Two Colorado medical researchers trying to stop HIV and AIDS got letters this month saying their federal funding has been terminated. Christine Tagliaferri Rael and Samantha Stonbraker, both assistant professors at the University of Colorado College of Nursing, are among dozens of HIV researchers nationally whose funding was suspended.
The National Institutes of Health and the U.S. Department of Health and Human Services cut the funding because the research projects “no longer effectuate agency priorities,” according to their letters.
Rael and Stonbraker said they had secured about $1 million focused on HIV prevention mostly among transgender people, like one study to help recruit transgender people for HIV vaccine trials.
“The reason that this line of research is so important is because transgender women shoulder a really disproportionate burden of HIV,” Stonbraker told CPR News.
Transgender people have a much higher rate of HIV than other populations, and it is particularly prevalent in transgender people who are Black and Latina.
“So focusing this research on transgender women is an effort to end HIV,” Rael said. “Focusing these efforts on specific populations like transgender women is not DEI. Focusing scientific interventions on populations that need them the most broadly is also not DEI. It’s an efficient use of resources.”
“It’s almost like a funnel effect, where we're kind of working on these last couple groups that really still have a lot of HIV infections,” Stonbraker added. “But the second you go ahead and do something like reverse that, thinking that HIV is going to stay concentrated in some of these more at-risk populations, it just goes right back up the funnel and then all populations are infected. It spreads globally.”
The grants management office at the National Institutes of Health said in their letter terminating the funding, “Research programs based on gender identity are often unscientific, have little identifiable return on investment, and do nothing to enhance the health of many Americans.”
Another grant Rael worked on was suspended because “It is the policy of NIH not to prioritize research activities that focuses [sic] on gaining scientific knowledge on why individuals are hesitant to be vaccinated and/or explore ways to improve vaccine interest and commitment,” according to the notification letter from the U.S. Department of Health and Human Services.
That project was studying “transgender women's immune and behavioral responses to seasonal COVID-19 vaccines,” to get more people vaccinated. Stonbraker said the work was not actually related to vaccine hesitancy, so she called the cancellation random.
The Trump administration’s decision to suspend funding for many types of HIV research is a turnabout from his first term in office. In 2019, Trump said in his State of the Union address, “My budget will ask Democrats and Republicans to make the needed commitment to eliminate the HIV epidemic in the United States within 10 years. We have made incredible strides. Incredible.”
Rael agreed that the progress on containing HIV has been incredible, and she wants it to continue. “In only a few short decades, we took HIV from a disease that would kill you imminently in a painful, ugly way to something that people can live long, healthy, high-quality lives with and die of something else,” she said.
Now, the World Health Organization warns that with funds being cut for HIV research, an additional 4.43 million to 10.75 million new HIV infections – including up to 880,000 in children – could occur by 2030.
“Without funding for this type of work, we’re going to see a return to the 1990s,” Rael said. She said in addition to the risk of more AIDS deaths, “We’re going to see mutations of HIV strains, and we’re also going to see medication resistance.”
Rael and Stonbraker spoke with CPR’s Arlo Pérez Esquivel.
This interview has been edited for length and clarity
Arlo Pérez Esquivel: When did you realize you wanted to go into scientific research?
Christine Tagliafferi Rael: My dad had Hepatitis B in 1991. It was the height of the HIV epidemic. It felt like everyone had HIV or knew someone that had HIV or was passing away of HIV. My neighbor across the street passed away of HIV.
And at that time, the medications that you took for Hepatitis B and HIV were similar, if you could get medications at all. And so I felt like from the time I was a really little kid, I was steeped in this because I knew how harmful it could be to people's lives and families.
I wanted to make treatment medications, if those were eventually available, better. And I wanted to do it in a way that would work for people because the side effect profiles were just so terrible. People during that time thought if the AIDS or Hepatitis B didn't kill you, the medication would. And so I knew that this was what I wanted to do from the time I was maybe 7 or 8.
Arlo Pérez Esquivel: Samantha, what about you?
Samantha Stonbraker: I always was focused on global health, and spent so much time in places where people couldn't get healthy. There were just so many barriers that they had to face in order to even get care and stay in care just to manage even simple things. And so I became a nurse, and then I realized that science and research is all about asking questions and coming up with how do you solve this problem and how do you solve this problem for more people? And that's when I fell in love with research because I think providing an evidence base is really how you get people to achieve those healthier lives that we're all looking for.
Pérez Esquivel: More recently, what were you working on with federal support?
Rael: The reason it focused on transgender women, and the reason that this line of research is so important, is because transgender women shoulder a really disproportionate burden of HIV everywhere, but also in the United States. About 14 percent of American transgender women are currently living with HIV in 2025.
And as we break this down by race and ethnicity, it gets worse. About 24 percent of Latina transgender women, and almost 50 percent of Black transgender women, are living with HIV in this country. So broadly, our work is focused on prevention in this community and developing evidence-based strategies to leverage existing and emerging biomedical HIV prevention tools and medications and self-test in the most efficient, cost-effective and sustainable way.
Pérez Esquivel: What did you hope to accomplish by pursuing this research?
Stonbraker: We're looking at controlling or eradicating HIV. And in the most simplistic terms, first, how can we most efficiently test at-risk people for HIV? We also need to know that we have effective prevention and treatment strategies that people are able and willing to use. We also ask the question: Can we get the tests and the treatment strategies and prevention tools to the people who need them? And can you do that efficiently and sustainably?
We were funded to start answering these questions or to continue answering these questions to contribute to the whole community who is working on answering these questions. And as Christine mentioned, most of our studies are in transgender women since that's been one of the populations that's just been so deeply impacted by HIV.
Pérez Esquivel: How would you describe the value of this work to taxpayers who are not transgender themselves?
Rael: HIV is not something that stays isolated in one community if it's left unchecked. So this is a huge issue from both a public health and a health care cost savings perspective. The medical costs that are saved by avoiding just one HIV infection are about $229,000. HIV without proactive attention can quickly spread widely and gets out of control fast. We learned that in the 1980s and the 1990s, and we don't want to go back to that time.
What we're doing in both isolated communities as well as broadly is a triumph. In only a few short decades, we took HIV from a disease that would kill you imminently in a painful, ugly way to something that people can live long, healthy, high-quality lives with and die of something else. Women can become pregnant and have a baby that does not have HIV. Couples where one partner has HIV and the other doesn't can use medication and not pass the virus.
Side effects for HIV treatment used to be nearly unbearable. And now we have things like daily oral tablets and long-acting injection medications for both prevention and treatment with really good side effect profiles. And now it's time to focus our work on the groups that are most vulnerable to HIV, especially transgender women, and also including gay and bisexual men.
By developing and testing evidence-based strategies to get prevention tools and tests and treatments to the populations that are going to benefit from them the most, that's a really efficient use of our resources.
So focusing this research on transgender women is an effort to end HIV, which is in sight. Focusing these efforts on specific populations like transgender women is not DEI. Focusing scientific interventions on populations that need them the most broadly is also not DEI. It's an efficient use of resources. And in the case of NIH-funded research, which ours was, it's a really efficient use of taxpayer dollars. We don't want to be offering medications to populations that don't need them.
Pérez Esquivel: Samantha, do you have anything to add to that?
Stonbraker: Focusing on how HIV has really diminished in size over time — and keeping it that way — is really important. It’s almost like a funnel effect, where we're kind of working on these last couple groups that really still have a lot of HIV infections, but the second you go ahead and do something like reverse that, thinking that HIV is going to stay concentrated in some of these more at-risk populations, it just goes right back up the funnel and then all populations are infected. It spreads globally.
We saw something similar with COVID-19. When people stop doing the research and stop creating the treatments that really matter, it just explodes. And that's the potential for HIV. That's why it matters now. You can't stop this work or you go backwards. You create this huge problem that we already know how to address and are almost at the end of fixing.
Pérez Esquivel: How did you feel when you found out the funding had been suspended, and saw the reasoning that was given?
Rael: I think for a lot of us in the HIV field, watching things like USAID funding disappear, watching PEPFAR contract, those were the real gut punches because those are the things that are going to eliminate treatments that are available for people that are living in countries that have very large epidemics like South Africa. People suddenly lost access to their medication.
Stonbraker: It's almost hard to put words to how sad and misguided the [letters we received] are, but it's not based in fact or evidence, which is what scientists believe so strongly in, and it's even hard to comprehend how someone can decide to make these choices that are going to so dramatically impact public health, people's lives, people's health and the scientific community — for years, generations, decades to come. It's just almost soul-crushing. I almost can't even talk about it without crying or getting so moved that it's just so impactful.
Pérez Esquivel: What about the letter that cited vaccine research?
Stonbraker: None of our studies were actually looking at vaccine hesitancy, which just means that they're sending random letters in my opinion, because that's not what our studies were doing at all. In no way could you read what we were working on [and think it] had to do with vaccine hesitancy.
And I also think the attack on vaccines in general is a huge public health crisis. Not understanding how to get vaccines to more people, especially in the communities that need them, is just shocking to me. It just doesn't make sense.
Pérez Esquivel: What will happen to your work and what will happen to the people you were trying to help?
Rael: The field of clinical HIV research is being eliminated. Without funding for this type of work, we're going to see a return to the 1990s and the early 2000s. Those were the worst years of the epidemic. We're going to see an increase in AIDS deaths, but we're also going to see mutations of HIV strains and we're also going to see medication resistance. So I think that it's only a matter of time before these highly effective HIV treatment medications, which mean a person won't even have a detectable HIV viral load anymore and won't pass HIV to another person, will stop working. That will undoubtedly lead to much more uncontrollable HIV here in the U.S.
Second, stopping this type of funding means that we won't be able to develop new prevention and treatment medications in ways that are effective and actually useful to the people who need them.
Stonbraker: I think the future of the field depends entirely on how long all of this is stopped. So every minute, every year, every five years that this research isn't allowed to continue, we go backwards. So for the field, it's a tremendous setback. Christine and I have been working on our grants and getting set up to be able to even apply for the grants we're applying for over 10 years. And so thinking about starting that at the beginning is a huge impact on the field.
Pérez Esquivel: Christine, what are the implications for your career here in Colorado?
Rael: NIH is by and large the biggest funder of scientific research in the world, let alone HIV research. And so if that is no longer available, we won't be able to do these types of projects on the scale that is necessary to continue advancing these HIV efforts.
But I think when something important in public health and science in general is threatened, you can run and you can hide or you can fight, and I don't hide. We're going to be here and we're going to fight — rethinking what we're doing and re-imagining it in different ways and going forward with the research that we can do.
I also think it means pushing back against these changes and trying to help people and our new administration and new leadership at NIH understand the drastic impacts that this is going to have, not only on the field of HIV research as a science but on people. I don't think that anybody wanted to see more AIDS deaths or pediatric AIDS cases.
And so I think that bringing that to light is going to be something that's really important because most of the time when I tell friends and family about what's happening, they're horrified. Nobody wants to see us return to the beginning of the epidemic when we've made so much progress.
