California has a $203 million surplus for HIV–now’s the time to spend it

SAN FRANCISCO, April 29, 2026–The End the Epidemics coalition released a bold and comprehensive budget request for the California Legislature this spring, which would bring an additional $143 million to HIV, STI, PrEP, and hepatitis C programs across the state. ETE is a statewide coalition that advocates for funding to eliminate health inequities and end the HIV, STI, viral hepatitis, and overdose syndemic in California. This funding request comes as the state confronts disruptions to federal funding for health programs, and stalled progress in confronting this syndemic due to severe underfunding. 

The state of California has more than enough resources at its disposal to stabilize and ramp up HIV, STI, and viral hepatitis prevention and care programs. A state fund that must be spent on HIV-related programs, the ADAP Rebate Fund, will have a $203 million surplus next fiscal year. Additionally, $900 million has been loaned from the ADAP Rebate Fund to the General Fund, and those dollars must be repaid if there is a need for the funds. 

“California has the resources and the proven strategies to accelerate progress in preventing new infections and ensuring people living with HIV receive timely, effective care,” said Robert Gamboa, Associate Director of Public Policy for the Los Angeles LGBT Center. “Year after year, Office of AIDS-funded programs prevent HIV with PrEP, cure hepatitis C, and rapidly link people to HIV care. But chronic underfunding means the Office of AIDS is forced to deny more funding applications than it can approve, leaving effective programs unable to expand or even continue. At a moment when federal cuts to HIV funding are threatened regularly and when the state has a significant surplus dedicated to HIV, increased investment is not only possible–it is essential.”

The End the Epidemics coalition’s budget request includes: 

• $33.8 million for the PrEP and PEP Initiation and Retention Initiative, in order to expand the use of PrEP and PEP among people at risk for HIV; 
• $14.5 million for Rapid Antiretroviral Therapy (ART) Projects, to develop projects that support people newly diagnosed with HIV to enter into care quickly after diagnosis; 
• $14.1 million for Project Cornerstone, which provides support and care to improve the health of people over age 50 who are living with HIV; 
• $30 million for the Emergency Department Screening Program, to establish opt-out testing for HIV, hepatitis C, and syphilis in emergency departments; 
• $50 million for rental assistance and housing services for people experiencing homelessness and living with HIV; and, 
• $550,000 for training and hepatitis C point-of-care RNA testing.   

“Sunburst Projects is proud to be a member of the End the Epidemics coalition and proudly supports ADAP Rebate Fund investments so that we can scale programming to meet community needs,” said Jake Bradley-Rowe, CEO of Sunburst Projects. “Through our Sunburst Clinic we are focused on providing free, confidential HIV and STI testing to reduce new infections while also working to get more people signed up for PrEP and PEP. The increase in funding in this area will allow for more programs like this across our state.” 

End the Epidemics also requests that opioid settlement funds be made available to support drug checking and overdose prevention ($10 million annually for five years) and renewal of the California Overdose Prevention and Harm Reduction Initiative ($16.25 million for four years). 

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