HIV Education and Advocacy in an Age of Uncertainty
Joseph Cherabie MD, MSc, explains the importance of how these 2 components go hand-in-hand, and what it means to continue forward in spite of being in an unpredictable time.
Federal clinical research funding freezes being carried out by the Trump Administration are affecting the HIV specialty. This means research looking at everything from HIV vaccines to new treatments to PrEP remains paused without any timeline for when the funding might resume again. These freezes may also influence HIV prevention and clinical care, which has been an ongoing topic of discussion, particularly this week at CROI 2025, held March 9-12, in San Francisco, California.
With concerns around these latter elements, the US Business Action to End HIV, the largest coalition of employers dedicated to ending the HIV epidemic in the United States, sent a letter in late February to Congress urging them to prioritize sustained federal funding for HIV prevention and treatment and underscoring the business sector’s commitment to advancing public health and ensuring progress in the fight against HIV.
The letter warns that funding freezes and grant delays could threaten hard-won progress, reversing declines in new HIV infections and exacerbating health disparities. Business leaders are calling on Congress to maintain investments in HIV research, prevention, and access to care.
Separately, there is a case around preventative services and testing related to HIV going to be heard by the Supreme Court next month. This court case originated in 2023 when 6 Christian-owned businesses in Texas challenged the Affordable Care Act’s (ACA) preventive services requirement, arguing that the PrEP coverage requirement violated their religious rights. A couple of weeks ago, 20 HIV and hepatitis organizations filed an amicus brief with the Supreme Court in support of the US government’s position in the case, Kennedy v. Braidwood Management.1
The preventative services coverage requires private insurers to include a range of testing, including HIV and hepatitis B and C, as well as preventative offerings, including PrEP for HIV and vaccinations for hepatitis A and B, and counseling for sexually transmitted infection prevention.2
“We currently are living through a time of massive uncertainty, right? We are seeing all of these changes come every single day. We're seeing different executive orders, different limitations, different restrictions with respect to funding,” said Joseph Cherabie, MD, MSc, medical director of the St. Louis STI/HIV prevention Training Center, and the medical director of the WashU PrEP Clinic. “On the global health scale, we're seeing issues with PEPFAR and USAID. On the local scale, people are unsure what can continue forward, and we're seeing this erasure of communities that are largely some of the most affected by HIV—like our transgender community, LGBTQIA + individuals. And so with this targeting and this fear and this uncertainty that's occurring, I think it is creating this kind of stasis. We're all are just sitting here thinking, what’s next? How can I continue to best take care of my patients, even at a basic level?"
At its cornerstone, HIV education and advocacy go hand-in-hand, and even in uncertain times, they can still forge a way forward explains Cherabie.
“Medical education is one of the most important fields in which continued advocacy for our patients living with HIV can take place,” Cherabie said. We know what this looked like in the 80s and 90s…And if we go back to that, it's history just repeating itself. But we need to look back. We need to remember where this movement started. We need to remember how far we've come, how far we still have to go, and it starts with the newest generation of healthcare providers across all specialties, across all different forms of healthcare education. I think medical education is where we have to start from the ground up to rebuild this house, to make sure we have a solid foundation moving forward.”
