.340bopais.hrsa.gov.
STD grants fall into a few different categories: prevention, treatment, or focused on a specific geography or population, and come from a few different sources: directly from the CDC, or from the CDC via your state or county health department.
We don’t have a crystal ball. But based on conversations with Hill staffers, the priorities of HIV advocacy organizations we work alongside, how the most recent appropriations process played out, and the stated priorities of this Administration, we’ve developed a view of which STD grant types appear more or less exposed to disruption. In general, grants that come through state or county health departments, rather than directly from the CDC, and grants focused on HIV treatment rather than prevention, appear to be more secure.
The good news is that this applies to the vast majority of grantees. More than 90% of STD clinics receive funding under NOFO PS19-1901, “Strengthening STD Prevention and Control for Health Departments.” These in-kind sub-awards from health departments are, in our view, the lowest-risk category. The remaining 10% of grantees, approximately 500 covered entities nationwide, rely on NOFOs that we view as medium or high risk. The most common grant types are outlined below.
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What You Can Do Now
There is active advocacy work underway through partners including NMAC, the U.S. Business Action to End HIV, and many others, to protect HIV funding currently at risk, by advocating to extend NOFO PS21-2102 set to expire in June of this year. The state Attorneys General of California, Illinois, Minnesota, and Colorado have sued the Trump Administration in response to the separate anticipated cuts to HIV funding in their states.
Beyond advocacy, every STD grantee should take a few concrete steps:
- Understand your grant type and how risky that NOFO may be
- Develop a contingency plan for potential funding loss. We published a guide and downloadable tools following the federal grant disruptions in February 2025, and that guidance still applies
- If your eligibility is tied to a higher-risk NOFO, pursue additional grants to create redundancy and protect continued access to the 340B program. Engage closely with your health department. They are your partner and are committed to the critical work you are doing. In many states, health departments form partnership with HIV service organizations by providing in-kind funding, which may offer a path to continued eligibility
Funding uncertainty is nothing new, but the decisions being made over the next several months matter. Understanding where your eligibility comes from and planning ahead now will put you in a stronger position if disruptions occur.
