The federal government has cut $29.2 million from Texas health organizations that test people for HIV in their communities, ending a five-year grant that made Texas the program's largest state beneficiary.
The Texas Tribune reports that the Centers for Disease Control and Prevention allowed the PS21-2102 grant to expire on Sept. 30. Over those five years the money went to 11 community-based organizations, mostly in urban areas, for testing and prevention work delivered in the communities those groups already reach.
A Smaller Check, and No Requirement to Share It
The replacement is real. It is also a fraction of the old line. The CDC awarded the Texas Department of State Health Services more than $5.2 million in one-time funding through May 2027. The Tribune reports that almost a quarter of that award, $1.2 million, will flow to community-based organizations.
Stateline puts the state award at $5.24 million and says Texas health officials plan to send about 23%, or about $1.2 million, to those groups. Texas community organizations had been receiving more than $3 million a year directly from the CDC. One planned pass-through does not restore an annual grant that has already expired.
The structure changed with the dollar amount. The Trump administration replaced direct grants to community organizations with one-time awards to state and local health departments, and Stateline reports there is no requirement that those jurisdictions pass the money on. Departments were encouraged, not required, to send 10% to community groups. Texas is planning to clear that unofficial bar. Clearing it still leaves the groups well short of the more than $3 million a year they had been getting straight from the CDC.
KFF's analysis estimates that health departments would need to allocate 46% of the supplemental funding overall to community organizations to replace prior PS21-2102 funding levels. Texas is planning about 23% of a smaller, one-time check. Separately, KFF reports that on Sept. 3 the CDC allocated $91 million in supplemental funding to health departments, 24% below the $120 million that had been anticipated.
Houston's Diagnosis Numbers Did Not Shrink
The expired grant lands on a region that already records a heavy caseload. A 2024 epidemiologic supplement from Houston Health reports 1,413 new HIV diagnoses in the Houston Eligible Metropolitan Area in 2022, a 5% increase from 2021. At the end of 2022, 33,397 people were living with diagnosed HIV in that area, also 5% more than the year before.
The same supplement says the 2022 rate of new HIV diagnoses in Houston/Harris County was more than twice the U.S. rate. Statewide, 2024 data put Texas fifth in the nation for new HIV diagnoses per capita, the Tribune reports. Those are counts of diagnoses already recorded. They are not a prediction of what this funding change will do.
Outreach, a Mobile Unit, and Possible Layoffs
For Allies in Hope, the expired grant paid for work that is easy to describe and hard to replace on short notice. Starting in 2021 the organization received about $441,000 a year from PS21-2102 for prevention measures including outreach and a mobile unit, the Tribune reports. The grant covered more than a quarter of the 2,000 HIV tests the organization administers each year.
Stateline reports that Allies in Hope CEO Jeffrey Campbell expects that federal funding to be cut by $441,000, which could force the organization to lay off at least three staff members. That is his stated expectation, not a completed layoff. Whether other money turns up is still an open question.
In Austin, the same grant made up 30% of Vivent Health's HIV-prevention funding, according to the Tribune. Vivent's own statement says PS21-2102 supported more than 1,000 HIV tests through the organization in Austin over the past two years.
The Groups That Were Finding More Cases
The older testing record sits awkwardly next to a policy that moves the money toward health departments and then hopes some of it comes back. From 2012 to 2017, community-based organizations diagnosed a new case of HIV in 1.4% of CDC-funded tests, compared with 0.5% for CDC-funded tests administered by local health departments, the Tribune reports. In that comparison, the community groups' positivity rate was nearly three times as high.
The one-time state award runs through May 2027. Between now and then, the practical question for the 11 Texas organizations is not whether a replacement check exists. It is whether about $1.2 million, carved from a little more than $5.2 million, can stand in for more than $3 million a year.
