Some affected individuals have resorted to illegal drug purchases at higher prices or rely on mobile clinics introduced after funding cuts, highlighting the critical need for support.

Discrimination and treatment refusal continue to be significant barriers for HIV-positive sex workers and transgender people, pushing some toward illegal drug markets or untreated status.

While limited waivers from the U.S. have allowed some HIV services to resume, the overall impact of aid withdrawal remains deeply harmful and widespread.

Critics argue that U.S. aid policy is influenced by domestic politics, and many South Africans are angry over how these cuts threaten their health and lives.

Before the aid cuts, about 2 million of South Africa’s 8 million people with HIV were not on medication, and recent disruptions threaten to reverse the progress made in controlling the epidemic.

Many vulnerable groups, including sex workers and transgender individuals, face discrimination and refusal of treatment at healthcare facilities, forcing some to buy medication illegally or go without.

Despite the South African government's pledge to maintain its largest HIV program, the aid cuts have made it difficult to sustain treatment, especially as private and black market options are often unaffordable.

Activists emphasize the urgent need for alternative funding sources to prevent a worsening public health crisis and to avoid reversing gains made in HIV control.

The recent U.S. aid reduction of $427 million has severely impacted South Africa's HIV treatment programs, leading to clinic closures and treatment disruptions for over 63,000 people, with up to 220,000 potentially affected.

Health experts warn that these disruptions could lead to a rise in new HIV infections and deaths, risking a regression in progress against the epidemic.

The decline in testing and monitoring due to funding cuts further threatens to increase HIV transmission and mortality rates if aid is not restored.