{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T16:46:01Z","timestamp":1792773961957,"version":"4.5.0"},"reference-count":46,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:00:00Z","timestamp":1792540800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:00:00Z","timestamp":1792540800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Glob Health Promot"],"abstract":"<jats:p>Sustained financing remains critical to the global HIV response, particularly in low- and middle-income countries (LMICs) where external aid supports treatment and prevention programs. Recent shifts in donor priorities have raised concerns about the continuity of essential HIV services. Using Nigeria as a case study, this paper examines how declining international HIV funding threatens HIV control efforts through increased transmission risk, treatment interruption, and strain on fragile health systems. Available evidence indicates that funding reductions have disrupted community-based HIV testing, prevention, and care services, particularly those serving key populations including orphans and vulnerable children. Nigeria\u2019s Global Fund allocation fell by over 11%, while thousands lost access to pre-exposure prophylaxis within months of donor funding freezes. Modeling studies suggest that across LMICs, similar funding shortfalls could result in millions of additional HIV infections and deaths by 2030 if mitigation measures are not implemented. This commentary highlights the urgent need for diversified and sustainable financing mechanisms, strengthened domestic resource mobilization, and coordinated global action to safeguard HIV gains and sustain progress toward the Joint United Nations Programme on HIV and AIDS 2030 targets.<\/jats:p>","DOI":"10.1177\/17579759261490883","type":"journal-article","created":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T08:38:43Z","timestamp":1792571923000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["From progress to precarity: how funding shifts threaten HIV gains in Nigeria"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1643-5995","authenticated-orcid":false,"given":"Stanley Chinedu","family":"Eneh","sequence":"first","affiliation":[{"name":"Department of Community Health, Obafemi Awolowo University, Osun, Ile-Ife, Nigeria"},{"name":"Interdisciplinary Health Sciences, The University of Texas at El Paso, TX, USA"},{"name":"Youth in Research Hub, Vital Health Reach Foundation (VHRF), Enugu State, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9262-1135","authenticated-orcid":false,"given":"Francisca Ogochukwu","family":"Onukansi","sequence":"additional","affiliation":[{"name":"Youth in Research Hub, Vital Health Reach Foundation (VHRF), Enugu State, Nigeria"},{"name":"Department of Public Health, Federal University of Technology Owerri, Imo State, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2594-7009","authenticated-orcid":false,"given":"Collins Chibueze","family":"Anokwuru","sequence":"additional","affiliation":[{"name":"Youth in Research Hub, Vital Health Reach Foundation (VHRF), Enugu State, Nigeria"},{"name":"Department of Public Health, Federal University of Technology Owerri, Imo State, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5771-4981","authenticated-orcid":false,"given":"Ogechi Vinaprisca","family":"Ikhuoria","sequence":"additional","affiliation":[{"name":"Youth in Research Hub, Vital Health Reach Foundation (VHRF), Enugu State, Nigeria"},{"name":"School of Public Health, University of Port Harcourt, Rivers State, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9330-7188","authenticated-orcid":false,"given":"Samson Adiaetok","family":"Udoewah","sequence":"additional","affiliation":[{"name":"Youth in Research Hub, Vital Health Reach Foundation (VHRF), Enugu State, Nigeria"},{"name":"Department of Public Health Nursing, Africa Centre of Excellence in Public Health and Toxicological Research, University of Port Harcourt, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3389-6176","authenticated-orcid":false,"given":"Chidera Gabriel","family":"Obi","sequence":"additional","affiliation":[{"name":"Youth in Research Hub, Vital Health Reach Foundation (VHRF), Enugu State, Nigeria"},{"name":"Department of Parasitology and Entomology, Nnamdi Azikiwe University, Awka, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Onyeka Chukwudalu","family":"Ekwebene","sequence":"additional","affiliation":[{"name":"Youth in Research Hub, Vital Health Reach Foundation (VHRF), Enugu State, Nigeria"},{"name":"Department of Pediatrics, Ryan White Center for Pediatric Infectious Disease and Global Health, Indiana University School of Medicine, Indianapolis, IN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2124-6088","authenticated-orcid":false,"given":"Chioma Adaora","family":"Nwalieji","sequence":"additional","affiliation":[{"name":"Youth in Research Hub, Vital Health Reach Foundation (VHRF), Enugu State, Nigeria"},{"name":"Faculty of Clinical Sciences, University of Nigeria Teaching Hospital, Enugu State, Ituku, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibuchukwu Nkeonyenasoya","family":"Orabueze","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Faculty of Basic Clinical Sciences, College of Medicine, University of Nigeria, Ituku-Ozalla Campus, Enugu, Nigeria"},{"name":"Department of Microbiology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2562-5561","authenticated-orcid":false,"given":"Patrick Yila","family":"Shaibu","sequence":"additional","affiliation":[{"name":"Interdisciplinary Health Sciences, The University of Texas at El Paso, TX, 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