Studies revealing the real-world impact of disruptions to the US President’s Emergency Plan for AIDS Relief (PEPFAR) and important advances in long-acting HIV prevention and treatment were announced ahead of AIDS 2026, the 26th International AIDS Conference, which will take place in Rio de Janeiro, Brazil, and virtually from 26 to 31 July.
Today’s scientific highlights press conference previewed studies selected from thousands of abstracts that will be presented next week, including:
• A pair of studies that shed light on the real-world consequences of PEPFAR disruptions
• Findings from the open-label extension phase of the PURPOSE 1 and 2 studies of twice-yearly injectable lenacapavir for HIV prevention
• The first detailed results from the Phase 3 ISLEND-1 and ISLEND-2 trials of oral islatravir/lenacapavir, which has the potential to be the first complete once-weekly oral treatment for HIV
• A study showing that HIV-specific immune activity may persist in the spinal fluid of adolescents with perinatally acquired HIV, even when the virus is suppressed in the blood
Convened by IAS – the International AIDS Society – AIDS 2026 will take place at a crucial time in the HIV response. In the face of an unprecedented funding crisis and major cutbacks to HIV programmes, the conference will unite people living with HIV, researchers, policy makers,
healthcare professionals, funders, media and communities with the theme Rethink. Rebuild. Rise.
“Science is moving fast, giving us more powerful HIV prevention and treatment tools. But these advances cannot save lives if they never reach the people who need them. That requires robust, stable financing and steadfast political commitment,” Beatriz Grinsztejn, IAS President, AIDS 2026 Co-Chair and Director of the HIV/AIDS Clinical Research Unit at the Evandro Chagas National Institute of Infectious Diseases – Fiocruz in Rio de Janeiro, said.
PEPFAR, the US global HIV programme, has saved more than 26 million lives since 2003 and changed the trajectory of the HIV pandemic. PEPFAR was a success under the first Trump administration, with major progress toward the 95-95-95 goals. Since the start of the second
Trump administration, however, it has undergone major disruptions.
The first is based on the PEPFAR Pulse Study – the first large-scale survey of PEPFAR implementing partners to document the scale and scope of PEPFAR disruptions globally. The survey reached 166 implementing partners in 46 countries.
The results are deeply concerning. More than half (52%) of all implementing partners had at least one terminated award, and 77% had been asked to restrict their work to comply with an additional US policy. Terminations led to 1,714 closed service sites, including 1,010 public health facilities, 325 access points and 126 drop-in centres. Locally based partners were particularly impacted.
Partners were most likely to have permanently stopped providing services for key populations, the groups most vulnerable to HIV. Among partners providing HIV treatment, more than one in five (21%) had permanently stopped at least one HIV clinical care activity.
Many partners reported that they were unable to obtain condoms (23%), lab commodities (23%), PrEP (22%) or antiretroviral drugs (20%). Among partners with no terminated awards, the majority had censored language (61%), stopped a service (61%) or stopped services to specific populations (44%) to continue receiving funding.
According to presenter Elise Lankiewicz of amfAR, the results make it clear that US funding and policy changes have caused PEPFAR-wide disruptions, with a disproportionate impact on local organizations and the populations most vulnerable to HIV. The second study, based on a rapid analysis of newly released PEPFAR data for fiscal year 2025, examined shifts in PEPFAR-supported paediatric treatment following a year of disruption. To get an accurate picture, the study team limited the analysis to PEPFAR- supported treatment, meaning site-level service delivery and technical assistance.
The team found that globally, 77,163 fewer children living with HIV received PEPFAR-supported treatment in fiscal year 2025 compared to 2024 – a decline of 14.2%. The team also examined data for 21 countries that have substantial numbers of children living with HIV on PEPFAR- supported treatment.
Among those countries, all but one reported a decline in the number of children receiving site-level treatment support from PEPFAR, with proportional declines among children living with HIV exceeding those among adults. South Africa recorded the largest absolute decline, with 30,880 fewer children receiving treatment support from PEPFAR– a 45% drop. The team also conducted an analysis that suggests that declines in five
countries – Uganda, Haiti, Zambia, South Africa and Kenya – represent potential departures from historical trajectories.
According to presenter Ramona Godbole of Heidelberg Institute of Global Health, Heidelberg University Hospital and Clinton Health Access Initiative, these findings warrant urgent country-level investigation and restoration of public dissemination of routine age-disaggregated PEPFAR data.
“These studies provide compelling new evidence that PEPFAR disruptions have had negative, far-reaching consequences, particularly for those most vulnerable people,” Kenneth Ngure, IAS President-Elect and Associate Professor of Global Health at Jomo Kenyatta University of
Agriculture and Technology in Juja, Kenya, said.
Abstracts and sessions: Measuring PEPFAR disruptions at scale: Results from a 46-country implementing partner survey, “AIDS 2026 Co-Chairs’ Choice”; Shifts in PEPFAR-supported pediatric treatment: rapid analysis of fiscal year 2025 PEPFAR program data; “People in crisis: Conflict, migration and sustaining HIV care”
