Following the loss of $6.7 million in federal funding in the past two years, Indiana’s Special Populations Support Program (SPSP), which provides community-based HIV, hepatitis C and sexually transmitted infection (STI) testing, counseling and support services to people with substance use disorders, will close on June 30.
“The less people that are working on this, the more the likelihood is we’re going to see rises in HIV. We’re going to see rises in hep C,” Dorothy Waterhouse, program director for HIV, STIs and syringe services at the Clark County Health Department, told the Indiana Capital Chronicle. “And you’re going to see a higher rate of morbidity in those diseases.”
Indiana’s HIV Outreach and Testing program was funded by the American Rescue Plan Act (ARPA). Part of President Biden’s COVID-19 relief plan signed into law on March 11, 2021, ARPA provided state and local governments with $350 billion in additional funding to spend on public health, economic recovery, infrastructure (water and sewer) and more. ARPA recipients were obligated to spend their recovery funds by the end of 2026, but December 2024 was the deadline to allocate those funds to specific programs, according to the Economic Policy Institute.
Indiana Department of Health spokesperson Lisa Welch told the Indiana Capital Chronicle that health officials prioritized other programs in the service area “based on performance and proven effectiveness” with “particular emphasis on the identification of new HIV cases.” As a result, public health staff who conduct testing, notify people who were potentially exposed and help connect people to care, known as disease intervention specialists, will remain funded in their roles.
Organizations across the state whose contracts are impacted include Indianapolis Urban League, Aspire Indiana Health, IU Health and several other local health departments and HIV service providers.
“Reducing HIV testing capacity could have a significant and long-term negative impact because the longer someone goes untested, the more likely they are to spread the virus unknowingly because treatment is delayed,” said Virginia A. Caine, MD, director and chief medical officer of the Marion County Public Health Department. “Knowing your status and getting tested early is critical to prevent transmission of HIV and improve the chances of living longer with improved health outcomes.”
State data shows that SPSP staff administered more than 17,600 HIV tests between 2021 and 2025, with a peak of 4,575 tests in just 2024. Overall, more than 112,000 HIV tests were conducted across the state during that period.
Constrained budgets have put pressure on HIV care and prevention programs across the United States, including the Ryan White HIV/AIDS Program, which provides comprehensive HIV care, medications and support to low-income people with HIV. Over half of the 1.2 million Americans diagnosed with HIV receive services supported by Ryan White. What’s more, over 90% of Ryan White clients reach viral suppression. In other words, their viral load is undetectable. Nationally, about 67% of people diagnosed with HIV were undetectable in 2023.
It’s important to test and identify newly diagnosed people. Those who adhere to their treatment regimen and achieve and maintain viral suppression experience slower disease progression, enjoy better overall health and are less likely to acquire opportunistic infections. What’s more, people with an undetectable viral load don’t transmit HIV to others through sex. This is known as treatment as prevention, or Undetectable Equals Untransmittable (U=U).
Among other initiatives, the Ryan White Program provides grants to states for their AIDS Drug Assistance Programs (ADAPs) to provide HIV treatment and insurance assistance for people living with HIV. Various states, including Florida, Pennsylvania, Kansas, Delaware and Rhode Island, have been forced to limit enrollment and reduce income eligibility for ADAPs under Ryan White.
To learn more about the impact of federal funding cuts on public health programs in the U.S., read:
