31 cities
Ryan White Program Disruptions: City-Level Impact Projections
What happens if Ryan White funding is interrupted or eliminated? Modeling impacts on HIV care outcomes across major US metropolitan areas.
Ann Intern Med, 2025
OpenJohns Hopkins Bloomberg School of Public Health
Joint HIV Epidemiology and Economic Model
JHEEM provides evidence for HIV policy decisions through calibrated mathematical modeling across US metropolitan areas and states.
We use mathematical modeling to understand and predict HIV transmission and the impact of interventions across local populations. The simulated population is stratified by age, race, sex, sexual behavior, and drug use, and is calibrated to real-world HIV surveillance data under the Ending the HIV Epidemic initiative — enabling projections of how policy and funding decisions may shape future transmission.
Local calibration
City and state projections anchored to surveillance data
Structured populations
Age, race, sex, behavior, and drug-use strata represented in the model
Policy scenarios
Funding, testing, and intervention assumptions compared over time
Modeling Tools
30 states
Ryan White Program Disruptions: State-Level Impact Projections
Statewide projections of Ryan White funding disruption, providing jurisdictional insights for policy makers.
AJPH, 2026 · CROI, 2026
Open18 states
CDC-Funded HIV Testing Disruptions: State-Level Impact Projections
What is the epidemiological impact of ending CDC-funded testing? Modeling cessation and interruption scenarios.
Clin Infect Dis, 2026
Open24 states
Projecting the Age Distribution of Persons With HIV in the US
How will the HIV population age over the next 15 years? State-level projections from 2025 to 2040.
Submitted
Open30 statesComing soon
The Economic Impact of Ryan White Program Elimination: State-Level Impact Projections
What are the economic consequences of eliminating the Ryan White program? Weighing downstream HIV care costs against the ADAP spending avoided, 2026-2035.
Working paper
PreviewRecent Publications
2025
Potential Impact of Ending the Ryan White HIV/AIDS Program on HIV Incidence in the United States: A Modeling Study
Forster RJ, Kasaie P, Schnure MC et al.
Annals of Internal Medicine
Ending the Ryan White HIV/AIDS Program could result in 75,436 additional HIV infections (95% CrI, 19,251 to 134,175) across 31 high-burden U.S. cities from 2025 to 2030—a 49% increase. Even temporary interruptions lasting 18-42 months would cause 19-38% more infections. The impact varies dramatically by city, from 9% increase in Riverside, CA to 110% in Baltimore, MD, highlighting the critical public health value of Ryan White services.
2025
Impact of Proposed Cuts to the Ryan White HIV/AIDS Program on HIV Incidence: A State-Level Analysis
Zalesak A, Kasaie P, Schnure MC et al.
medRxiv (preprint)
Proposed cuts to Ryan White Parts C/D, Minority AIDS Initiative, and Ending the HIV Epidemic programs could result in 23,883 additional HIV infections (17.6% increase) across 30 states and DC from 2025 to 2030. The impact would be largest in states with high Ryan White dependency, with rural and underserved communities experiencing disproportionate effects.
2026
The Potential Effect of Ending Centers for Disease Control and Prevention Funding for HIV Tests: A Modeling Study in 18 States
Balasubramanian R, Schnure M, Forster R et al.
Clinical Infectious Diseases
Ending CDC funding for HIV testing could result in 12,719 additional HIV infections (a 10% increase) across 18 states from 2025 to 2030. Testing reductions would delay HIV diagnoses by an average of 0.5-1.5 years, increasing onward transmission and worsening health outcomes, with disproportionate impacts in rural and underserved communities.
Funding & support
Institutional support
This research is supported by grants from the National Institute of Mental Health, the National Institute of Allergy and Infectious Diseases, and the National Institute on Minority Health and Health Disparities.
- K08MH118094
- K01AI138853
- P30-AI094189
- R01MD018539
A note on the name: JHEEM was previously published as the “Johns Hopkins Epidemiology and Economic Model.” The acronym is retained; the name was revised in 2026 to reflect use beyond a single institution. Citations to the prior name remain equivalent for attribution, reproducibility, and continuity.