The U.S. Department of Health and Human Services (HHS) is making changes to how federal funds for HIV/AIDS are used. This comes after concerns that money meant for HIV treatment was being spent on gender-affirming care, a practice that was allowed during President Biden’s time in office.
Under the previous administration, federal funding was used by some states to cover costs related to transgender surgeries and hormone therapies. For instance, the Ryan White HIV/AIDS Drug Assistance Program had been providing access to gender-affirming hormone therapy.
In April, HHS announced its intention to prevent these funds from being misused and is now taking further steps to clarify this policy. Tom Engels, the administrator of the Health Resources and Services Administration (HRSA), stated that the Ryan White Program is crucial for many Americans living with HIV. He emphasized that funds should only support HIV-related treatments, not procedures aimed at changing sex traits.
HHS is set to release a new “Notice of Funding Opportunity” that will specify that the AIDS Drug Assistance Program (ADAP) Emergency Relief Funds can only be used for HIV/AIDS treatments. Hormones may be covered if they are necessary for HIV care, but not if they are intended for sex-trait modification.
The department has also raised concerns about how some states were using these funds. For example, the District of Columbia’s AIDS Drug Assistance Program was openly covering transgender hormone treatments, raising questions about whether federal drug rebate funds were being redirected for unrelated health services.
In New Jersey, the Department of Medicine at Rutgers University has been offering gender-affirming hormone therapy as part of a broader wellness approach, which has been criticized in light of the new funding rules.
The updated notice from HHS will remind states that any therapeutics funded under the ADAP must be used solely to treat HIV/AIDS or to prevent serious health deterioration due to the virus. This means that if a state provides hormone therapy, it must be for HIV-related reasons, not for gender transition.
HHS is reinforcing that all drug rebates from the ADAP must be used for HIV/AIDS activities and cannot be diverted for other purposes, including sex-trait modification. This move aims to ensure that funding is used appropriately and effectively to support those living with HIV.
