By Liz Essley Whyte, Dominique Mosbergen and Jonathan D. Rockoff

The Health and Human Services Department is weighing plans to drastically cut the federal government's funding for domestic HIV prevention, according to people familiar with the matter.

The plans could be announced as soon as within a day, the people said, but they haven't been finalized and could be pulled back or adjusted.

The discussions come as the Trump administration is preparing for deep cuts of personnel at the Centers for Disease Control and Prevention, part of a reorganization of the agency, people familiar with the planning said.

The cuts and reorganization would take advantage of a weakness of the agency's legal underpinnings: No single law outlines its purposes and authorizes its many programs.

The CDC has a department dedicated to the prevention of HIV and other infectious diseases. The department funds state and local surveillance programs for HIV, syringe services and community-outreach initiatives.

The agency spent about $1.3 billion on the prevention of HIV, viral hepatitis, sexually transmitted infections and tuberculosis in the 2023 fiscal year, the agency said on its website. About three-quarters of the CDC's funds to address the infectious diseases go to grants and cooperative agreements with organizations outside the agency, the CDC has said. That includes money for state and local health departments and nonprofits working to prevent HIV or respond to outbreaks.

Among the programs that could be scaled back or eliminated is the CDC's PrEP initiative, which launched last fall as a pilot program and provides free pre-exposure prophylaxis, medication that helps prevent HIV, according to Mitchell Warren, executive director of HIV prevention organization AVAC.

"One of the greatest lessons in public health is you can't end epidemics with treatment alone. Without prevention, we are going to be fighting the virus with one hand behind our back," said Warren, who also noted that cuts to domestic HIV prevention would conflict with President Trump's 2019 pledge to end the HIV epidemic in the U.S.

The Health Department said it is following the administration's guidance and taking a careful look at all divisions to see where there is overlap that could be streamlined to support the president's broader efforts to restructure the federal government.

"No final decision on streamlining CDC's HIV Prevention Division has been made," a department spokesman said.

The CDC didn't immediately respond to requests for comment. The White House didn't immediately provide a comment.

The Trump administration has made cuts to the President's Emergency Plan for AIDS Relief, or Pepfar, which supplies antiretroviral drugs to millions of people globally. The administration has also suspended the work of the U.S. Agency for International Development, which helped administer Pepfar.

The CDC has estimated that about 1.2 million people in the U.S. are living with HIV. About 13% of them don't know they have the virus.

The cuts could affect drugmakers like Gilead and Viiv Healthcare, which sell HIV/AIDS medicines. Gilead stock dropped nearly 3%, while American depositary shares of GSK, majority owner of Viiv, were down less than 1% in after-hours trading, following The Wall Street Journal's report on the administration's discussions.

Gilead has asked the Food and Drug Administration to approve the company's next-generation prevention treatment, called lenacapavir, which patients could take twice a year. Morgan Stanley estimates the drug's sales could surpass $6 billion a year by 2030, with most of the revenue from commercial health insurers.

Write to Liz Essley Whyte at liz.whyte@wsj.com, Dominique Mosbergen at dominique.mosbergen@wsj.com and Jonathan D. Rockoff at Jonathan.Rockoff@wsj.com

(END) Dow Jones Newswires

March 18, 2025 18:03 ET (22:03 GMT)

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