As national Pride month comes to an end this year, the organizations fighting rising HIV rates in rural Oregon don’t know if their funding will continue through the summer.

Oregon’s rates of HIV infections are relatively low compared to other states, but they are on the rise — especially in rural counties. Based in Eugene, HIV Alliance is one of the organizations fighting that increase. It serves people living with HIV and those at greatest risk — especially in rural and underserved communities — by offering free HIV and STI screening, free condoms, a syringe exchange and overdose prevention services across 15 Oregon counties.  

The organization pieces together a variety of funding streams, and relies heavily on annual grants from the Centers for Disease Control and Prevention that cover the wages of four full-time employees. As the end of June approaches, HIV Alliance still hasn’t heard from the CDC about whether the agency will extend its federal contract with HIV Alliance into the new fiscal year that starts July 1. 

Renee Yandel, the organization’s executive director, said HIV Alliance heard rumors of a three-month funding extension. Then the CDC said that would not happen, Yandel said. Later, federal officials said they would extend funding after all. But the status of funding is still unclear.

“The CDC has kind of been in disarray,” Yandel said. 

Oregonians will feel the effects of reduced services without CDC funding. Over the last five years, federal funding has helped HIV Alliance offer HIV testing to thousands of people, in counties where testing was not happening before the organization began offering it, she said. 

“It would be a huge impact on the availability of community-based HIV testing,” Yandel said.

On the rise

Until 2020, new cases of HIV in Oregon were on the decline, according to the Oregon Health Authority. But in this decade so far, new diagnoses have increased — mostly in rural counties, where more people lack insurance, there are fewer clinics offering free or low-cost testing and there’s more stigma about HIV- and STI testing.

In 2024, End HIV Oregon estimated 8,564 people are living with HIV in Oregon. 

According to an analysis by the HIV+ Hep Policy Institute, the federal budget for the fiscal year beginning July 1 “maintains funding for existing domestic HIV care, treatment, and PrEP programs.” However, the analysis found it would cut more than $1.5 billion in HIV prevention and related programs.  

In Oregon, HIV Alliance and others fighting the rise in rates of new HIV diagnoses rely on federal funding to provide testing and other services. That includes the Oregon Health Authority, Cascade AIDS Project and Oregon Health & Science University, among others. As federal funding streams dry up, organizations across the state could be forced to make cuts.

Effective treatment

Cascade AIDS Project runs the PRISM primary care service. But it’s perhaps best known for its testing clinic, Pivot, with locations on Southeast Belmont Street and North Morris Street. The free clinic offers drop-in testing for HIV, syphilis, chlamydia and gonorrhea for anyone and everyone, regardless of whether or not they provide identification documents. 

Like HIV Alliance, CAP receives funding from a variety of entities, but its prevention programs are mostly funded by the CDC. Without federal funding, CAP would lose five full-time employees, out of a staff of 14 that works on prevention efforts. 

“For prevention, specifically, our biggest single source of funding is directly from CDC,” said Edgar Mendez, CAP’s director of prevention. “It is approximately 30% of our overall operating costs. We’re all up for renewal. Dozens of organizations like CAP across the country are looking to see from CDC what’s going on. Historically we normally get that communication around January or February. This time, that hasn’t yet come through. So there is no certainty about what the future of that direct federal support for HIV testing and linkage to care is going to look like.” 

CAP usually relies on public health partners like OHA and Multnomah County Health Department to identify trends in spiking infections and areas of increased need for testing. According to Mendez, with anticipated cuts to testing services, it’s likely that new cases of HIV in Oregon will continue to rise.

“We’re lucky that we’re a relatively low preponderance state of HIV compared to some other states in the United States,” he said. “I think the key takeaway is that is the result of very active efforts by our public health entities. There’s a clear correlation when testing services are cut. It’s only a matter of time before there’s a spike in new infections.”

One of CAP’s missions is empowering people with knowledge about what is risky, and what isn’t. The social component is more complicated — many people living with HIV endure social isolation, harmful assumptions, stigma and fear when telling a loved one that they’re at risk.

“HIV is a very physically weak thing,” Mendez said. “If it’s exposed to oxygen it dies. So there’s so many situations — like sharing a kitchen, sharing a bathroom, being in public, touching somebody — that have absolutely zero risk for any possible transmission, no matter what.”

And treatment for HIV is extremely effective. The issue isn’t finding treatment that works, Mendez added, it’s removing barriers to accessing treatment. 

“I don’t want to minimize the impact of living with it,” Mendez said. “But for most people, the reality is one pill, once a day of extremely effective medication.” 

Some communities face higher risk than others. For people who are uninsured, communities with fewer primary care providers and communities who have been historically disenfranchised from our healthcare system, HIV testing is not as accessible. For that reason, HIV infections are more prevalent within those communities. 

Reducing stigma

One of CAP’s partners is Familias en Acción, a local Latine-serving organization that helps CAP provide culturally-specific, Spanish-language testing services, resource navigation, sexual education and medical care to Latine populations around the state.

For the past five years, Familias en Acción (Familias for short) has used CDC funding to collaborate with CAP. 

Ayla Rosen, sexual health program manager at Familias, cited transportation barriers, lack of childcare coverage and fear of federal immigration enforcement as factors impacting Latines’ abilities to access medical care and HIV/STI testing services. In rural areas of Oregon, it can take up to an hour to drive to a testing location. 

Additionally, changes to federally-funded healthcare programs and cuts to Medicaid funding have created confusion and apprehension about accessing and paying for medical care in Oregon — especially for immigrants who are afraid to leave their homes. Fear of ICE presence and anticipated language barriers can dissuade Latines from going to public administrative offices like DMVs or Oregon Department of Human Services to apply for the Oregon Health Plan. 

One aspect of Familias’ Sexual Health Program is Me Cuido, Te Cuido — a series of sexual health education workshops conducted in Spanish. These workshops work to normalize conversations about sexuality, HIV and STI prevention, sexual health, relationships and community resources. Familias has reached approximately 1,500 people through these workshops, with participants from 21 of Oregon’s 36 counties.

“The community has received it really well, and people are always so grateful, because a lot of times they’ve just never had an opportunity to have a space to have these types of conversations,” Rosen said.

According to Rosen, these conversations play an important role in reducing cultural stigma.

The Portland Pride Festival at Tom McCall Waterfront Park will take place July 18 and 19. CAP and HIV Alliance will be there, alongside queer makers, vendors and artists, celebrating queer resilience and offering free HIV testing services.

This article appears in June 24, 2026.