By Tab Buckner, HANC Board
As Mayor Daniel Lurie’s FY (Fiscal Year) 2025-26 budget proposal is expected in early June, many are bracing for constraints on critical resources that serve some of the community’s most marginalized residents. San Francisco has one of the nation’s largest populations of people living with HIV, comprising approximately 15.000+ individuals. Despite a decline of new HIV diagnoses in San Francisco during the past decade, ongoing challenges persist with disparities in HIV prevalence and viral suppression rates among communities that include African American women, Latino men, unhoused individuals and people who inject drugs. The vast majority of San Franciscans living with HIV are over 50 and experience the additional health-related issues of aging. The ability to stay safely housed in a city as expensive as San Francisco remains an ongoing challenge for many residents living with HIV/AIDS. The Trump Administration’s budget plan that favors slashing healthcare for low- income people adds to the stress.
Last year, Candidate for Mayor Lurie stated “As mayor, I am committed to investing in comprehensive HIV/AIDS prevention, treatment, and support. Every San Francisco mayor has backfilled Republican-driven cuts to federal HIV funding, and we cannot stop now.
With a $14.6 billion budget, a few hundred thousand dollars is a small but vital investment, especially at a time when the City Hall insiders I’m running against continue to fund
unaccountable programs that fail to deliver results.” (San Francisco Bay Times, June 27, 2024).
The HIV/AIDS Providers Network (HAPN) is coalition of community-based, non-profit
agencies that serve people living with and at risk of HIV/AIDS in San Francisco. In a recent statement, HAPN declared “We recognize the enormity of the financial challenges facing our City, in addition to the crisis we face at the federal level with respect to funding and
policy related to public health and healthcare services across the country. Our most at-risk communities, community-based organizations, and public institutions are being targeted by the federal government in unprecedented ways.” HAPN also refers to San Francisco’s
past tough times when strategic budget priorities reflected core values. Coalition members say they are ready to work closely with the city’s leadership to respond to federal threats of aid restrictions or cuts.
HAPN has presented four budget priorities for FY2025-26 for San Francisco:
- The City’s must continue funding the HIV safety net through general fund dollars to ensure continuity of care, prevention, and treatment for all San Francisco residents living with and at-risk for HIV, STIs, and viral
- The City must continue its nearly 20-year record of backfilling with City dollars federal funding reductions in grants through the Ryan White CARE Act, CDC, and
HOPWA (Housing Opportunities for Persons With AIDS). While we do not know the extent of federal reductions at this time, HAPN members are actively engaging with multiple national and state associations advocating to protect the entire portfolio of HIV funding.
- The City needs to commit to working with community based organizations receiving direct federal HIV funding (e.g., HRSA/Ryan White, CDC, SAMHSA, HUD/HOPWA, ) if these awards are terminated to ensure continuity of services being provided by these direct federal dollars.
- Ryan White-funded contracts require the same level of Cost of Doing Business (CODB) increases that are awarded to City general fund contracts to ensure parity and to maintain a constant level of HIV services in San Annual CODB
increases ensure that community-based organizations remain viable and keep up with rising costs necessary to run a business in San Francisco.
San Franciscans are encouraged to contact the Mayor’s Office and Board of Supervisors to urge them to support the budget priorities HAPN has laid out. An online petition hosted by the San Francisco AIDS Foundation and the HIV Advocacy Network can be found at