Chicago is in the middle of a quietly unfolding public health crisis.
New HIV diagnoses are rising: 818 Chicagoans were newly diagnosed in 2024, according to the Chicago Department of Public Health. That’s a 12.5% increase over 2023 and nearly 30% higher than 2022.
The communities bearing the greatest burden are Black and Hispanic Chicagoans on the city’s South and West sides, where structural inequities have long shaped health outcomes. And yet, at this critical moment, a bureaucratic failure has cut — and in some cases, altogether eliminated — funding to several established providers serving these very communities.
This is not a story about a shortage of federal dollars. It is a story about what happens when the process breaks down, and who gets left behind.
Every year, CDPH distributes millions of dollars in Ryan White Part A federal funding to HIV service providers through a competitive grant process. Ryan White, a federal program established in 1990, serves as the backbone of HIV care in the United States, providing essential services for people living with HIV who have no other means of accessing care.
The law requires that before CDPH issues requests for proposals, the Chicagoland HIV Integrated Planning and Action Council — the federally mandated planning body — first complete its priority setting and resource allocation process, determining how much funding goes to each service category. In the most recent grant cycle, this did not happen. CDPH issued requests for proposals before the council completed its allocations.
When asked about this, a CDPH representative declined to comment, citing the possibility of pending litigation.
Providers submitted applications without knowing how much money was available in each category. The resulting mismatch between what providers requested and what was available produced grant awards that did not reflect the actual need.
While discussions of procurement timelines and grant cycles are important, they tend to obscure what is truly at stake: The health and lives of real people.
South Side Help Center, in partnership with AIDS Healthcare Foundation and CALOR, serves over 4,500 clients across all Chicago communities, almost 300 of whom face immediate disruptions to their HIV primary care as a direct result of this funding loss.
These are not new patients navigating a system for the first time; they are individuals established in care. They have been seen by the same providers, prescribed the same medications, and have achieved viral suppression, keeping them healthy and preventing HIV transmission. Forcing a transition mid-treatment is not clinically neutral. It means missed appointments, medication lapses, disengagement from care and the possibility of viral rebound.
For Black and Hispanic communities, this reality translates to an exponential increase in new HIV diagnoses. In 2024, nearly half of all new diagnoses in Chicago were among Hispanic residents; Black Chicagoans accounted for 36%, a diagnosis rate significantly higher than white residents.
Set against the background of only 49% of people living with HIV retained in care — meaning they receive regular HIV-related health care — Chicago’s HIV epidemic is not receding. It is accelerating in communities of color. For these communities, this is precisely the wrong moment to defund trusted providers.
The city of Chicago has an opportunity to correct this failure. The resources exist, the need is clear and communities are waiting. What’s missing is the willingness to act.
CDPH has at its disposal mechanisms to correct this now — through bridge funding, reallocation of unspent Ryan White dollars or other means — keeping proven providers in the field and patients in care. The City Council can exercise its oversight authority, demanding accountability for how this process failure occurred and preventing it going forward.
The Getting to Zero Illinois plan calls for health equity, trauma-informed care and cultural responsiveness. These are not just values, they are commitments. And commitments require that, when the system fails the communities most in need, those with the power to act do so — not eventually, but now. Chicago can and must do better.
Vanessa Smith is the executive director of South Side Help Center, an affiliate of the AIDS Healthcare Foundation.