Special to IFN

RALEIGH — The N.C. Department of Health and Human Services is working with the NC AIDS Action Network to raise awareness about the important work underway to end the HIV epidemic in North Carolina. State leaders and advocates highlighted the progress that is at risk due to expected cuts at the federal level.

“Over the past few decades, we have made tremendous progress together toward the goal of eliminating HIV both globally and here in North Carolina,” said NCDHHS Secretary Dev Sangvai. “Sustained funding is essential, not only to prevent the spread of HIV but also to support the health and well-being of North Carolinians living with the virus. Cuts would reverse hard-won gains and increase long-term costs for our state.

“Now more than ever, we must renew our commitment to supporting people living with HIV and protecting the public health of our communities,” Sangvai added.

HIV, or human immunodeficiency virus, is a virus that attacks the body’s immune system. It’s often spread through sexual contact or sharing needles, syringes or other drug injection equipment. While there is currently no effective cure, those who receive HIV treatment can live long, healthy lives and will not transmit infection.

As of December 31, 2024, there were 38,634 people living with HIV in North Carolina with 1,385 people newly diagnosed with HIV last year. While it’s estimated that 85 percent of those living with HIV across the state are aware of their diagnosis, there are still thousands who are unaware.

Proposed budget cuts would decrease access to HIV testing, meaning more people would remain unaware of their status and be unable to take the actions needed to protect their own health and avoid further transmission.

For those living with HIV, care is prevention. People who receive treatment and are virally suppressed don’t transmit the disease.

The NCDHHS Division of Public Health conducts individualized outreach to people living with HIV and HIV care providers to improve access to supportive and culturally appropriate care. Additional efforts include reducing stigma associated with HIV care and testing, ensuring access to free testing options, and improving awareness and access to the range of tools that are now available to prevent the spread of HIV — including condoms and pre-exposure prophylaxis or “PrEP,” the medication that prevents HIV infection. Access to these prevention options that contribute to decreased potential for disease spread are threatened by budget cuts.

NCDHHS most recent award from the Health Resources Services Administration (HRSA) Ryan White Program, received in April, was approximately half of what had been awarded in previous years. Future funding is currently uncertain, and the proposed federal budget suggests no funding for HIV prevention activities.

If cuts proceed, impacts could include:

♦ An increase in HIV transmission due to decreasing investment in promising new HIV prevention methods (like long-acting PrEP), decreased access to care that prevents transmission, and increased time with undiagnosed disease.

♦ Increase in HIV transmissions because individualized outreach that helps people with HIV access care and helps exposed partners get testing will end.

♦ Decreased ability to detect outbreaks early and prevent tragic outcomes.

Cuts to this vital funding in North Carolina would be detrimental to all parts of the state, particularly in rural counties. Additionally, congressional proposals to reduce Medicaid funding and implement eligibility restrictions could jeopardize state public health infrastructure and infectious disease programs in North Carolina.

Medicaid is the single-largest provider of insurance coverage for people living with HIV. Eroding access to Medicaid coverage could result in increased HIV cases and deaths. In North Carolina, Medicaid Expansion has given many people with HIV access to comprehensive health care, some for the first time.