LGBTQ+ health centers brace for Trump’s attacks

John Peller’s two decades as an AIDS Foundation of Chicago (AFC) staff member have been marked by highs and lows.

In 2010, after President Barack Obama signed the Affordable Care Act into law, millions of people living with HIV or vulnerable to the virus could, for the first time, access comprehensive care.

Two years later, the U.S. Food and Drug Administration approved the first pre-exposure prophylaxis (PrEP), which revolutionized HIV prevention. The treatment is more than 99 percent effective when taken consistently and correctly.

Then, in 2015, a two-year budget impasse under then governor Bruce Rauner meant state-funded agencies like AFC were left with a dry well and no cash flow.

But Peller, who joined AFC as a lobbyist in 2005 and is now the organization’s president and CEO, says President Donald Trump’s attacks on public health care represent some of the most serious threats he’s seen. “[The] changes that are happening now and being proposed are definitely some of the toughest that we have seen in my history of the AIDS Foundation,” Peller says.

The Trump administration has been making strident cuts to public health initiatives for LGBTQ+ people and HIV prevention and treatment.

Trump officials have already slashed $1.8 billion in research grants through the National Institutes of Health (NIH), and the Centers for Disease Control and Prevention (CDC) removed references to gender identity, transgender people, and equity in its data. The chaos in the federal administration is starting to affect Chicago today, as those changes have resulted in lost funding, fewer community programs for LGBTQ+ people, and a growing wave of anti-LGBTQ+ sentiment in the city and across the country.

One of the first programs targeted by the Trump administration was the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), the world’s flagship program for distributing HIV medication to clinics and vulnerable people globally. Shortly after taking office, Trump instituted a 90-day freeze on all programs overseen by the U.S. Agency for International Development (USAID)—which administers PEPFAR—before swiftly laying off most USAID staff. Since then, his administration has illegally refused to spend the vast majority of the $7 billion appropriated for PEPFAR by Congress.

Trump’s 2026 budget proposes maintaining funding for domestic HIV care and PrEP, but it suggests cuts of more than $1.5 billion—including the elimination of HIV prevention and surveillance from the CDC, housing assistance programs, and more. The proposal also seeks to slash millions of dollars in funding that flows to local organizations like AFC.

“When we saw the really brutal, devastating, heartless cuts that the Trump administration made without congressional authorization to the PEPFAR program,” Peller says, “we became increasingly concerned about the future of HIV programs domestically.”

Truvada for PrEP, an HIV antiretroviral drug taken by HIV-negative persons in at-risk communities like people in relationships with partners who are HIV-positive or have an unknown status, to prevent an HIV infection. Taken daily, it can be about 99% effective in combination with safe sex practices.Credit: Tony Webster, CC BY-SA 2.0 / Flickr

University researchers, whose funding comes largely from the NIH, and queer community organizations, many of which rely on money from the CDC, are bearing the brunt of the storm.

The NIH terminated $8.9 million in financial support for Northwestern University’s Impact Institute, which supported research into health care for queer teenagers, effective HIV prevention, and more. The Impact Institute is one of the largest LGBTQ+ health research centers in the world, and Brian Mustanski, the institute’s director, says the loss of funding has left people without jobs and ended groundbreaking research and successful community partnerships.

Postdoctoral students whose work was funded by slashed grants are now trying to transfer to another of the lab’s research projects, according to Caitlin Kelleher-Montero, a research project coordinator. Some people who lost funding have been offered positions at other institutions, while others are unemployed. “All across the LGBTQ health spectrum, funding has been slashed,” she says.

One of the research studies that lost funding was nearly 20 years old—one of the longest HIV studies following a group of gay and bisexual men over time, Mustanski says. It sought to understand the risk and protective factors for HIV and substance use in that population, and it provided more than 2,000 HIV tests to more than 1,000 young men who participated in the project. When participants were diagnosed, researchers connected them to care through a collaboration between the institute and the Center on Halsted.

In these contexts, the description “research” is almost a misnomer because it obscures the amount of HIV services delivered to the community through research projects. “We’ve got excellent treatment approaches, but we are just not implementing them sufficiently in the United States in a way that would let us end the epidemic,” Mustanski says. “We were making tremendous progress on helping organizations throughout the country understand how to most effectively deliver HIV services, and that was also terminated by the administration.”

Mustanski tells the Reader that designing a study like this takes collaboration between epidemiologists, physicians, biologists, virologists, and more. When a project this comprehensive is terminated, it could take years to get it back up and running. Scientists are used to the rejection that comes with highly competitive NIH grants. “What we’re not used to,” Mustanski says, “is these ideas and these studies that have gone through such a rigorous process being terminated with very little justification.”

The second hit that the institute, and research and community health centers like it, are suffering is censorship. The CDC removed or edited out all references to transgender people, gender identity, and equity from its website in January. Now, the organizations the CDC funds must follow suit in their own reporting to the federal government. “Everything having to do with LGBTQ healthcare, basically, we can’t talk about,” Kelleher-Montero says.

Until May, the Impact Institute was called the Northwestern Institute for Sexual and Gender Minority Health and Wellbeing. The name change, Kelleher-Montero says, is a result of censorship. As researchers apply for new grants, LGBTQ+-related words cannot be used in applications. Kelleher-Montero says, in her opinion, queer people will have a more difficult time finding support when organizations have to hide what they offer. Although HIV disproportionately impacts queer folks, she continues, defunding HIV work affects everyone. “By defunding queer research, we’re defunding public health as a whole,” Kelleher-Montero says.

Amongst young people, Mustanski says, more than three-quarters of HIV cases are diagnosed in young gay and bisexual men, so to be cost-effective research must be done in a way that focuses on how to reach that particular community. “There’s no practical way to do HIV prevention in the United States that doesn’t recognize the existence of these disparities that impact our community.”

The Impact Institute is not the only place that’s changed its name in response to the presidential administration’s attacks on LGBTQ+ people. The Trans Empowerment Center at the Puerto Rican Cultural Center in Humboldt Park—now simply the Empowerment Center—is navigating a similar issue.

Chicago LGBT Hall of Famer Lisa Isadora Cruz started the Empowerment Center, nicknamed Trans Chicago, as a program to prevent AIDS in the Latine community through free HIV testing. Trans Chicago continued to develop as new hands added and molded new programming. Today, the organization provides counseling for safer sex, sex toys and contraceptives, trans support groups (which includes nonbinary and gender nonconforming people), queer markets, free clothing distributions, hormone referrals, hygienic supplies, and more.

Because it receives CDC grants, the Empowerment Center has to abide by CDC policy. Program coordinators Jai Perez and Tichike Tumalan say that before the CDC policy changes, they could transparently say that they served the trans community. But, after Trump’s election, much of the center’s work came to a halt because the CDC sent them a letter saying they needed to cut all programming related to “gender ideology.” They were also directed to take down trans-themed decorations and redesign their logo, which featured the trans flag.

“We’re still trying to keep these programs running,” Perez says. But now those events must be paid for out of pocket or using funds from other sources. “However, with the letter that we received, it made it very clear that if a CDC grants compliance officer were to come in and see stuff that’s specifically for the trans population, they can report it.”

They also cannot include anyone’s sexuality or gender (outside of “male” and “female”) in HIV test reporting sent to the CDC. Perez says the organization’s director had to spend an entire day delving into reports to remove any language relating to gender identity or sexuality. “It felt like a song with a lot of cuss words on the radio. It was just like a lot of blanks,” Perez says. “That funding is now secure for the Empowerment Center activities, but we don’t really have access to that when it comes to, like, immediate support for trans people.”

The Empowerment Center still plans to keep the focus on transgender people, even if they have to omit the language. They’re just trying to figure out which channels they can use to reach the trans community without breaking CDC rules and getting their funding cut.

John Peller, president and CEO of the AIDS Foundation of ChicagoCredit: Breeze Art Photography

While the Trump administration’s attacks on LGBTQ+ health care have forced some Chicago-area research and community centers to cut services, other providers are bracing for more to come.

AFC relies on the federal government for funding—it makes up 80 percent of the organization’s budget, according to Peller. The nonprofit leads Getting to Zero Illinois, a statewide public–private partnership of 50 government, community, and health-care organizations working to end the HIV epidemic in Illinois by 2030. AFC provides case management to more than 8,000 people living with HIV in the Chicagoland area and offers 1,000 units of housing for people living with HIV.

Peller says, “We have been very, very fortunate to escape major cuts so far, but it does feel like those cuts could come any moment.”

Despite the uncertain future of public health, the Test Positive Aware Network (TPAN) and Vivent Health doubled down on their commitment to the LGBTQ+ community with a new, state-of-the-art facility in Edgewater in May. The partnership with Northwestern Medicine offers wraparound care, including a medical clinic with primary care doctors, a pharmacy, behavioral health care, access to PrEP and other preventive services, a food pantry, case management, and housing services.

Four decades ago, TPAN started as a peer-led, Chicago-based HIV support organization that offered case management and social services. The organization merged with Vivent Health in 2023.

“I’m able to say today that all of the funding that we received previously is still coming to Vivent Health,” says Bill Keeton, the organization’s chief advocacy officer, “which means we are continuing to deliver all of the same care and treatment services that we have throughout our history.”

Why is Trump targeting LGBTQ+ and HIV/AIDS care and research? Peller believes the Trump administration’s war on universities and higher education is, in part, because of the perception that “elite” institutions are against them. But many of the programs are also targeted because they’re geared toward Black and Brown and trans and queer communities—the very communities Trump has sought to attack.

According to Kelleher-Montero, “The most powerful HIV prevention and treatment tools exist right now because of how much research has been done,” so access to those resources is more important than ever.

This article was originally published by The Chicago Reader.