Health officials in Tennessee say they will reject federal funding for groups that provide services to residents living with HIV.
Earlier this week, the Tennessee Department of Health announced it would no longer accept grant money from the Centers for Disease Control and Prevention earmarked for testing, prevention and treatment of HIV.
In an email reviewed by NBC News, the Department of Health told certain nonprofit organizations that provide these services that the state would turn down the federal funding as of June, relying only on state funds afterward. "It is in the best interest of Tennesseans for the State to assume direct financial and managerial response for these services," the email read.
When asked for comment by NBC News, a spokesperson for the Department of Health said that "the letter speaks for itself."
An estimated 20,000 people in Tennessee are living with HIV, though not all would be affected by the cuts. There was no further guidance on how the state planned to fund such programs on its own.
The move stunned HIV experts.
"I can't understand why the state would give back funds targeted toward health care," said Diane Duke, president and chief executive officer of Friends for Life, a Memphis group that provides services to people living with HIV. Friends for Life was among the groups that received notice from the state. "It's outrageous," she said.
Shelby County, where Memphis is located, is among the nation's counties with the highest rates of HIV and AIDS. In 2020, 819 per 100,000 Shelby County residents had HIV, according to the Centers for Disease Control and Prevention.
And those were only the people who'd received an official diagnosis.
"A lot of people are walking around with HIV, and they don't even realize it," Duke said. Providing testing for the virus is a major part of the work Friends for Life carries out. "Once somebody has tested positive, we are able to get them into care immediately," she said.
Greg Millett, director of public policy for the nonprofit group amfAR, the Foundation for AIDS Research, called the decision "devastating." He is concerned that Tennessee health officials are setting a dangerous precedent.
"If other states follow suit," Millett said, "we're going to be in trouble."
Millet said that the CDC provides Tennessee as much as $10 million in HIV funding. It remains unclear how much of that money will be turned away.
He said he worries that the state's directive will lead to discrimination against marginalized groups most at risk for HIV.
"The overwhelming majority of new HIV cases are among gay and bisexual men, transgender populations, heterosexual women, as well as people who inject drugs," he said.
"We have the tools needed to end the HIV/AIDS epidemic in terms of prevention and care," Millett said. "If Tennessee is not using those tools, not using CDC funding and not focusing on the groups most at risk for HIV, we have the possibility of an outbreak."
The CDC provides millions of dollars each year to states for HIV testing kits, condoms and medications to prevent infection, called PrEP.
In a statement provided to NBC News on Friday, the CDC said that it was unaware that Tennessee — or any other state — planned to stop accepting the grant money.
"We have not received any official notification from the Tennessee Department of Health withdrawing from CDC's HIV prevention funding," the CDC said. Without such notice, the CDC will automatically continue payments to the state.
The federal agency also said that it would "certainly be concerned if the services people in Tennessee need to stay healthy were interrupted or if public health capacity to respond to HIV outbreaks and bring an end to this epidemic were hindered."