The Centers for Disease Control and Prevention (CDC) and other federal health agencies removed hundreds of pages of HIV-related information from their websites last week as part of a government-wide purge triggered by President Donald Trump’s executive orders on “gender ideology” and “DEI” (diversity, equity, and inclusion). Much of the content was back up by Tuesday, but transgender people have largely been edited out.

CDC and other agency employees received a memo late last week instructing them to avoid so-called gender ideology and to recognize only male and female sexes. Information on HIV, sexually transmitted infections (STIs), contraception, racial/ethnic minority and LGBTQ health and other sensitive topics appears to have gotten swept up in the rush to delete potentially banned material by the January 31 deadline. Staff reviewed, revised and restored content over the weekend, but by the time the dust settled, some material related to key HIV populations was left out.

“The removal of HIV- and LGBTQ-related resources from the websites of the Centers for Disease Control and Prevention and other health agencies is deeply concerning and creates a dangerous gap in scientific information and data to monitor and respond to disease outbreaks,” Infectious Diseases Society of America (IDSA) president Tina Tan, MD, and HIV Medicine Association (HIVMA) chair Colleen Kelley, MD, MPH, said in a statement. “This is especially important as diseases such as HIV, mpox, sexually transmitted infections and other illnesses threaten public health and impact the entire population.”

Screenshot from CDC website

Some content, including HIV surveillance data, has since been reinstated without obvious changes. Other pages have been replaced with edited versions that omit any mention of transgender people. In contrast, the CDC website continues to include content about gay, lesbian and bisexual people. A page about smoking cessation, for example, now refers to “LGBQ+” instead of “LGBTQ+” people.

Screenshot from CDC website

Some searches for HIV prevention and epidemiology info now return either a 404 “page not found” error or a notice that the content is temporarily offline to comply with executive orders. Among the “not found” content is a series of HIV fact sheets with statistics for key populations, including gay and bisexual men, Black people, Latino people and transgender people. Also missing is the CDC’s widely used pre-exposure prophylaxis (PrEP) guidance. HIV risk estimator and risk reduction tools were taken offline entirely, returning a “site can’t be reached” message. (Many POZ Basics and news reports contain links to the now-deleted pages.)

Screenshot from CDC website

Sexually transmitted infection (STI) content appears largely intact and still includes a page on STI treatment for transgender and gender-diverse people. The CDC’s guidelines for doxycycline post-exposure prophylaxis (doxyPEP) was taken down briefly but is now back up with no apparent alterations. The CDC website still has basic information about mpox (formerly monkeypox), but it includes no indication that gay and bisexual men account for the vast majority of cases in the United States or recommendations for mpox vaccination.

“CDC has authoritative, evidence-based and vital information about treatment and prevention of HIV and other sexually transmitted infections,” Paul Sax, MD, of Brigham and Women’s Hospital, told POZ. “Just last week, while preparing a presentation to teach other clinicians, I looked up the most recent version of the HIV PrEP guidelines on the CDC site. These are no longer available. These are important resources for clinicians and patients alike.”

Other Federal Agencies

The National Institute of Health’s HIV.gov website has undergone more focused editing. This site still features a set of population-specific HIV fact sheets from the National Institutes of Health (NIH), but the one about transgender people is no longer included. Likewise, among more than a dozen HIV awareness days for various affected populations, National Transgender HIV Testing Day appears to be the only one missing. Awareness days for Asian/Pacific Islander, Black, Caribbean, Latinx and Native communities remain, suggesting that trans people specifically—rather than “DEI” more broadly—are the main target.

Screenshot from HIV.gov website

HIV treatment information has generally fared better but has also undergone some changes. The Department of Health and Human Services’ Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents With HIV—the federal government’s primary treatment resource for clinicians—were revised in September with an updated section on “Transgender People With HIV.” That section is still listed on the guidelines landing page, but clicking through on the link returns a 404 page not found error.

The DHHS Perinatal HIV Clinical Guidelines continue to refer to “pregnant people” (instead of “pregnant women”) and still include a note about referring to transgender men and gender-diverse individuals by their preferred terminology (for example, “chestfeeding” instead of “breastfeeding”). But clicking on a link to “Perinatal HIV Prevention for Transgender and Gender-Diverse People Assigned Female at Birth” again returns a 404 error.

Screenshot from HIV.gov website

"Removing the HIV content is quite problematic. The guidelines on testing, prevention and treatment are used all the time by practitioners not only in the U.S. but globally,” Carlos del Rio, MD, of Emory University School of Medicine, told POZ. “Pretending that trans people don’t exist and thus we should not talk about them is not only inhumane but also bad for HIV prevention and care, as transpeople have some of the highest risk for HIV.”

As previously reported, the CDC, NIH, Food and Drug Administration (FDA) and other DHHS agencies were ordered to pause external communications until February 1. But that date has come and gone, and they’re still largely incommunicado. The CDC’s Morbidity and Mortality Weekly Report—which clinicians, local health officials and science journalists rely on to learn about disease outbreaks and other important public health news—has not been published for two weeks. The HIV.gov blog has not had a new entry since January 16, and there have been no new NIH news releases since January 17.

Soon after his inauguration, Trump put a halt to all foreign aid, including funding for PEPFAR (the President’s Emergency Plan for AIDS Relief), which provides HIV prevention, testing and treatment services in low-income countries. After a public outcry, Secretary of State Marco Rubio issued a waiver allowing clinicians to offer life-saving antiretroviral medication, but some providers have been unable to continue their work. The PEPFAR website, which was taken down last week, was put back up even as its parent agency, USAID, is under attack by Trump and Elon Musk’s DOGE.

Screenshot from X

Many experts expressed concern when the CDC’s Youth Risk Behavior Surveillance System, which includes topics such as sexual activity, substance use, exposure to violence and mental health, was taken offline. The YRBSS website is back up now, but there have been reports that some gender data are missing.

In the midst of Robert F. Kennedy, Jr’s Senate confirmation hearings last week—which largely focused on his views about vaccines—CDC’s Advisory Committee on Immunization Practices (ACIP) web pages, including recommended vaccine schedules, were taken down. ACIP content is back up this week with a note stating that “CDC’s website is being modified to comply with President Trump’s Executive Orders.”

Screenshot from NCI website

Other agencies have not been spared in the purge. On the National Cancer Institute website, a page about transgender inclusion in cancer research was deleted. The NIH Office of Research on Women’s Health website was taken down but later restored. The DHHS ReproductiveRights.gov website, however, remains offline. The Sick Times reported that data on long COVID had been taken down, though this has largely been restored. As previously reported, the FDA removed web pages referencing racial/ethnic and socioeconomic diversity in clinical trials, which could result in the approval of drugs that do not work for the population at large.

Alternative Information Sources

While much of the federal government’s HIV prevention and treatment content is once again accessible—albeit with some major holes—clinicians, researchers and people living with HIV are looking to other sources.

In the days after Trump’s inaugurations, calls went out on social media to archive sensitive information, and people working in numerous health fields took up the challenge. Deleted and original versions of altered CDC web pages and datasets have been uploaded to the Internet Archive. Experts in other countries are also stepping up.

Screenshot from BlueSky

IDSA and the International Antiviral Society-USA (IAS-USA) both have their own HIV guidelines. Last updated on December 1, the IAS-USA recommendations are generally comparable to the federal DHHS guidelines, featuring information about PrEP, doxyPEP, HIV diagnosis, first-line antiretroviral therapy, switching treatment, monitoring and other health conditions in people with HIV.

The British HIV Association and the European AIDS Clinical Society also have extensive online guidance. According to Laura Waters, MD, a former BHIVA chair and member of the guidelines writing group, BHIVA follows a “remarkably similar methodology,” and there’s “very little difference” from U.S. guidelines. The World Health Organization offers guidelines on HIV prevention, testing, treatment and service delivery tailored for low- and middle-income countries.

Del Rio, a coauthor of the IAS-USA recommendations, told POZ that the IAS-USA and DHHS guidelines “are closer and closer each time, but I suspect that going forward IAS-USA guidelines—and others, such as HIVMA primary care guidelines—will need to be more bold and cover the populations and topics that the government has chosen to ignore.”