Impact of US government funding freezes on the HIV response: findings from a rapid survey in 32 countries

Introduction: After the freezing of US foreign assistance in January 2025, the International Epidemiology Databases to Evaluate AIDS (IeDEA) conducted a rapid survey among clinics and programs actively participating in the research consortium to assess the status of HIV-related service delivery in mid-2025. Methods: In June-July 2025, an online survey was distributed to 103 IeDEA-participating clinics/programs in 41 countries in sub-Saharan Africa, Latin America and the Caribbean, and Asia-Pacific. Survey domains included US funding-related disruptions in service delivery, medication availability, laboratory services, clinic operations, and attendant mitigation strategies. Responses were received from 76/103 (74%) clinics/programs in 32/41 (78%) countries. Descriptive statistics were used to characterize disruptions in HIV-related care and mitigation measures. Results: Almost half of responding sites reported disruptions in HIV-related services (47%) since January 2025, along with disruptions in medication availability (28%), laboratory services (34%), and non-research clinic operations (47%). Among those reporting disruptions in HIV-related services, only 14% reported that all disruptions were fully resolved at the time of the survey. Conclusion: Given anticipated reductions in global HIV funding, government- and community-led monitoring of HIV prevention and treatment services and care outcomes are critical for informing national responses and averting reversal of progress in ending the epidemic.