Indiana will end a statewide HIV outreach and testing program this summer after health officials say a drop in federal pandemic relief dollars forced them to scale back services — a move providers warn could limit access for some of the state’s highest-risk populations.
Indiana’s Special Populations Support Program — which provides HIV testing, counseling and support services in addiction treatment settings — will sunset June 30, according to the state Department of Health.
The decision follows a $6.7 million reduction over two years in federal American Rescue Plan Act, or ARPA, funding that had supported the program.
Lisa Welch, an IDOH spokesperson, told the Indiana Capital Chronicle health officials opted to prioritize other services.
“To minimize the impact, other programs in this service area were prioritized based on performance and proven effectiveness,” Welch said.
She noted that the agency reviewed programs with “particular emphasis on the identification of new HIV cases” and ultimately chose to prioritize disease intervention specialists, or DIS — public health staff who conduct testing, notify partners of potential exposure and help connect people to care.
“The state funding allows the DIS to continue HIV, STI, and hepatitis C testing and provide the greatest service to Hoosiers,” Welch said.
The cuts affect multiple organizations across the state, including the Indianapolis Urban League, Aspire Indiana Health, IU Health and several local health departments and HIV service providers.
Those impacted contracts include:
- Aspire Indiana Health — $360,000
- Indianapolis Urban League — $180,000
- IU Health — $135,000
- Health Plus Indiana — $90,000
- AIDS Task Force of LaPorte and Porter Counties — $90,000
- Clark County Health Department — $60,000
- Northeast Indiana Positive Resource Connection (NEIPRC) — $45,000
State data shows SPSP-funded staff conducted more than 17,600 HIV tests between 2021 and 2025, including a peak of 4,575 tests in 2024 alone.
Overall, more than 112,000 HIV tests were conducted statewide during that period.
Because many tests are anonymous, Welch said state health officials can’t determine how many individual Hoosiers were served.
Concerns about gaps in testing
The SPSP program specifically targets people with substance use disorders — a population considered at higher risk for HIV transmission — by embedding testing and counseling services in facilities overseen by the Indiana Division of Mental Health and Addiction.
Testing counselors conduct risk assessments, provide pre- and post-test counseling, and connect individuals who test positive with care coordination and treatment services. Additional screening for hepatitis C and other sexually transmitted infections is also offered, when appropriate.
All services are provided free of charge and have been available statewide through a network of regional providers.
Advocates and service providers say the loss of SPSP could create gaps in early detection — a key component of HIV prevention.
Testing is often the first step in identifying infections and linking patients to care, which can reduce transmission rates and improve health outcomes.
Organizations losing funding told the Capital Chronicle the program has long served as a front-line outreach effort — particularly for people unlikely to seek testing in traditional medical settings.
The less people that are working on this … the more the likelihood is we’re going to see rises in HIV. We’re going to see rises in Hep C. And you’re going to see a higher rate of morbidity in those diseases.Dorothy Waterhouse, program director for HIV, STD and syringe services at the Clark County Health Department
Leaders at Aspire Indiana Health, which has received SPSP funding since 2004 and serves 32 counties, said the program supports community-based testing in jails, shelters, treatment programs and other non-clinical settings.
The central Indiana-based nonprofit health system conducts roughly 800 HIV tests and 600 hepatitis C tests annually through the program, primarily serving people who use drugs, those who are incarcerated or unhoused, and individuals in recovery.
“Community-based HIV and HCV testing will be drastically reduced across the state,” Aspire officials said in a written statement. “In some areas, community-based testing will be completely eliminated.”
Program funds to IU Health have similarly supported free HIV and hepatitis C screenings for people at increased risk, along with risk reduction and treatment referrals, said Lisa Tellus, a spokesperson for the health system.
IU Health conducts roughly 500 to 600 HIV tests annually with SPSP funding and is “still working to evaluate the impact of the change” and determine how to continue serving those populations, she said.
Separately, Health Plus Indiana — which has received SPSP dollars for about 20 years — uses the program to support a peer recovery specialist and testing staff. The funding has also covered costs for some 50 HIV tests annually.
“By continuing to cut testing funds, it reduces people learning their status,” said executive director Leeah Hopper. “If people don’t know their status, there could be new cases which may cause an epidemic.”
Hopper said the nonprofit will lose both a recovery support position and a testing role tied to the funding.
Local impacts vary
Local health departments are also affected, but impacts vary.
In Clark County, where the health department receives about $60,000 annually through SPSP, the funding has primarily supported staffing for testing and outreach.
Dorothy Waterhouse, program director for HIV, STD and syringe services at the Clark County Health Department, said the program has existed locally for more than 20 years and has primarily supported staffing for testing and outreach.
Her department conducts between 1,500 and 1,800 HIV tests annually, including roughly 50 to 100 tests tied directly to SPSP funding.
Those efforts often focus on high-risk populations in jails, recovery centers and other settings where large-scale testing can be conducted quickly. Teams handle dozens of screenings in a single visit to a county jail.
While Clark County has been able to shift staff into other funding streams for now, Waterhouse warned that broader reductions could still have consequences.
“The less people that are working on this … the more the likelihood is we’re going to see rises in HIV. We’re going to see rises in Hep C,” she said. “And you’re going to see a higher rate of morbidity in those diseases.”
She added that without testing, people may go years without knowing they are infected, increasing both health risks and the likelihood of transmission.
“The biggest takeaway from this is that for the community is that they’re losing out on critical services,” Waterhouse said. “The less people that are working on this, the less people that we are reaching.”
“If they’re not diagnosed, they’re out there … not on medicine, so their viral loads are really high,” she continued. “And this is what increases the chance of transmission.”
State says care will continue
SPSP began in 2008 and was historically funded through the state’s general fund, with a total annual budget of about $960,000. Federal relief dollars in recent years helped sustain or expand those efforts.
But many of those initiatives are now being scaled back or eliminated as much of the pandemic-era federal funding expires.
State officials said no direct replacement program has been announced, though some services — particularly testing tied to disease intervention specialists — will continue under other funding streams.
Despite the cuts, Welch emphasized that treatment will not be affected, and that “HIV medical services remain a top priority.”
“IDOH will continue to ensure there is no interruption in care for people living with HIV,” she said.
Still, advocates and public health experts maintain that testing and prevention are critical to controlling the spread of the virus.
Without consistent testing and outreach, new infections may go undiagnosed longer — increasing the risk of transmission.
“Reducing HIV testing capacity could have a significant and long-term negative impact because the longer someone goes untested, the more likely they are to spread the virus unknowingly because treatment is delayed,” said Dr. Virginia A. Caine, director and chief medical officer of the Marion County Public Health Department.
“Knowing your status and getting tested early is critical … to prevent transmission of HIV and improve the chances of living longer with improved health outcomes,” she added.
Caine also noted that communities with higher HIV rates — often served by “trusted” local organizations that are critical for outreach and education — “are more likely to be disproportionately affected by any funding cuts.”
Advocates echoed those concerns, emphasizing that testing is the entry point to both treatment and prevention.
“If you don’t do that work, the spread of HIV continues,” said Alan Witchey, president and CEO of the Damien Center, Indiana’s largest HIV/AIDS-focused organization. “What we know is that most people who spread HIV don’t yet know that they’re positive. As soon as we identify them … and get them on medications, they can no longer spread the virus.”
The Damien Center previously received SPSP funding but is not currently funded through the program or affected by the latest round of cuts. The organization continues to receive other state funding for HIV prevention services, including a separate grant set to expire June 30.
Even so, Witchey said the latest round of cuts to testing programs could disproportionately affect rural communities and people of color, where access to care and prevention services is often more limited.
He also noted that SPSP-funded sites often provide more than just testing — offering safe, nonjudgmental environments where people can discuss risks and connect to care.
“Without these networks, without these rural networks, that’s where I would expect future cases are,” Witchey said. “People will have options available — just not as many.”
Indiana Capital Chronicle is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Indiana Capital Chronicle maintains editorial independence. Contact Editor Niki Kelly for questions: info@indianacapitalchronicle.com.
