As federal funding for HIV prevention and treatment programs becomes less certain, the number of people newly diagnosed with the virus in the Kansas City region is trending up.
Provisional data from the Kansas City Health Department show that an 11-county region in Missouri and Kansas saw 227 new cases in 2024, up from 206 the previous year.
Sean Ryan, who oversees the department’s HIV programs, said this is the second year the number of new cases in the region has climbed.
The upward trend, which holds true nationally, can be traced in part to the COVID pandemic, when HIV testing and prevention programs went temporarily dormant, he said. Fewer people were screened, and since HIV symptoms can take years to show up, more people likely spread the virus unknowingly.
“We are seeing a bit of catch-up from those years and the (prevention) efforts that we lost,” Ryan said.
The gap in testing during the pandemic and the subsequent rise in new cases is an example of what could happen if federal funding wanes and HIV suppression work subsides.
The Trump administration’s One Big Beautiful Bill Act, a massive budget bill now making its way through Congress, could reduce existing HIV funding. And cuts to Medicaid and the elimination of tax credits for supporting the Affordable Care Act marketplace could leave 16 million people uninsured, another blow to maintaining HIV treatment and prevention efforts.
“It stresses the importance of having continued services without a gap,” Ryan said, “because the second you step back from these services, people are going to miss critical testing, they’re not going to know their status and they’re going to be out in the community continuing to spread the disease.”
Reduction in HIV funding
The first Trump administration, building on work started during the Obama administration, emphasized reducing new HIV infections, launching the Ending the HIV Epidemic Initiative (EHE) in 2019. The initiative’s stated goal was a 75% reduction in new infections in five years, and a 90% reduction in 10 years.
In 2022, the Centers for Disease Control and Prevention reported 37,981 HIV diagnoses in the United States. In 2023, the number reached 39,201. Men, Black people and people living in the South were most affected.
Congress allocated $267 million to multiple federal agencies for the EHE initiative in the 2019 fiscal year. That went up to $573.3 million in 2024. With the additional funds, total HIV prevention spending allocated just to the CDC climbed from $788.7 million in the 2019 fiscal year to $1 billion last year.
Designated “priority jurisdictions,” including Missouri, which had a substantial number of cases, received the bulk of the added federal funding.
The current Trump administration has not committed to continuing the effort. It has already delayed or terminated existing grants, closed government offices focused on HIV and moved to end research. And it appears poised to reduce future spending on key HIV programs.
The Kansas City Health Department has used federal grant funding it has received for outreach education and testing in nonclinical settings, like at bars or festivals. The health department administered 70 HIV tests at a recent Juneteenth celebration, for example.
And on June 27 — National HIV Testing Day — the health department will provide free testing at the Walgreens at 3845 Broadway Blvd. Other Walgreens locations will also offer testing that day.
Some people don’t feel comfortable going to a traditional health care setting for testing, or they don’t have access, Ryan said. That’s why taking the health department’s mobile clinic into the community to meet people where they already are is important.
At its recent “Health on the Block” event at Central High School, the health department administered 32 tests for HIV, gonorrhea, syphilis and chlamydia, all sexually transmitted infections. The result was four positive results.
“That’s a huge return on investment,” Ryan said.
Grant already delayed, causing uncertainty
Federal funds also help pay for some of the 750,000 condoms the health department distributes annually; for other harm reduction materials; and for support services to help HIV patients find out where to obtain Pre-Exposure Prophylaxis (PrEP), a medication that people can take to prevent an HIV infection.
“PrEP navigators,” the health department staff who connect people to PrEP, also help patients understand whether they have health insurance to cover the cost of the treatment and other options for paying for it if they don’t.
Currently, the health department refers patients to other health clinics for PrEP prescriptions. But the department hopes to provide the service directly to patients by the end of the year. The city is funding that effort through general funds, Ryan said.
Other important work that the health department does that relies at least partially on federal funds involves HIV surveillance — encouraging HIV-positive patients to get treatment and stay in treatment. And surveillance work involves notifying people who might have been exposed to the virus.
Last year, Missouri’s Department of Health and Senior Services received $5.66 million through a CDC grant program known as the High-Impact HIV Prevention and Surveillance Programs for Health Departments. That was just one of the federal grants the state relies on.
Second-year funding of the grant, which was expected in June, had not come through midway through the month. So on June 17 the state agency told health departments, including Kansas City’s, and health clinics, including KC Care Clinic, to pause work. Funds from the grant they had been counting on would not be available, the state said, so reimbursements from the state would not be possible. That changed June 26, Ryan said, when the state notified the health department that funding had finally come through.
Without federal support, Ryan said, the work his division of the health department has been doing to try to slow the increase in new HIV cases would be impaired.
“We as the city and the health department will have to determine what services we want to continue” if funding is reduced, he said.
This story was originally published by The Beacon, a fellow member of the KC Media Collective.
