By: Thiago Peniche, Luciana Kamel and Kris Herik de Oliveira
The President's Emergency Plan for AIDS Relief (PEPFAR) is a United States government initiative to respond to the global HIV/AIDS epidemic, focusing on prevention, treatment, and support for those affected. Launched in 2003 through PEPFAR, the U.S. government has invested more than $110 billion in the global HIV/AIDS response, the largest commitment by any nation to address a single disease in history. The initiative has helped save an estimated 26 million lives, prevented millions of HIV infections, and accelerated progress toward controlling the epidemic in more than 50 countries.
In January 2025, then-US President Donald Trump announced the cessation of funding for HIV programs, including PEPFAR. The interruption of PEPFAR funding resulted in the suspension and reduction of essential programs in South America. The measure affected research, distribution of antiretrovirals, testing, psychological support, among other actions and services, putting the lives of more than 30 million people at risk, mainly immigrants, refugees and LGBTQIAPN+ populations.
In light of this scenario of reduced international funding for the response to HIV/AIDS, PrEP South America mapped the impacts resulting from cuts to the PEPFAR program in South American countries. Below, we present a summary of the main repercussions observed in the region, as well as a selection of recently published reports and analyses on the topic.
Image: Thiago Peniche/Prep América do Sul
Brazil: impact on local projects, but not on the SUS
In Brazil, the Unified Health System (SUS) guarantees universal, free and uninterrupted access to HIV diagnosis, prevention and treatment. Therefore, the national response to the epidemic was not directly affected by PEPFAR cuts. However, local projects that worked in partnership with the program suffered significant impacts.
An example is the project “A Hora é Agora”, funded with PEPFAR resources and developed in four capitals – Porto Alegre, Curitiba, Florianópolis and Campo Grande. The project offered medical care, testing, distribution of antiretrovirals and PrEP, in addition to other public health services aimed especially at vulnerable populations. With the end of funding, the project he was locked up.
According to the State Secretary of Health of Rio Grande do Sul, the users of the project are redirected to other reference services, but without the same capacity of care, which compromises the prevention and treatment of HIV among the most vulnerable groups. Em Santa Catarina, five infectious disease specialists, three nurses and two pharmacists have been separated from their service positions and will lose their contracts.
The courts also affected initiatives that were not directly linked to health, but rather depended on supporters funded by PEPFAR. TO NGO Trans Vida, for example, had to suspend its free services for transgender people about legally changing their names and gender markers on their documents.
Colombia, Peru and Venezuela: demisses and risks for migrants and refugees
In Colombia, the cuts affected approximately 4,000 migrants and refugees – a group that already faces an HIV prevalence twice that of the general population. Without PEPFAR funding, the country’s ability to include these individuals in the health system has been compromised.
According to UNAIDS (the UN agency that coordinates the global response to the HIV/AIDS epidemic), a community organization that offered assistance to immigrants and LGBTQ+ people living with HIV had to terminate contracts of 40 of its 70 professionals, reducing its capacity to provide care.
Venezuelan migrants also face increasing difficulties in accessing medicines. The NGO Red Somos, for example, which is the main supplier of medicines for this population, has had to had to withhold 3,000 units of medicines antiretrovirals, as it is not yet authorized to distribute them. As a result, hundreds of people were left without treatment.
In Peru, the suspension of funding has directly affected the distribution of prevention supplies, such as condoms, and disrupted access to PrEP for young women, sex workers, men who have sex with men, and trans people. It has also weakened essential community services, such as counseling, treatment adherence support, and peer-led prevention efforts. Immigrants and refugees—already vulnerable in accessing the health system—are among those most affected.
Impacts of cuts in scientific production on HIV
PEPFAR cuts have also affected scientific research on HIV and public health. The Trump administration has banned the use of terms such as “gender,” “transgender,” “LGBT,” and “vulnerable” in scientific papers, which restricts research on populations most affected by the HIV epidemic. According to Infobae, more than 30 studies in areas such as HIV, child nutrition, and cancer have been halted, including in South American countries such as Peru and Chile.
See below the impact of PEPFAR cuts in South America in detail:
Trump's humanitarian aid cuts could cause HIV fight to collapse | Source: Viva Bem | Language: Portuguese | Brazilian activists and experts warn of the risk of collapse in the fight against HIV, especially in developing countries, and call for urgent international mobilization to reverse the measure and rethink sustainable models of global health financing. Read more here.
The critical impact of freezing PEPFAR funds for HIV in Latin America and the Caribbean | Source: UNAIDS | Language: Spanish | The freeze on U.S. funding, including PEPFAR, has severely impacted the HIV response in Latin America and the Caribbean. More than 20 countries that rely on this aid are facing disruptions to treatment and prevention services, especially those targeting marginalized communities. Read more here.
After Trump's cut, project for HIV patients has services suspended in Porto Alegre | Source: G1 | Language: Portuguese | Services under the “Now is the Time” program were suspended in Porto Alegre after the US government cut funding. Funded by PEPFAR, the project offered HIV testing and monitoring in partnership with Fiocruz and the CDC. Read more here.
Clarification Note – Discontinuation of the civil name and gender rectification service | Source: Trans Vida | Language: Portuguese | The organization TRANS VIDA reported that, due to changes in Trump administration policies, its main sponsor, “Race and Equality”, has suffered restrictions that directly impacted its services. As a result, the organization will no longer be able to offer services of changing the name and the gender marker in documents of transgender people.. Read more here.
Colombia: USAID Suspension cuts off lifesaving HIV medications for migrants | Source: HIV Justice Network | Language: English | Venezuelan migrants with HIV in Colombia face serious risks after Donald Trump suspended USAID funding. The NGO Red Somos, the main supplier of medicines for this population, was prevented from distributing 3,000 vials of antiretrovirals, especially affecting 350 undocumented migrants, 104 of whom are in an advanced stage of the disease. Without valid documentation, they do not have access to the Colombian health system. Read more here.
Impact of US funding freeze on HIV programmes in Peru | Source: UNAIDS | Language: English | Disruptions include the distribution of condoms and prevention supplies, and restrictions on access to PrEP for young women, sex workers, men who have sex with men (MSM) and transgender people. There has also been a reduction in testing and counseling for vulnerable groups, such as people who inject drugs and people in prison. Read more here.
The devastating impact of the Trump administration on global health and science: how does it affect Peru? | Source: Infobae | Language: Spanish | The US withdrawal from the WHO and the closure of programs such as PEPFAR, USAID, NIH and CDC during the Trump administration have crippled global health funding. This has affected research, eliminated health alerts and shut down websites with essential information. In Peru, thousands of people have been left without access to treatment and disease prevention measures. Read more here.
Trump halts distribution of anti-HIV drugs in poor countries | Source: Globo | Language: Portuguese | The Trump administration has instructed organizations in other countries to stop distributing HIV drugs purchased with U.S. aid, even if the drugs have already been obtained and are in local clinics. Read more here.
A bold step in the fight against AIDS | Source: OUTRASAUDE | Language: Portuguese | With the suspension of PEPFAR, 21 Testing and Counseling Centers (CTA), 16 specialized services and primary care support actions are at risk of being discontinued, compromising goals for eliminating HIV/AIDS as a public health problem. Read more here.
As Fellow Pro-Lifers, We Are Begging Marco Rubio to Save Foreign Aid | Source: New York Times | Language: English | The Trump administration’s temporary funding cut to the President’s Emergency Plan for AIDS Relief (PEPFAR) program has directly impacted global efforts to prevent mother-to-child transmission of HIV, one of the greatest public health victories in decades. Read more here.
How US funding suspension impacts program for people with HIV in SC | Source: NSC TOTAL | Language: Portuguese | Five infectious disease specialists, eight nurses and two pharmacists were dismissed from their posts and lost their contracts, suspending the program's activities in early February. Read more here.
Trump's decision affects HIV treatment in Florianópolis: 'Global threat' | Source: NDMAIS | Language: Portuguese | Florianópolis was one of the capitals covered by the “A Hora é Agora” program. The city government is studying measures to continue guaranteeing HIV treatment after the end of the program. Read more here.
Trump's cuts affect program that serves AIDS patients in Curitiba | Source: Bem Paraná | Language: Portuguese | The City of Curitiba announced that it will take over the care of AIDS patients who were previously treated by “A Hora é Agora”. As a result, they will be welcomed and treated by professionals from the department. Read more here.
English 
Portuguese 
Spanish