Impact of Trump’s HIV Medication Ban

On Monday, January 20, 2025, President Donald Trump signed a flurry of Executive Orders, hours after his swearing-in as the 47th president of the United States. One of the Executive Orders he signed was titled, “Reevaluating and Realigning United States Foreign Aid”.

Section 3a of the order directed a “90-day pause in United States foreign development assistance”. By Friday, January 24, the State Department issued a cable that enforced the order. That effectively halted the action of all United States-funded programs around the world including the President’s Emergency Plan for AIDS Relief (PEPFAR)—established by former President George W. Bush.

According to multiple reports, the ban also halts the supply of lifesaving medications for HIV, malaria, tuberculosis, and newborn care in countries formerly supported by the United States Agency for International Development (USAID).

Although Secretary of State Marco Rubio announced a waiver for essential medicines and medical services on Tuesday, January 28, 2025, it is unclear if it will extend to HIV preventive medications. Meanwhile, PEPFAR’s future remains uncertain, along with the well-being of over 20 million people who depend on its support. The potential consequences of this decision for the Black community continue to unfold.

The potential impact of Trump’s ban on the Black Community

It is estimated that 1.2 million people are living with HIV in the United States and people in Black community make up 40% of that number. It has long been proven that HIV disproportionately affects our community for several reasons.

The majority of Black adults living with HIV in the United States and elsewhere depend on the free or subsidized treatment offered by United States-funded NGOs to live healthier lives—and also reduce their risk of transferring the disease to others.

With Trump’s executive order cutting funding to NGOs like PEPFAR, people living with HIV will have no option but to pay for the not-too-affordable treatment. Considering the fact that many Black adults are living with underlying health conditions, this can stretch their medical expenses beyond their means.

In poorer countries, this can be a serious issue for both the people living with HIV and the rest of the population who will now be at a greater risk of contracting the virus from those who have it.

The cost of HIV treatment without subsidy

Without government subsidy, the real cost of treating HIV can run between $1,800 to $4.500 monthly, according to one study. Truvada, the antiretroviral therapy (ART) medication taken to suppress the viral load below the infectious level, can cost as much as $1,700 for a 30-day supply. Sadly, this monthly expenditure will continue through the patient’s lifetime.

Although there are cheaper options like Epivir which costs around $400 for a 30-day supply, it can still be a lot for patients who are not under insurance cover. The burden of paying for HIV treatment will become clearer when you consider the lower earnings of adults in most Black communities.

Since the 1970s, white people in the United States have persistently earned more on average compared to Black adults. For example, the median income of white people in 2023 was $69,070 while that of Blacks was $51,960.

In most African countries, the minimum wage cannot afford a person living with HIV a 30-day supply of the most affordable HIV medication. For example, Nigeria—which has the largest population of Black people—has a minimum wage that is below $50 a month.

What people exposed to or living with HIV should do

The Trump administration’s ban on HIV treatment funds is likely to cause anxiety for those living with the disease. If you have recently been exposed to HIV or are currently receiving treatment, there are ways to mitigate the potential financial burden stemming from funding cuts. One of the following options will help you to sustain your treatment.

1. Get an insurance cover

Enrolling with public or private insurance that covers HIV treatment will help cut down your expenses. In the United States, Medicaid and Medicare cover PrEP, an important drug that can lower your risk of contracting the virus.

2. Patient assistance programs (PAPs)

Uninsured patients or those whose insurance doesn’t cover HIV treatment can leverage PAPs to get post-exposure prophylaxis under the uncertain Trump administration. Some pharmaceutical companies offer PAPs and help patients access the medication they need at lower or no costs.

3. Ryan White HIV/AIDs Program

This program is primarily designed to provide care for people living with HIV. The program offers medication and essential support services for low-income people. Many families in our community will qualify for the program.

4. Support network

People in Black communities facing uncertain times can fall back on their support network for emotional, physical, and financial support. Unsure of how to find the right support network for you? Check our publication titled, “Finding a Support Network after an HIV Diagnosis”.

If you are HIV-negative, it is important that you step up efforts to protect yourself from getting the disease. Elevate Black Health has a publication titled, “Revisiting HIV/AIDS Prevention in Black Community” which highlights ways to protect yourself from getting the disease.

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