A snapshot of how U.S. funding cuts impacted HIV care in one county of Kenya

A qualitative case study

Dados Bibliográficos

ID22433504
AutoresErica Sedlander (0000-0002-5128-669X, Institute on Aging, autor correspondente), Kyla Lawson (Independent consultant), Njeri Wairimu (0000-0002-0597-2736, Kenya Medical Research Institute), Kalin Werner (0000-0001-7759-5397, Independent consultant), Sharon Mutai (Kenya Medical Research Institute), Daniel Mwai (0000-0002-6750-9480, Kenya Medical Research Institute), Monica Gandhi (0000-0001-6674-5388, Department of Medicine, University of California), Kenneth Ngure (0000-0002-8062-0933, Jomo Kenyatta University of Agriculture and Technology)
Ano2026
Volume14
Data de publicação2026-07-13
Peer ReviewedSim
Open AccessSim
TipoARTICLE
PeriódicoFrontiers in Public Health (JOURNAL)
Identificadores do periódicoISSN: 2296-2565 • E-ISSN: 2296-2565
EditoraFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2026.1812962
OpenAlexW7168126885
IdiomaEN
Referências citadas11

Introduction In January 2025, the United States government froze most foreign assistance and issued a 90-day stop-work order affecting many global health, education, and nutrition programs. Methods Using a qualitative case study approach, we examined perceptions about experiences around how this abrupt funding disruption affected HIV care in one county in Kenya through in-depth interviews with women and men living with HIV and with healthcare providers. Results Participants described immediate and severe antiretroviral therapy (ART) rationing and broader, cascading effects across the HIV care continuum, including missed visits, interrupted monitoring, and heightened anxiety about treatment continuity. Respondents also reported that rapid integration of HIV and primary care services—implemented amid the funding shock—undermined confidentiality in clinical settings, intensifying stigma concerns and discouraging care seeking among people living with HIV. Discussion These findings highlight how sudden financing shocks can destabilize HIV programs in ways that extend beyond medication supply. We translate qualitative evidence into actionable recommendations to support person-centered HIV services during periods of uncertainty, including safeguarding continuous access to affordable/free ART, reducing access barriers such as transportation costs, and strengthening confidentiality protections as HIV and primary care services integrate. Systematic review registration https://www.who.int/publications/i/item/9789241549684 .

Confidentiality · Health care · Qualitative research · Rationing · Safeguarding · Adolescent Sexual and Reproductive Health · Global Maternal and Child Health · HIV/AIDS Research and Interventions