UN warns of reversal in HIV/AIDS progress as criminalization and funding cuts threaten vulnerable groups

A new report by UNAids reveals a concerning trend: key populations at higher risk of HIV infection, such as gay men, people who inject drugs, and transgender people, are facing increasing criminalization worldwide. This rise in punitive laws, coupled with significant US funding cuts, threatens to reverse decades of progress in the global fight against the HIV/AIDS epidemic.

For the first time since UNAids began tracking these laws a decade ago, the number of countries criminalizing same-sex sexual activity and gender expression has increased. Recent examples include Mali, which criminalized homosexuality and transgender individuals, and Trinidad and Tobago, where a court overturned a ruling that had decriminalized same-sex relations. Uganda's Anti-Homosexuality Act and similar legislation in Ghana further exacerbate the situation.

As reported by The Guardian, these crackdowns coincide with abrupt cuts in US funding for HIV/AIDS programs, creating a perfect storm of challenges. Combined with "unprecedented" humanitarian crises and the impacts of the climate crisis, these factors jeopardize the internationally agreed goal of ending AIDS as a public health threat by 2030.

In 2025, only eight of 193 countries have decriminalized all key populations and behaviors, including non-disclosure of HIV status, exposure, or transmission. While the number of new HIV infections and AIDS-related deaths reached a 30-year low in 2024, with 1.3 million new infections and 630,000 deaths, the progress remains uneven.

The US funding cuts, initiated earlier this year, have significantly impacted HIV prevention services. For example, the number of people receiving preventive drugs in Nigeria plummeted from approximately 43,000 in November 2024 to below 6,000 by April 2025. This particularly affects key populations who may rely on donor-funded community clinics due to stigma or fear of prosecution.

UNAids modeling indicates that without replacement funding for US Pepfar, an additional 4 million deaths and 6 million new infections could occur globally by 2029.

Despite these challenges, Winnie Byanyima, executive director of UNAids, notes that 25 of the 60 low- and middle-income countries included in the report have increased domestic HIV spending for 2026, signaling a move towards nationally owned and sustainable responses.