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Tennessee says it is cutting federal HIV funding. Will other states follow?

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Health officials in Tennessee say they will reject federal funding for groups that provide services to residents living with HIV.

Earlier this week, the Tennessee Department of Health announced that it would no longer accept funding from the Centers for Disease Control and Prevention for HIV testing, prevention and treatment.

In an email reviewed by NBC News, the Department of Health told certain nonprofits that provide these services that the state would decline federal funding starting in June, relying only on state funds afterward. “It is in the interest of Tennesseans that the state assume the direct financial and managerial response to these services,” the email read.

When contacted by NBC News, a spokesperson for the Department of Health said “the letter speaks for itself.”

An estimated 20,000 people in Tennessee are living with HIV, although not all are affected by the cuts. There was no further guidance on how the state planned to fund such programs on its own.

The change surprised HIV experts.

“I cannot understand why the state would return funds directed towards health care,” said Diane Duke, president and chief executive of Friends for Life, a Memphis-based group that provides services to people living with HIV. Friends for Life was among the groups that received notice from the state. “It’s scandalous,” she said.

Shelby County, home to Memphis, is among the counties in the country with the highest rates of HIV and AIDS. In 2020, 819 per 100,000 Shelby County residents had HIV, according to the Centers for Disease Control and Prevention.

And those were just the people who got an official diagnosis.

“A lot of people walk around with HIV and don’t even realize it,” said Duke. Providing testing for the virus is an important part of the work that Friends for Life does. “Once someone tests positive, we can get them into care right away,” she said.

Greg Millett, director of public policy for advocacy group amfAR, the Foundation for AIDS Research, called the decision “devastating”. He is concerned that Tennessee health officials are setting a dangerous precedent.

“If other states follow suit,” Millett said, “we’re going to be in trouble.”

Millet said the CDC provides Tennessee with up to $10 million in funding for HIV. It remains unclear how much of that money will be embezzled.

He said he fears the state guideline will lead to discrimination against marginalized groups most at risk of HIV.

“The overwhelming majority of new HIV cases are among gay and bisexual men, transgender populations, heterosexual women, as well as people who inject drugs,” he said.

“We have the tools to end the HIV/AIDS epidemic in terms of prevention and care,” Millett said. “If Tennessee is not using these tools, not using CDC funding, and not focusing on groups most at risk for HIV, there is the possibility of an outbreak.”

The CDC provides states with millions of dollars each year for HIV test kits, condoms and drugs to prevent infection called PrEP.

In a statement provided to NBC News on Friday, the CDC said it was unaware that Tennessee — or any other state — planned to stop accepting grant money.

“We have not received any official notification from the Tennessee Department of Health withdrawing HIV prevention funding from the CDC,” the CDC said. Without such notice, the CDC will automatically continue payments to the state.

The federal agency also said it would “certainly be concerned if services that people in Tennessee need to stay healthy are disrupted or if public health’s ability to respond to HIV outbreaks and bring this epidemic to an end is impaired.” .

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