Request to Protect and Preserve HIV and STD Prevention Infrastructure in Los Angeles County

As a follow up to the May 6, 2025, policy update on the End the Epidemics Coalition (ETE) Day of Action in Sacramento, this week APLA Health met with representatives from the Board of Supervisors and submitted the following letter urging the Board to identify emergency funding that will preserve our LA County HIV and STD prevention infrastructure while advocates fight for ongoing resources from the state and federal government.

May 7, 2025

Los Angeles County Board of Supervisors
Kenneth Hahn Hall of Administration
500 West Temple Street, Room 383
Los Angeles, CA 90012

Subject: Request to Protect and Preserve HIV and STD Prevention Infrastructure in Los Angeles County 

Dear Honorable Members of the Board:

As you know, Centers for Disease Control and Prevention (CDC) funding for HIV and STD prevention services appears to have been eliminated. Award notices for the second year of the CDC’s PS-24-0047 High-Impact HIV Prevention and Surveillance Programs for Health Departments program should have been transmitted by now for a start date of June 1, but neither the state Department of Public Health’s Offices of AIDS (OA) nor LADPH’S Division of HIV & STD Programs (DHSP) have been notified of a renewal. 

The Trump Administration has already eliminated staff at the CDC’s Division of HIV Prevention, and terminated prevention grants and HIV research projects nationwide. The Administration has strongly signaled an end to all federal funding for the Ending the HIV Epidemic effort, initiated by President Trump during his first term and responsible for a 12% reduction in new HIV diagnoses nationwide since 2018.

In light of this development, on April 30, 2025, DHSP terminated all 83 HIV and STD prevention contracts as of May 31. Prior to the termination notices, contracts were set to expire on June 30, 2025 with an anticipated July 1 start date for newly awarded contracts under DHSP’s 2024-014 RFP for Comprehensive HIV and STD Prevention Services. Note that while the CDC contract cycle runs from June 1 to May 31, DHSP’s contract cycle aligns with Los Angeles County’s fiscal cycle of July 1-June 30. 

The elimination of federal funding is effectively wiping out prevention services at 39 organizations Countywide, including APLA Health. This will have a devastating impact to our communities and risk reversing decades of hard-won progress to end the HIV epidemic in Los Angeles County. DHSP currently reports 1,400 new HIV diagnoses each year, down from 1,700 in 2020. If prevention programs end, it is estimated that over the next five years we would see an accelerated incidence rate, leading to an additional 9,000 new diagnoses above the current baseline. Additionally, some of Los Angeles County’s most vulnerable and underserved community members who are at risk for HIV will bear the biggest brunt of these cuts, especially Black and Latinx individuals, particularly young men who have sex with men, LGBTQ+ individuals, especially our transgender and non-binary community, and people who are unhoused. 

At the state level, the End the Epidemics Coalition (ETE) is advocating for $60 million from the AIDS Drug Assistance Program (ADAP) Rebate Fund to preserve HIV and STD prevention infrastructure statewide, with an additional request that the state Administration immediately pay back at least $60 million of the $900 million in borrowed ADAP funds. The $60 million would backfill lost federal funding through June 30, 2026. APLA Health appreciates the Board’s historic and ongoing support of ETE and especially the Board’s advocacy in support of this year’s budget request.

However, even if this budget request is successful, funding would not be available until July 1, 2025 at the earliest. This leaves a gap in the system for the month of June 2025, putting our prevention infrastructure in danger. While some larger organizations might be able to support prevention activities for this gap month, most smaller agencies do not have the ability to support programming without funding for any amount of time; people will lose jobs, members of our community will fall out of care and lose critical and life saving support programs, seroconvert, and LA county will reverse course on our hard earned progress toward ending the HIV epidemic. Our prevention infrastructure will be decimated and it will be extremely difficult to build it back in the future. 

APLA Health currently supports HIV and STD testing at our Long Beach Health Center, our Out Here Sexual Health Center in Baldwin Hills, and three of our other clinic sites, CEDIS activities (partner notification), our “Options” care coordination program for people with HIV, Biomedical HIV Prevention (PrEP) navigation services, and our crystal meth harm reduction program. We offer prevention services Countywide, serving clients living in all five districts and are recognized as a safe and trusted community provider within the LGBTQ+ community.  

Last year, APLA Health provided over 16,000 HIV and STD tests, offering immediate access to treatment and linkage to care for any positive tests, prescribed PrEP to 2,000 individuals, and served nearly 2,000 individuals through our Out Here Sexual Health program. 72% of APLA Health’s clients identified as LGBTQ+, and two-thirds were people of color, with a large percentage of Black and Latinx individuals, and nearly half of our clients who received testing were men who have sex with men. Through our harm reduction programs we supported over 400 individuals with outreach and education, contingency management, health navigation (including PrEP), SUD treatment, linkage to behavioral health and oral health services, and linkage to HIV and STD treatment and care. One-third of the individuals in these programs were unhoused, half identified as LGBTQ+, and 81% were Black and Latinx individuals.

 We cannot afford to lose the fight to end the HIV epidemic. The Board of Supervisors has an opportunity and responsibility to be a national champion in the fight against the Trump Administration’s draconian cuts and attacks on our communities. We must preserve HIV and STD prevention infrastructure in Los Angeles County. We ask that the Board of Supervisors identify funding immediately to support all 83 HIV and STD prevention contracts, at a minimum through June 30, 2025. This will ensure that prevention services are protected and preserved while community advocates, including APLA Health, fight for long-term, stable funding at the state and federal level.

If you have any questions or need any additional information, please contact Katja Nelson at knelson@aplahealth.org. We thank the Board of Supervisors for your ongoing leadership in supporting HIV care and prevention and STD screening, treatment, and prevention services in Los Angeles County and hope that you will take action on this urgent funding request that will prevent a catastrophic crisis. We look forward to working together in this fight.

Sincerely, 

Craig E. Thompson
Chief Executive Officer