Lindsey Dawson, a leading voice on HIV policy at KFF, has raised concerns that stagnant federal funding and persistent stigma are weakening the United States’ response to HIV, particularly among underserved populations.
Speaking during a recent appearance on the Health IQ programme, Dawson said public perception often treats HIV as a crisis of the past, despite evidence showing it remains a pressing public health issue.
HIV remains a current and evolving challenge
According to Dawson, more people are living with HIV in the United States today than ever before. Advances in treatment have significantly improved life expectancy, enabling those diagnosed to live longer, healthier lives. However, new infections continue to occur at a steady rate, contributing to a growing overall population of people living with the virus.
She noted that approximately 1.2 million Americans are currently living with HIV, with disproportionate impacts on communities of colour, as well as gay and bisexual populations.
Funding gaps strain care systems
Dawson highlighted that federal investment in HIV programmes has remained largely unchanged for over a decade. Funding for state AIDS Drug Assistance Programs under the Ryan White HIV/AIDS Program has not increased since 2014. When adjusted for inflation, she said, current funding levels have the equivalent purchasing power of the late 1990s.
This stagnation comes amid rising drug costs, increased enrolment, and evolving standards of care, placing significant pressure on state-level programmes. As a result, healthcare providers and administrators are being forced to make difficult decisions about maintaining essential services.
Black women face disproportionate risks
Dawson emphasised that disparities remain a critical concern, particularly for Black women, who face higher risks of HIV infection but often have lower awareness and access to preventive care.
While preventive treatments such as Pre-Exposure Prophylaxis (PrEP) are widely available and typically covered by insurance, uptake has been uneven. Dawson noted that usage rates are significantly higher among white gay men compared to women and people of colour.
She attributed the gap to factors including stigma, limited patient-provider communication, and insufficient awareness among healthcare professionals about prescribing preventive treatments.
New prevention tools offer hope
Among recent developments, Dawson pointed to the approval of a long-acting injectable form of PrEP as a potentially transformative step in HIV prevention. The drug, lenacapavir, administered twice yearly, could improve adherence among individuals who struggle with daily medication routines.
Call for awareness and community engagement
While refraining from specific policy prescriptions, Dawson underscored the importance of increasing awareness at all levels from community leaders to policymakers. She stressed that HIV prevention and treatment efforts must be integrated into everyday spaces, particularly those frequented by young people.
HIV is preventable and treatable, she noted, adding that individuals who achieve an undetectable viral load through treatment cannot transmit the virus. Communicating this message clearly and without stigma, she said, remains one of the most effective tools in combating the epidemic.
As health experts continue to highlight gaps in funding and access, Dawson’s remarks reinforce the need for renewed attention to both policy and community driven solutions in addressing HIV across the United States.
