Rubio Gives International Emergency Relief For PREP But NOT For LGBTQ!! Makes Sense?

Dozens of AIDS activists and advocates shut down Constitution Avenue outside the U.S. State Department in Washington, D.C. on Friday to protest Donald Trump and Secretary Marco Rubio’s proposed pause on the President’s Emergency Plan for AIDS Relief (PEPFAR) funding.

Linking arms, protestors chanted, “Hands off PEPFAR!,” calling attention to the 20 million people whose lives are jeopardized by a federal halt on AIDS and HIV relief funding abroad. Speakers like Broadway actor Javier Muñoz shared personal stories and calls to action in conjunction with the civil disobedience.

On January 25, Rubio ordered the freeze on nearly all foreign aid, including PEPFAR, a federal program providing HIV medications that has been credited with saving 25 million lives and preventing over 5.5 million children from being born with HIV in over 50 countries. 

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The President’s Emergency Plan for AIDS Relief (PEPFAR) is still barred from providing PrEP to LGBTQ+ people around the world, according 

to recent State Department documents, placing millions of people at elevated risk of HIV exposure.

Shortly after President Donald Trump and Secretary of State Marco Rubio ordered a 90-day freeze on foreign aid in January, Rubio issued an additional “emergency humanitarian waiver” on February 6 which appeared to allow HIV medications to be distributed abroad during that time. That waiver ostensibly meant that pre-exposure prophylaxis, or PrEP — the antiretroviral drug that prevents the transmission of HIV — would be distributed through PEPFAR. But Rubio’s waiver itself stated that “gender or DEI ideology programs” and “transgender surgeries” — e.g., any overseas programs or organizations that support trans people — should not receive aid during the “pause,” and that any programs not specifically named in the waiver “may not be resumed without express approval.” 

Now, a new State Department document, dated February 6 and published online by the Joint United Nations Programme on HIV/AIDS (UNAIDS) confirms that PrEP “should be offered only to pregnant and breastfeeding women,” whereas anyone else “who may be at high risk of HIV infection or were previously initiated on a PrEP option can not be offered PEPFAR-funded PrEP” (emphases in original) during the aid freeze.

Among the “high risk” populations currently blocked from receiving PrEP through PEPFAR is LGBTQ+ people — particularly men who have sex with men (MSM) and trans people, two demographics with an increased risk of exposure to HIV. UNAIDS estimated this week that more than 3,000 new HIV infections have occurred worldwide as a result of the Trump administration’s aid freeze.

Founded in 2003 to combat the international spread of HIV, PEPFAR reported distributing antiretroviral treatments to over 20 million people worldwide in 2024, including 2.5 million new PrEP users. In 2022, PEPFAR spent 8.9% of its budget, or approximately $20.1 million, on services for MSM and trans people, according to an analysis by the health policy research organization KFF. A further $28 million went to provide HIV prevention and treatment services for sex workers.

 

Trump and Rubio’s aid freeze has also already resulted in PEPFAR-assisted programs shutting their doors. The Kenyan “Fahari ya Jamii” initiative, a five-year HIV prevention project founded in 2022, shut down more than 150 clinics and placed more than 700 workers on unpaid leave following the freeze last month, as the Washington Blade reported February 5.