Tennessee says it is cutting federal HIV funding. Will other states follow?

Tennessee health officials say they will reject federal funding for groups that provide services to residents living with HIV.

Earlier this week, the Tennessee Department of Health announced that it would no longer accept Centers for Disease Control and Prevention grants for HIV testing, prevention and treatment.

In an email reviewed by NBC News, the Department of Health told some nonprofits that provide these services that the state would withhold federal funding beginning in June, relying only on funds from the state thereafter. “It is in the interest of Tennesseans that the state assume a direct financial and managerial response for these services,” the email read.

When contacted by NBC News, a Department of Health spokesperson said “the letter speaks for itself.”

An estimated 20,000 people in Tennessee are living with HIV, although not all are affected by the cuts. There was no further indication of how the state planned to fund these programs itself.

This decision stunned HIV experts.

“I don’t understand why the state would return funds intended for health care,” said Diane Duke, president and CEO of Friends for Life, a Memphis-based group that provides services to people living with HIV. Friends for Life was among the groups that received a notice from the state. “It’s outrageous,” she said.

Shelby County, where Memphis is located, is among the counties in the country with the highest rates of HIV and AIDS. In 2020, 819 of Shelby County residents out of 100,000 were HIV-positive, according to the Centers for Disease Control and Prevention.

And those were just the people who had received an official diagnosis.

“A lot of people are walking around with HIV, and they don’t even realize it,” Duke said. Providing virus testing is an important part of the work done by Friends for Life. “Once someone has tested positive, we are able to take care of them immediately,” she said.

Greg Millett, director of public policy at advocacy group amfAR, the Foundation for AIDS Research, called the decision “devastating”. He fears Tennessee health officials are setting a dangerous precedent.

“If other states follow suit,” Millett said, “we’re going to be in trouble.”

Millet said the CDC is providing Tennessee with up to $10 million in HIV funding. It’s still unclear how much of that money will be denied.

He said he feared the state directive could lead to discrimination against marginalized groups most at risk of contracting HIV.

“The overwhelming majority of new HIV cases are among gay and bisexual men, transgender populations, heterosexual women, as well as people who inject drugs,” he said.

“We have the tools to end the HIV/AIDS epidemic in terms of prevention and care,” Millett said. “If Tennessee doesn’t use these tools, doesn’t use CDC funding, and doesn’t focus on groups most at risk for HIV, we have the possibility of an epidemic.”

The CDC provides millions of dollars each year to states for HIV test kits, condoms and drugs to prevent infection, called PrEP.

In a statement provided to NBC News on Friday, the CDC said it was unaware that Tennessee — or any other state — planned to stop accepting grant money.

“We have not received any official notification from the Tennessee Department of Health withdrawing CDC HIV prevention funding,” the CDC said. Without such notice, the CDC will automatically continue payments to the state.

The federal agency also said it would “certainly be concerned if the services that Tennessee residents need to stay healthy were interrupted or if public health’s ability to respond to HIV epidemics and end the this epidemic was hampered”.

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