Service disruptions and stockouts: Ongoing impacts of U.S. funding freezes on HIV care across clinics in 38 low- and middle-income countries in late 2025

Following the freeze of U.S. foreign assistance in January 2025, researchers conducted a survey among clinics in 38 low- and middle-income countries to assess the impact on HIV care provision. The survey was conducted from August to December 2025 and received 158 responses from various healthcare facilities including health centers, hospitals, and specialized HIV clinics. Overall, 81 percent of respondents reported disruptions in at least one HIV service since January 2025 due to changes in U.S. foreign assistance. The largest disruptions were reported in pre-exposure prophylaxis (67 percent), HIV testing (63 percent), patient tracing (67 percent), and adherence support (63 percent). Disruptions were more prevalent in PEPFAR-supported countries and were often not fully resolved at the time of the survey. The research also revealed negative impacts on patient trust in the health system and staff morale.