Trump funding cuts threaten HIV prevention as disease gains ground in Colorado

One of the largest HIV prevention nonprofits in Colorado is warning that cases of new infection, which took an upward turn after the pandemic, will continue to rise if federal funding is slashed as the Trump administration has threatened.

The nonprofit Vivent Health — providing HIV prevention and treatment to 3,700 people at a medical clinic in east Denver — stands to lose as much as $1.14 million in federal funding if the Centers for Disease Control and Prevention’s division of HIV prevention is cut.

Mass layoffs at the federal Department of Health and Human Services began Tuesday, including teams that led HIV surveillance and research. It’s unclear at this point whether the division is at risk of closing, or whether it might move to another agency.

The looming funding cuts add to others already impacting public health and behavioral health programs in Colorado. Just last week, the state announced it is losing $250 million in federal grants that went toward tracking diseases, improving mental health and battling substance misuse.

Any loss of funding related to HIV could devastate the work of Vivent Health, which provides care for people who have HIV or are at risk of contracting the virus transmitted through unsafe sexual practices and injecting drugs. 

If the federal division is gutted, Denver would be one of the most impacted cities in the country, said Matt Pagnotti, Vivent’s director of state and local government relations.

Colorado had 15,414 people living with HIV in 2023, according to the most recent statistics from the state health department. The state sees 400-500 new diagnoses per year, a number that has increased since the pandemic. 

“These types of cuts are ultimately very wasteful”

HIV is preventable, thanks to a drug called PReP, and treatable, thanks to a combination of daily medications that can suppress the virus to the point it is undetectable in the bloodstream. Vivent provides medication management in its Denver medical offices and pharmacy, and has an outreach team visiting homeless encampments and other locations throughout the city. 

Cutting HIV prevention would not save the government money in the long run, Pagnotti said. A new case of HIV costs an average of $500,000 in lifetime medical expenses — far more than it costs to provide preventive medication, he said.

“This administration talks a lot about trying to tackle waste, fraud and abuse, and claim that is their ultimate goal, but these types of cuts are ultimately very wasteful,” he said. Disrupting funding “is only going to result in more cases of HIV and that is going to be fiscally irresponsible as well as the impact on people’s lives.

“It doesn’t make any sense no matter how you try to spin it.” 

The Trump administration has reportedly discussed a plan to cut $1.3 billion nationwide in HIV prevention funding. Vivent Health, which operates in six states, is the second-largest provider of HIV prevention care in the nation and receives about $6 million in federal HIV prevention funds, plus about $18 million in other federal grants. 

Combined, all of Colorado’s HIV prevention organizations receive about $11 million annually in federal funding.

“We really could see a very significant reversal in the progress of HIV prevention,” Pagnotti said, noting that with the ongoing state budget crisis, Colorado has little ability to backfill any lost federal funds. The loss would hit hardest among communities of Black and brown people, LGBTQ people and people living in poverty, he said.

Cuts already impacting Colorado

The state is already trying to figure out how to handle hundreds of millions of dollars in federal funding cuts to health programs — at a time when the state faces a more than $1 billion budget deficit for the coming year and likely deficits in subsequent years, as well.

Last week, the Trump administration announced it was ending grants appropriated under the pandemic-era American Rescue Plan Act.

A spokesperson for Colorado’s Behavioral Health Administration said grant cuts to the agency will affect 60 programs across the state, including those providing services for adults with severe mental illnesses, crisis resolution teams, peer support for people battling substance issues, and programs helping kids and young adults experiencing the onset of psychotic illnesses.

“In so many cases, these are life-saving programs and services,” the spokesperson, Allie Eliot, wrote in an email to CPR News.

The grants were originally intended to address the effects of the COVID pandemic, but state officials said their value had become much broader.

For instance, one grant to the Colorado Department of Public Health and Environment paid to support epidemiology teams and the state public health lab in their work to spot and track emerging infectious diseases.

Canceled grants include one to improve vaccination rates

Other canceled grants at CDPHE included one to address COVID health disparities among rural communities, communities of color and other higher-risk populations; one that helps the state respond to the health needs of newly arrived immigrants; and one that sought to improve vaccination rates among kids for preventable diseases.

“We are concerned that this sudden loss of federal funding threatens Colorado’s ability to track COVID-19 trends and other emerging diseases, modernize disease data systems, respond to outbreaks, and provide critical immunization access, outreach, and education — leaving communities more vulnerable to future public health crises,” Kristina Iodice, a CDPHE spokesperson, wrote in an email.

Asked Tuesday whether the funding cuts and the mass firing of federal workers could hurt Colorado’s ability to respond to a new case of measles, state officials said they weren’t yet sure.

“At this point, we have insufficient information to predict whether or not that will have an impact on Colorado’s ability to respond to the current measles case,” Dr. Ned Calonge, CDPHE’s chief medical officer, said during a briefing.