HIV prevention cuts would hit lower-resource areas of New York hardest, experts warn

Most of New York City’s HIV testing sites are located in Manhattan and nearby areas of Brooklyn and the Bronx, according to an annual database published by the city health department. Deeper into the city’s outer boroughs, brick-and-mortar testing locations are harder to find.

That disparity likely reflects the fact that most health facilities are centrally located in the city, said Sarah Braunstein, assistant commissioner of the city’s Bureau of Hepatitis, HIV, and STI.

In New York, Braunstein said HIV tests are generally easy to obtain, as the city distributes test kits through local partners. But many testing programs are federally funded, and members of Congress are considering sweeping reductions to HIV prevention funding this year.

Braunstein said these cuts could have downstream consequences, especially for neighborhoods with fewer health resources.

“We are worried that we will see less access to HIV testing, treatment and prevention services,” she said. “Fewer people will know their HIV status. There may be increased HIV transmission and, ultimately, more HIV and AIDS-related deaths.”

HIV prevention is a broad category encompassing efforts to stop the disease’s transmission, including testing, condom use and antiretroviral medication. About 88% of the city’s funding for the prevention of HIV and STI, or sexually transmitted infections, come from the federal government, Braunstein said.

“That's why it's very concerning, the proposals at the federal level,” she said. “City and state health departments are very reliant on federal funding.”

Braunstein said barriers to accessing health care, including HIV prevention and treatment, break down differently across neighborhoods and demographic groups.

Nearly 1,800 New Yorkers were diagnosed with HIV in 2024, the second consecutive year cases rose in the city. Among them, 91% were men who have sex with men and 85% were Black or Latino, according to an annual report from the New York City Department of Health and Mental Hygiene.

Lower-income areas also experience greater rates of transmission, which Braunstein said is likely because residents have a harder time accessing care. These communities would likely be hit hardest by reductions to federal funding, she said.

“We know very clearly, not just in HIV but across public health areas, that poor access to health care doesn't affect populations evenly,” she said. “There's an unfair distribution of those negative impacts across any community or set of communities, including in New York City.”