A science advocacy rally against attacks by the Trump administration on the sidelines of the 2025 edition of the San Francisco Cross. Photo: Brooke Anderson.
By Fred Lebreton
United States: Increasing restrictions on access to HIV treatments
In the United States, several states are tightening access to public programs that fund HIV treatments. An investigation by the New York Times reveals that these decisions, justified by rising costs and stagnant federal funding, could deprive tens of thousands of people of stable access to their medications and weaken public health efforts.
Essential programs weakened by budget constraints
Nearly twenty American states have recently tightened access to AIDS Drug Assistance Programs (ADAP), which support approximately a quarter of the 1.2 million people living with HIV in the United States. Pressured by increasing treatment costs and stagnant federal funding, these programs are facing challenges in meeting demands. Some states have already implemented cost-saving measures, such as limiting access based on income levels or reducing the list of covered medications. Specialists fear that these decisions may compromise treatment continuity, leading to the development of resistance and an increase in new infections.
Florida at the forefront, with thousands excluded
One of the most concerning situations is in Florida, where access to the program has been cut for at least 16,000 people living with HIV, and coverage for the widely prescribed Biktarvy treatment has been stopped. The income threshold for eligibility has been drastically reduced, adding to the financial burden for many. The state cites a projected budget deficit of $120 million to justify this decision, prompting concerns from HIV advocacy organizations. Legal actions have been taken to challenge these restrictions, as experts warn that other states may follow suit as budgets tighten and social assistance programs change access to Medicaid.
The potential impact extends beyond individuals with HIV, with economic, public health, and moral consequences at stake. The broader concern is that the safety net for people living with HIV in the United States may be progressively weakened as more states implement cost-control measures.
