The news: Gilead Sciences is doubling down on its commitment to provide new HIV prevention drugs at cost to low-income countries around the world. It will distribute lenacapavir, a twice-yearly injection to prevent HIV transmission, for two to three years as long as it gets approved by both the FDA and EMA, per Reuters.

In context: US and global HIV prevention programs are under fire in the new Trump administration, caught in budget cuts and anti-DEI efforts.

• A Trump executive order froze funding for the President’s Emergency Plan for AIDS Relief (PEPFAR) and USAID in January. Some HIV treatment funding was subsequently restored, but not for HIV prevention.
• The CDC provided $1 billion last year, more than 90% of federal funding for HIV prevention. The newly proposed HHS budget for 2026 doesn’t mention HIV but cuts all CDC healthcare prevention funding. The US also contributes 73% of the global funding for HIV prevention and treatment in low- and middle-income countries, per KFF.
• The Supreme Court is reviewing a case filed by a Christian-owned business in Texas disputing employee reimbursement for HIV preventative treatment, also known as pre-exposure prophylaxis (PrEP). The case challenges the Affordable Care Act’s provision that private insurance must cover preventative services without cost sharing. If the Court rules for the Texas business, it could end preventative care coverage.

Zooming out: About two-thirds (65%) of Americans are concerned about adequate funding for federal HIV prevention programs, per an April KFF survey about federal funding cuts.

But HIV prevention garnered less support than other funding, such as mental health and addiction programs (74% oppose cuts), tracking infectious disease outbreaks (71% oppose cuts), and medical research (69% oppose cuts).

Why it matters: Gilead’s pill Truvada was the first HIV PrEP drug approved in 2012. GSK’s ViiV Healthcare Apretude was the first long-acting injectable, approved in 2021.

HIV diagnosis rates in the US dropped 38% over the first 10 years of PrEP availability, per a recent study published in the Lancet. States with higher PrEP coverage had progressively larger declines in HIV diagnoses.