US Aid Cuts Force Nepalese HIV Prevention Workers Into Sex Work Amid Rising Risks

For nine years, Rubi Lama, a transgender activist in Hetauda, central Nepal, worked tirelessly to combat HIV by distributing condoms, encouraging testing, and supporting marginalized sex workers. Lama was employed by Friends Hetauda, an organization providing HIV prevention and counseling services to the LGBTQ community. However, following US President Donald Trump's decision to cut foreign aid budgets and dismantle USAID in early 2025, Lama and about 100 other LGBTQ aid workers lost their jobs. Unable to find alternative employment due to discrimination and high unemployment, many, including Lama, were forced into sex work to survive.

Friends Hetauda's offices now sit abandoned, with empty condom dispensers and unused computers bearing USAID stickers. The funding cuts led to the loss of approximately 35,000 aid jobs in Nepal alone, worsening an already dire employment situation. Lama, who previously earned about $200 a month, now earns as little as $4.50 per client on the streets, facing significant personal danger including violence and sexual assault. Several former aid workers interviewed reported experiences of rape, physical abuse, and coercion into unprotected sex, increasing their risk of HIV infection.

The health impact is severe. Blue Diamond Society, which operated 20 clinics providing antiretroviral drugs and PrEP preventive treatment, lost 262 of its 350 staff and saw over 1,200 patients cut off from services. PrEP distribution has nearly ceased except for pregnant and nursing women, leaving high-risk groups unprotected. Many transgender sex workers living with HIV have stopped treatment due to stigma and lack of resources. Experts warn this could trigger a resurgence of HIV in Nepal and the wider region, given Nepal’s open border with India and the mobility of its population.

The crisis reflects a global setback in HIV prevention, with over 1,700 clinics closed worldwide and a 51% drop in US spending on HIV prevention within a year. The US State Department defended the aid restructuring as a move toward efficiency and partnership, urging other countries to increase their contributions. Meanwhile, Nepalese aid workers like Lama continue to face poverty, discrimination, and violence, caught between survival and the risk of a public health disaster.

Summary: After US aid cuts dismantled HIV prevention programs in Nepal, many LGBTQ aid workers lost jobs and were forced into sex work, facing violence and increased HIV risks. The shutdown of clinics and prevention services threatens a resurgence of HIV locally and regionally.

Points: - US aid cuts led to loss of 35,000 Nepalese aid jobs, forcing many LGBTQ workers into sex work. - Former HIV prevention workers face violence, sexual assault, and coercion into unprotected sex. - Closure of clinics cut off over 1,200 patients from HIV treatment and prevention services. - PrEP distribution nearly stopped, increasing risk of HIV resurgence in Nepal and neighboring regions. - Global HIV prevention funding dropped 51%, closing 1,700+ clinics and costing 16,000+ jobs. - US State Department cites aid restructuring for efficiency, calls on other nations to share burden.

Topic: health israel_relevant: false entities: {"people":["Rubi Lama","Donald Trump","Prinsi Tamang","Sujata Chaudri","Barsha Magar","Bhearti Thapa","Ashika Tamang"],"organizations":["Friends Hetauda","USAID","Blue Diamond Society","PEPFAR","US State Department"],"places":["Hetauda","Nepal","India"]}