Funding cuts, discrimination, and workforce strain are doing significant harm to HIV prevention and care, and they threaten to undo three decades of progress, according to the HealthHIV State of HIV Prevention and Care™ Eighth National Survey Report.
2026 marks the first year the survey asked providers, people with HIV, and PrEP users to describe what the state of HIV care is for them. More than four in five providers say the policy changes since January 2025 have affected their ability to provide or sustain services. People with HIV and PrEP users detail how services that facilitate their access to prevention and care, including transportation, housing support, telehealth, and community outreach, are being cut, the very ones that help them stay engaged in care.
The survey addresses HIV prevention, care, and treatment from the vantage of the audiences surveyed:
- HIV clinical and service providers
- People with HIV
- Prospective, current, and past PrEP users
Its topics trace where the pressure is building: PrEP awareness, access, and long-acting options such as injectables and lenacapavir; treatment and care integration, from rapid start to single-tablet regimens and HIV in primary care; retention, adherence, and care coordination; coverage and cost, from payer mix to income-linked gaps and funding disruptions; provider burnout, threats and harassment, and intent to stay; and stigma, discrimination, mental health, and stress. Survey findings are detailed across five domains:
- HIV Prevention covered PrEP awareness, access, and cost among prospective, current, and past PrEP users; long-acting options, including injectables and lenacapavir; and viral suppression among people in care.
- HIV Treatment and Comorbidities examined ART and rapid start, single-tablet regimens, polypharmacy, retention and adherence, co-infection screening, vaccines, and HIV in primary care.
- Behavioral Health focused on everyday discrimination, HIV and PrEP stigma, mental health and stress, and the legal and law-enforcement worries that deter testing and care.
- Access addressed coverage and cost across private insurance, RWHAP/ADAP, Medicare, and Medicaid; income-linked gaps; care coordination; telehealth; and funding disruptions.
- Workforce assessed issues around burnout and emotional exhaustion, threats and harassment, training needs, and intent to stay in the field.
