For years, the people keeping Indonesia’s queer and trans communities connected to HIV care weren’t doctors. They were outreach workers: peers who handed out condoms, explained PrEP, got people tested, checked that they stayed on treatment and sometimes walked with them to the clinic.

According to a new report from Human Rights Watch, that whole layer of care for LGBT people disappeared in 2025, when the US government dismantled USAID.

What the report found

The report, “We Want to Be Treated as Human”: Impact of US Foreign Aid Cuts on HIV/AIDS Prevention and Care in Indonesia, was published on November 11. It’s 33 pages. The headline findings, from HRW’s news release:

  • The money: US-government data show obligated HIV funding for Indonesia fell from $11.9 million in fiscal year 2024 to $7.9 million in fiscal year 2025.
  • What was cut: All USAID-funded community-based HIV prevention and care for LGBT people.
  • Who’s most at risk: HIV prevalence in Indonesia is about 0.4% in the general population, but about 22% among men who have sex with men and 25% among transgender people.
  • Who was paying: In 2020, only 0.1% of Indonesia’s own HIV spending went to programmes for men who have sex with men, and none went specifically to trans people. International donors covered 98% of HIV programming for those groups.

So when one big donor walked away, nobody stepped in. HRW notes that after the US cuts, France, Japan, Germany and others also pulled back HIV/AIDS funding.

What it looks like on the ground

HRW interviewed 35 people in Jakarta, Depok and Serang in November 2025 and June 2026: people living with HIV, outreach workers, activists, academics, aid recipients and NGO staff.

Outreach workers told HRW they have lost contact with clients. Some clients missed doses or were late collecting medication. Local groups say they can no longer track new infections or who has dropped out of treatment.

One gay activist living with HIV put it bluntly: “If you are LGBT and living with HIV, it’s the end of the story. You are doomed.”

“The Trump administration’s gutting of USAID eliminated services that helped LGBT people” in Indonesia, said Julia Bleckner, senior health researcher at HRW.

A new law makes it harder to even ask for help

The funding gap landed at the worst possible moment.

Indonesia’s new criminal code took effect on January 1, 2026. It criminalises consensual sex outside heterosexual marriage and allows close family members to file complaints. HRW says this effectively criminalises same-sex conduct for the first time.

Police raids on private gatherings have used condoms and purported HIV medication as evidence, according to the report. That turns the tools of prevention into something people are scared to carry. Why get tested, or keep PrEP in your bag, if it might be used against you?

For trans people there’s another layer. HRW says those whose IDs don’t match their gender can be publicly addressed by a former name, which exposes them to humiliation and discrimination. “Just leaving the house as a trans person is scary,” a trans outreach worker living with HIV told HRW.

We’ve been tracking how the pressure on LGBTQ+ Indonesians has grown this year: a push to wipe LGBTQ+ content off the internet, attacks on university students, and a clerical push to criminalise LGBTQ+ people outright. Losing HIV services is happening on top of all of that.

The global picture

Indonesia isn’t the only place feeling this. HRW cites estimates that more than 170,000 additional people have died worldwide in the year since cuts to the HIV response began. UNAIDS executive director Winnie Byanyima has said: “There’s no question that this is the most serious disruption in the HIV response.”

We’ve seen the same pattern closer to home. In the Balkans, North Macedonia’s LGBTQ+ groups lost core funding when USAID withdrew, and in the US, community HIV prevention groups have been cut too.

What HRW is asking for

From Indonesia’s government: fund HIV prevention and care for men who have sex with men and trans people, support community-led groups, keep antiretroviral supplies steady, train health workers, repeal discriminatory laws, end raids, stop treating condoms and HIV medication as evidence, and protect LGBT people from vigilante violence.

From the US: keep PEPFAR money flowing on time, disclose what happened when programmes were terminated, and withdraw the “Promoting Human Flourishing in Foreign Assistance” policy.

From other donors: give more to the Global Fund to Fight AIDS, Tuberculosis and Malaria, and fund LGBT-led groups in Indonesia directly.

HRW says it wrote to the US State Department and to Indonesia’s Ministries of Health and Home Affairs on September 24, 2026. By the time the report came out, none had replied.

Why it matters

HIV is preventable and treatable. A person on effective treatment can live a long, full life and won’t pass the virus on to partners. Everything here depends on keeping people connected to care.

That’s what Indonesia’s outreach workers were doing, and the report shows how quickly it falls apart when the money and the legal space vanish together. The fix is just as clear: fund the people the community already trusts, and stop treating a condom as evidence of a crime.