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Recent federal budget cuts are threatening decades of progress in HIV prevention and care, particularly for Native Hawaiians and Pacific Islanders (NHPIs), who already experience a disproportionate impact from HIV.
The National Institutes of Health (NIH) has terminated multiple grants focused on PrEP, a drug regimen effective in preventing HIV infection. The Trump administration also cut funds to HIV vaccine research, recently terminating a $258 million program as, “NIH expects to be shifting its focus toward using currently available approaches to eliminate HIV/AIDS,” a senior official at NIH said. Federal workforce cuts within the Department of Health and Human Services (HHS), and leadership at NIAID, have sparked concerns about future HIV prevention and treatment efforts. The Trump administration is also considering eliminating the Centers for Disease Control and Prevention’s (CDC) HIV prevention division, which provides funds for prevention, detection, and outbreak response. This dismantling of our nation’s HIV prevention and treatment infrastructure comes amid a critical time for HIV-positive Native Hawaiians. Nationally, NHPIs have the third-highest HIV diagnosis rate, behind African Americans and Hispanic people, according to one report. Native Hawaiians are 2.4 times more likely to be diagnosed with HIV than white individuals; and native Hawaiian women are 2.5 times more likely to die from HIV-related complications, according to the Office of Minority Health. A recent review of Hawaiʻi hospital data found that HIV-positive Native Hawaiians were significantly more likely to be hospitalized compared to other races. “This means Kānaka Maoli were more likely to wind up in a hospital on their deathbed at the time of [HIV] diagnosis,” Kekoaopololū Kealoha, an administrator at Hawaiʻi Health & Harm Reduction Center and social media influencer, said in a recent video. Access to early diagnosis and ongoing treatment remains a challenge, shaped by deep-rooted social factors. Many Native Hawaiians live in under-resourced areas—far from clinics, specialists, and consistent care. High costs of living, limited insurance options, lack of in-language and culturally competent resources, and housing and employment insecurity (1 in 6 NHPIs live in poverty) make it harder to maintain treatment. The social stigma surrounding HIV impacts LGBTQ, transgender, or māhū individuals, leading to reduced testing and adherence to treatment. “Drastic reductions in the workforce across the Department of Health and Human Services, along with the cancellation of billions of dollars in federal grants to states, municipalities, educational institutions, and community-based organizations that form the very foundation of our national infectious disease prevention and treatment programs, is reckless and will result in increased HIV cases and the loss of life,” said Papa Ola Lōkahi's CEO Dr. Sheri Ann Daniels. “For HIV vaccine design and development, we’ve begun to see light at the end of the tunnel after many years of research,” said Dennis Burton, an immunology professor at Scripps Research. “This is a terrible time to cut it off…This is a setback of probably a decade for HIV vaccine research.” Advocates point out that between 2012 and 2022, CDC-led efforts prevented nearly 28,000 infections, saving over $15 billion in lifetime medical costs. As Congress debates future spending, community leaders have urged lawmakers to restore funding and maintain broader safety-net services. “With dialogue and with talk story, we can better focus on the issues, principles, other than pointing the finger and to come out to a better place than where we are,” Kumu Hula Brad Lum said. Comments are closed.
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