When University of California Los Angeles epidemiologist Pamina Gorbach, DrPH, received a letter of termination for her NIH grant on March 20, she almost fell on the floor.
The notice implied the work her team had been doing for years to keep their 200-plus cohort of marginalized, HIV-infected men from hospitalization and death was not only unscientific, it provided "low return on investment" and did "not enhance health, lengthen life, or reduce illness."
"Worse," the letter continued, "so-called diversity, equity, and inclusion (DEI) studies are often used to support unlawful discrimination ... which harms the health of Americans."
It had been signed by the chief grants management officer for the National Institute on Drug Abuse.
Several NIH-funded researchers told MedPage Today they received the exact same letter, even when their grants had nothing to do with DEI. Gorbach's letter made it clear that the 5-year Race & Place grant for $3.2 million was terminated immediately, just 9 months into its first year.
Gorbach's grant targeted unhoused, addicted methamphetamine users who -- without the interventions her team provided in partnership with the LGBT Center of Los Angeles -- have a hard time accessing care.
"These are the people that RFK Jr. [HHS Secretary Robert F. Kennedy Jr.] will have to step over as they are overdosing, living on the streets," she said.
Gorbach said that as insulting enough as the letter is, its claims about the worth of her project are dead wrong. Without regular visits to clinical and social service providers, not only are her clients more likely to develop AIDS and die, "they'll also just be sick a lot more, our emergency rooms will be more filled with people suffering not only from HIV, but other comorbidities like diabetes or heart disease."
The work done through her program was saving money for hospitals and clinics. When these people develop respiratory illnesses like COVID, influenza, or tuberculosis, their compromised immune systems make them more infectious to others.
She co-led the project with Marjan Javanbakht, PhD, MPH, and Terrell Winder, PhD, from the University of California Santa Barbara.
Several people involved with the project will lose their jobs, she said.
Gorbach is far from alone in her shock and dismay.
Several researchers interviewed by MedPage Today said it seems the administration has lodged a war against projects that have anything to do with HIV or other sexually transmitted diseases, even those impacting infants and children or caring for those groups when they get sick.
They pointed to massive cuts for HIV programs previously funded by the U.S. Agency for International Development (USAID) and the President's Emergency Plan for AIDS Relief (PEPFAR); HHS' likely elimination of its Office of Infectious Disease and HIV/AIDS Policy; the feared closing of the CDC's HIV prevention unit, and the CDC's pause of its webpages detailing pre-exposure prophylaxis (PrEP) coverage updates.
As of the evening of March 28, The Grant Tracker, a database of NIH grants terminated in 2025 as reported by either NIH or the grantee, showed 232 HIV-related program terminations, amounting to $1.6 billion in funding just for this year. Of that, $1.06 billion had not yet been spent, and presumably, could not be because the terminations took effect with the date of these letters. The tracker showed 459 projects involved gender or LGBTQ issues.
HHS' official notice of all grant terminations this year, which has been regularly updated, is now 42 pages long.
The tracker is maintained by Scott Delany of the Harvard T.H. Chan School of Public Health and Noam Ross of rOpenSci and is regularly updated.
Harms to Patients, Fear of Further Punishment
Another grant recipient, Gregory Phillips, PhD, associate professor of medical social sciences and preventive medicine at Northwestern University in Chicago, got the same letters for several of his grants.
One of them terminated a long-standing research project in which his team studied the impact of alcohol use on risky behaviors among sexual minority youth, and identified opportunities for intervention. He said that the termination, coming in the middle of the grant cycle, means a loss of $750,000 that had been allocated.
The sample size was large enough that his team was able to differentiate between cultural differences involving alcohol among ethnic groups, such as Alaska Native, American Indian, or Hawaiian, that ordinarily would be lumped into one Asian category. The project also looked at how public health policies play a role in alcohol use, such as home delivery of alcoholic beverages.
"I also have a non-HIV-related grant that got terminated, based on gender ideology," he said, with another "very offensive" letter. The administration also "is setting research back decades, probably even if everything is eventually reinstated. It's a huge disruption. You can't terminate basically all of this HIV-LGBT work and not think it's going to have huge repercussions. It's going to hurt LGBT people."
Several other researchers whose grants were abruptly terminated in recent weeks told MedPage Today they wished to remain anonymous for fear that if they spoke out, they would be further punished.
Some said their academic research institutions were skittish about approving their conversations with media. Some said they didn't want to ruin their chances of winning an appeal. A few principal investigators are deciding the best ways to inform their employees or non-profit partners that their services would no longer be compensated. How would they handle severance?
Since the letters said they could spend no more money, how would they pay the rent for the remaining months in office leases? And some said they hadn't yet informed the clients or study participants that the services they had counted on could not be provided as of that day.
The terminations have provoked fear in researchers who suspect their other grants may be on thin ice simply because they include one of the Trump administration's forbidden words, even if some of those words were required in their applications. One researcher, who asked not to be named, saw one relatively small portion of a COVID-related grant terminated, but worries that the larger HIV-related grant will be chopped as well.
Trials Network Targeted
Lynne Mofenson, MD, a pediatric infectious disease physician who specializes in research involving HIV, children, pregnant women, and families, and a former researcher with the National Institute of Child Health and Human Development, is dismayed by the administration's termination of so many grants connected with the Adolescent Medicine Trials Network for HIV/AIDS Intervention.
ATN was receiving $18 million a year for 7 years to study ways to prevent and treat HIV in youth ages 13 to 24, since 19% of new HIV infections occur in this population. Since the network began in 2001, it enrolled more than 30,000 trial participants across 150 studies, Mofenson said. "And its researchers helped develop many methods to prevent HIV, which avoids $500,000 in lifetime treatment costs, said Mofenson, who is now with the Elizabeth Glaser Pediatric AIDS Foundation."
"This population undergoes less HIV testing, experiences lower viral suppression and higher mortality than older people and they have different needs," she said. "They're not just little adults."
But late Friday, March 21, in the third year of specific projects, funding was abruptly stopped by a letter much like the one sent to other researchers in calling ATN programs "antithetical to the scientific inquiry ... and ultimately do not enhance health, lengthen life, or reduce illness."
"This is a ridiculous and insulting lie," Mofeson said. Among the terminated programs are:
HAPPY, the HIV and Pregnancy Prevention in Youth study, which had enrolled 341 participates to study a product designed to prevent HIV and pregnancy 78% of the sample size goal.
IMPACT, Intervention for Motivating and Promoting Engagement in Care and Treatment, a sexual health counseling and behavioral therapy program to reduce HIV infection and transmission among youth who use stimulants such as crystal meth, cocaine, ecstasy, and ADHD medications.
A program that was launching in April to study use of doxycycline to prevent sexually transmitted diseases in women of childbearing age.
Other important studies that were cancelled involved researching ways to increase HIV screening in emergency rooms, examining how to improve PrEP use among youth through community providers, and exploring the use of digital tools to prevent pregnancy and STIs, she said.
"Fear, Anger, and Disbelief"
Robert Garofalo, MD, of Ann & Robert Lurie Children's Hospital in Chicago, is another researcher who is losing several NIH grants including one that funds HIV prevention in Nigeria. He posted on LinkedIn and Facebook about the devastating effects the terminations are causing and called it "overwhelming and infuriating" and a "dismantling of science and scientific inquiry in the U.S."
"I don't have words to adequately express my sadness, confusion, fear, anger, and disbelief," he wrote.
Garofalo's projects "ranged from developing mental health tools for transgender youth, to understanding the epidemiology of STI and HIV acquisition in women, to connecting young men to vital HIV prevention services and PrEP, to the lifesaving work on HIV prevention and treatment we have been doing in Nigeria with adolescents for the past 7 years."
His "heart breaks for the students, and post-docs, and early career researchers whose work has been upended and/or interrupted," and said that this "dismantling of science and scientific inquiry in the U.S. is deeply disturbing."
Lawsuits are already being filed. In February, Lambda Legal Defense and Education Fund of Los Angeles filed a 73-page complaint for declaratory and injunctive relief in U.S. District Court in Northern California against the Trump administration on behalf of eight community-based organizations serving the HIV/AIDS and LGBT communities. They argue that executive orders on gender impose "a disparaging, demeaning, idiosyncratic and unscientific viewpoint about transgender people and gender identity."
It also argues that Trump's DEI orders "express a viewpoint that 'diversity, equity, inclusion, and accessibility' or related programs are 'illegal and immoral discrimination programs'" and lay out "specific mechanisms to punish contractors and grantees that embrace" DEI principles.
Many of the researchers said they were so stunned, they don't know what they'll do now. But many of them, like Gorbach, plan to appeal. She's heard legal advice that she'll have to demonstrate her project is in line with the NIH's policies.
So that's what she plans to do.
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Cheryl Clark has been a medical & science journalist for more than three decades.