Cutting Federal Funds for HIV Testing Means Not Ending the HIV Epidemic

(See the Major Article by Balasubramanian et al on pages e746–54.) In 2025, the federal administration proposed approximately $1.7 billion in cuts to the Centers for Disease Control and Prevention (CDC), including eliminating the agency's Domestic HIV Prevention Program [1, 2]. Should these proposed cuts be enacted, a range of core human immunodeficiency virus (HIV) prevention activities would be at risk, including federally funded HIV testing. Any funding cuts to HIV testing would cause both measurable and hidden negative impacts. HIV testing is a foundational, cost-effective strategy for ending the HIV epidemic in the United States [3–6]. Since the first commercial HIV test was licensed in 1985, HIV testing at state and local health departments, at community-based organizations, and, most recently, for individuals via at-home self-tests has been funded largely by CDC programs [7]. Each CDC-funded HIV testing program has been instrumental in diagnosing people with HIV, particularly in jurisdictions with the greatest needs [8]. From 2010 to 2021, up to 3 million CDC-funded HIV tests were performed annually across the United States, leading to 24%–33% of all new HIV diagnoses [3, 9, 10]. In its first year (2023–2024), Together TakeMeHome, a CDC-funded program to expand at-home HIV self-testing, mailed 440 000 self-test kits, leading to more than 8000 diagnoses [11]. Taken together, these data underscore the central role of CDC-funded programs in supporting HIV testing and diagnosis efforts.