A modelling study presented at IAS 2025 in Kigali (Abstract 6731) estimates that the suspension of PEPFAR funding for HIV pre-exposure prophylaxis (PrEP) in sub-Saharan Africa could result in over 6,600 new HIV infections in just one year, primarily among key populations.
Researchers projected 5,663 additional infections among female sex workers, men who have sex with men, and people who inject drugs. Over five years, secondary transmissions could push the total number of new infections to 10,313.
As of late 2024, PEPFAR supported oral PrEP for 719,384 individuals across 28 African countries, including 205,868 people from key populations. In countries with the highest PrEP coverage, the removal of PEPFAR support could increase new infections by as much as 18% among men who have sex with men and 7.8% among people who inject drugs. The authors urge governments and donors to find alternative funding to prevent a significant reversal in HIV prevention gains.
