Consequences of United States funding suspensions on community-led HIV services in Latin America and the Caribbean: findings of a rapid service provider survey.

INTRODUCTION

Foreign aid provided by the United States government (USG), including support for HIV services, has been suspended or dismantled since January 2025. Early research and modelling projections have suggested significant impacts globally and in sub-Saharan Africa. We aimed to evaluate the consequences of USG funding suspensions on community-led HIV services in Latin America and the Caribbean (LAC).

METHODS

We surveyed community-led organizations providing HIV services in LAC in February-March 2025. Organization leaders were recruited through a network of HIV service organizations. Survey items measured USG funding (past 12 months) and funding sources; experiences of funding suspensions; and programmes, beneficiaries and workforce affected by funding suspensions.

RESULTS

Of 40 respondent organizations, 24 (60%) had received USG funding in the past 12 months. Of the 24, 21 (87%) organizations representing 10 countries reported that they had experienced a funding suspension. These included direct and indirect funding from PEPFAR (62%), USAID (48%) and, less frequently, other USG agencies. Programmes most frequently affected by the funding freeze included sexual prevention programmes, HIV testing services, psychosocial support and humanitarian services. An estimated 156,164 beneficiaries had been receiving HIV services across respondent organizations that were affected by funding suspensions. Populations commonly served included (but were not limited to) people living with HIV, transgender people, people engaged in sex work, men who have sex with men, migrant populations and women.

CONCLUSIONS

LAC HIV programmes have had comparatively less reliance on USG funding than other regions; however, they are still likely to be significantly affected by funding suspensions and the dismantling of USAID. Achievement of global HIV goals in LAC will require support from government and foreign donors, as well as collaboration with pharmaceutical companies to ensure access to biomedical HIV prevention and treatment.