Trump quietly purges presidential HIV advisory council, sparking public health fears
HIV advocates and public health experts are raising alarms after the Trumpadministration moved to remove all members of the Presidential Advisory Council on HIV and AIDS — a group that for three decades has provided critical guidance on federal HIV prevention, treatment, and care policy.
The decision, first reported by Reuters, comes amid sweeping cuts at the Department of Health and Human Services under Health Secretary Robert F. Kennedy Jr., including layoffs of 10,000 federal health employees and the closure of half of HHS’s regional offices. The Trump administration eliminated several offices within HHS dedicated to infectious disease prevention, and the U.S. Centers for Disease Control and Prevention has cut five branches of its HIV prevention division, affecting about 150 staff.
The removal of PACHA members comes at a time when HIV remains a significant public health challenge in the U.S., particularly for Black and Latine Americans, gay and bisexual men, and people living in the South.
About 1.2 million people in the U.S. are living with HIV, and roughly 13 percent of them don’t know their status, according to HIV.gov. In 2022 alone, an estimated 31,800 people in the U.S. acquired HIV. Nearly 70 percent of new infections were among Black and Latine people, and the South accounted for roughly half of all new cases.
This shift comes after the Biden-Harris administration had significantly expanded the federal government’s HIV response. In 2024, the White House highlighted a 12 percent decrease in new HIV infections nationwide from 2018 to 2022, driven in part by a 30 percent decrease among people ages 13 to 24. Federal efforts also led to a 16 percent decline in new infections in the South during the same period — a region long hit hardest by the epidemic. The administration also proposed a $9.8 billion National PrEP Program to expand access to HIV prevention medications for uninsured and underinsured individuals.
Now, HIV advocates fear that progress could stall — or reverse.
Current PACHA members told The Advocate they had not received formal notice of their removal but learned of the administration’s plans through media reports.
“My initial reactions are sad and disappointed,” said Dr. Philip Chan, a PACHA member and infectious disease physician at Brown University. “PACHA has been vital to advising HHS on the HIV response here in the U.S. It was great to be able to address HIV care and prevention issues at the national level — and I think just sad to no longer be part of that group.”
Chan told The Advocate that beyond the removal of PACHA members, the administration’s broader cuts to HIV prevention programs and research are deeply concerning. He said the administration recently canceled two of his NIH research grants — including one focused on HIV prevention among Black gay men.
He described a recent patient encounter that illustrates the real-world impact of what’s at stake. Chan said he recently had to deliver an HIV diagnosis to a Black gay man in Rhode Island who had previously been taking PrEP but lost access to the medication after losing his health insurance. In the short time he was off PrEP, the patient contracted HIV.
“It breaks my heart that we’re still seeing preventable HIV cases,” Chan said. “We have all the tools to end HIV. It just makes me sad to see a lot of this infrastructure being systematically dismantled across the country.”
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Dr. Jirair Ratevosian, a current PACHA member and associate research scientist at the Yale School of Nursing, echoed those concerns, telling The Advocate the move risks sidelining science and community voices at a critical time.
“Every member of this PACHA accepted the call to serve with a deep commitment to improving the health and well-being of all Americans — especially the communities affected by HIV,” Ratevosian said. “Disrupting this work risks sidelining science and community voices at a critical moment in the fight to end the epidemic, both in the U.S. and globally. There remains a readiness to work in partnership with this administration to ensure that progress is not lost.”
Adrian Shanker, a former PACHA member and former deputy assistant secretary for health policy in the Biden administration, said that removing the council members is “devastating.” He explained that while PACHA members serve at the pleasure of the HHS secretary, the council’s charter allows members to serve up to four years — with flexibility for the secretary to divide that into terms of varying lengths, such as two two-year terms or a three-year term followed by a one-year renewal.
“PACHA is not a partisan council — its members are scientists, prevention advocates, and people living with HIV,” Shanker said. “It would have been wise for the administration to talk to PACHA before making such drastic and dangerous decisions.”
Carl Schmid, executive director of the HIV+Hepatitis Policy Institute and a former PACHA co-chair, said he wasn’t surprised by the removal of PACHA members.
“The real question is how quickly will they appoint new members and who will they be?” Schmid said.
Schmid said he is concerned about the broader direction the administration is taking on HIV policy.
“So far, this administration has moved quickly in decimating many parts of our nation’s HIV response, and we are afraid that there will be more cuts on the way,” Schmid told The Advocate. “We understand they will be forming an HIV component of the new administration for a Healthy America that will combine HIV prevention and treatment programs. In doing so, they must reiterate a commitment to ending HIV and provide the proper leadership, funding, and community input — including a new PACHA.”
HHS did not respond to The Advocate’s request for comment. However, a spokesperson for the agency told Reuters that removing PACHA members is common practice when a new administration takes office. The spokesperson added that HHS intends to continue receiving advice and recommendations on HIV policy and said the administration believes a new streamlined structure will be better positioned to address the epidemic.
The shake-up comes as the Trump administration is also reportedly preparing to eliminate all federal funding for domestic HIV prevention programs — a move experts have described as “catastrophic” and potentially devastating for public health. As The Advocate previously reported, the plan shutters the CDC’s HIV prevention division entirely and halts federally funded prevention efforts across the country, undoing decades of progress and leaving uninsured and marginalized communities without access to testing, PrEP, and lifesaving care.
During Trump’s first term, the administration launched the Ending the HIV Epidemic initiative, which contributed to a 12 percent decrease in new HIV infections between 2018 and 2022, according to HHS data. However, advocates fear that the latest actions could undo that progress.
“We are getting so close to ending the epidemic,” Chan said. “It would be sad to see us take a step back here when we’ve had so much good momentum and progress.”