Overview:
HIV is a hidden epidemic in Central Oregon and is spreading through communities already struggling with isolation, overwhelmed healthcare systems and economic uncertainty.
Beth thought the hardest part was over when her COVID symptoms finally cleared in late 2022. Like many Central Oregonians, she had delayed routine health care during the pandemic, focusing instead on getting by while the world shut down around her. But months later, a routine blood test at Deschutes County’s health clinic revealed something far more serious: She was HIV positive and had likely been living with the virus for over a year without knowing it. Beth, whose last name is being withheld for privacy, had become one of an estimated 1,087 Oregonians living with HIV without realizing it — casualties of a pandemic that disrupted testing schedules, overwhelmed health care systems and left a hidden epidemic to spread unchecked through communities already struggling with isolation and economic uncertainty.
A hidden crisis emerges
Across Central Oregon, HIV rates are climbing to unseen levels.
“Preliminary data show that in 2024 we had 15 HIV cases in Central Oregon, the highest number ever recorded for our region,” says Jessie Hunsaker, STI/HIV regional epidemiologist for Deschutes County.
According to the Central Oregon Health Data Report, HIV in Deschutes County reached 88.7 cases per 100,000 people, the second-highest rate in Central Oregon. Jefferson County reported 90.4 cases per 100,000, while Crook County had 74.2. These figures represent a troubling reversal of nearly a decade of progress, as new HIV diagnoses across Oregon jumped between 2021 and 2024, with rural counties bearing a disproportionate burden.
Central Oregon’s HIV crisis reflects broader national challenges: the intersection of rural health disparities, funding cuts, pandemic disruptions and changing social behaviors.
People are now being diagnosed with advanced HIV at higher rates than in previous years, suggesting they’ve been living with the virus longer before detection. The two-to four-week window when most people experience flu-like symptoms after contracting the virus often goes unrecognized or is attributed to COVID or flu. Some people show no symptoms at all.
Risk factors
Today’s HIV landscape differs dramatically from the crisis of the 1980s and 1990s. People diagnosed with HIV can live long, healthy lives with proper treatment. Daily HIV medication can reduce the virus to undetectable levels, meaning there’s effectively no risk of transmitting it to sexual partners — a concept known as “undetectable equals untransmittable.”
Medical advances have transformed HIV from a fatal diagnosis into a manageable chronic condition. Yet despite these breakthroughs and decades of public health education, HIV rates continue climbing in Central Oregon and across the nation.
Central Oregon’s HIV surge isn’t happening in isolation — it’s part of a significant regional increase in sexually transmitted infections including gonorrhea and syphilis. Except for a brief decrease in 2018, gonorrhea rates in Central Oregon have been steadily increasing since 2009.
The rise in syphilis is the most concerning. Deschutes County reports that, “the syphilis rate in Central Oregon is growing faster than the statewide rate.” In 2013, there were four cases of syphilis reported in Central Oregon; in 2024, there were 67 cases. The sharp increase in syphilis among women also raises concern for infants, who can be infected during pregnancy. “As syphilis continues to rise so dramatically, we expect to see HIV cases increase as well. These infections often occur together,” states Hunsaker.
People who engage in higher-risk sexual behavior are more likely to contract STIs and HIV. According to the “International Journal of Sexual Health,” the rise of dating apps and online platforms has led to an increase in anonymous sexual encounters, making it harder to trace partners and contain the spread of infections. Even people who get tested for STIs may not realize that HIV and syphilis aren’t always included.
“Many people assume that when they get tested for STIs, they are automatically tested for HIV and syphilis. That is not always the case,” explains Hunsaker. “People need to ask specifically for these tests and advocate for themselves.” As HIV has become more manageable, many people now see it as less of a threat — often assuming they’re not at risk. A consensus studies report from the National Academies of Sciences, Engineering and Medicine notes that this shift has had serious public health impacts, making it harder to trace partners and control the spread of infection.
Injection drug use presents similar challenges for contact tracing and prevention efforts. The HIV Alliance reports that a connection between injecting drugs and HIV spread happens in several ways. When people share needles, the Alliance explains, it’s usually because they can’t get clean ones easily. The Trump administration has been pushing back against harm reduction services which offer opioid overdose reversal medications and clean needles. The approach has become a hot-button issue in drug policy debates. In July, President Donald Trump signed an executive order targeting homeless people and harm reduction efforts, telling the Department of Health and Human Services not to fund “programs that fail to achieve adequate outcomes, including so-called ‘harm reduction.'” Without clean needles, the chances of passing HIV go way up. On top of that, the shame and judgment around drug use often stops people from getting tested or seeking help, which just makes the problem worse, reports the journal of Medical Humanities.
According to an October 2024 Oregon Health Authority newsletter, total deaths among people living with HIV rose by 73%, from 100 in 2013 to 173 in 2022. During that time, drug-related deaths in this group jumped by 460%, far outpacing the 214% increase seen in the general population.
The Public Health Division of the Oregon Health Authority points out that when multiple health challenges pile up together, they create even bigger risks for people who are already struggling — especially those dealing with homelessness, trauma and ongoing stress. Each of these factors working together can lead to more HIV cases.
Still, it’s important to remember that HIV can affect anyone, regardless of their background or circumstances. As Hunsaker points out, “HIV affects people from all walks of life. Anybody can acquire it.”
Federal cuts threaten HIV progress, prevention and care
The first half of 2025 brought an upheaval to HIV research funding. Government and medical sources documented sweeping changes to HIV-related federal programs. Among the cuts, both the National Institutes of Health and Health and Human Services terminated more than 1,800 grants—many focused on HIV, health equity and disparities research. Yale University researchers lost 17 NIH grants totaling $42.7 million, while George Washington University researchers saw over $3 million in similar funding disappear. A federal judge eventually intervened, halting further cancellations and ordering approximately 900 projects reinstated, but the damage had already begun.
Plans are also underway to ask Congress to rescind previously approved funds, and the latest budget request pushes for even deeper reductions. While Congress holds ultimate authority over federal spending, the president’s budget signals clear priorities for the administration. If these proposed cuts advance, the consequences for HIV research could be far-reaching and potentially undermine efforts to prevent new infections, advance treatment research and provide care for people already living with HIV.
According to the Kaiser Family Foundation, the proposed budget calls for cutting $1.5 billion from domestic HIV programs. The most significant reduction would target the Centers for Disease Control and Prevention, historically the backbone of HIV prevention efforts, which would lose all $794 million of its HIV prevention funding. This represents a 78% cut nationwide and accounts for more than 90% of federal prevention dollars. The Ryan White HIV/AIDS Program would survive, but take a $74 million hit. Several key parts of the program — such as education, training and health services — would vanish completely, finds the KFF. Cutting funds from domestic HIV programs would severely limit access to testing, treatment and prevention, especially in communities most at risk.
HIV research is expected to take a hit in the latest round of federal budget cuts. As a longtime global leader in HIV prevention, care and treatment, the U.S. could face serious setbacks. Funding for the National Institute of Allergy and Infectious Diseases is projected to drop by $2.4 billion compared to 2024 levels. The HIV + Hepatitis Policy Institute also reports that the National Institutes of Health could face a roughly 40% cut.
Support from legislation and local programs
Oregon lawmakers are taking a different approach, with new legislation aimed at expanding HIV testing and care access. House Bill 2943, introduced in 2025, would require emergency departments to include HIV and syphilis testing in routine blood work unless patients opt out. The bill remained in committee when the legislature adjourned on June 27, 2025, with no word yet on whether it will be reintroduced. Meanwhile, a companion measure, House Bill 2942, would address a bureaucratic barrier that has prevented pharmacists from receiving reimbursement for HIV care despite gaining prescribing authority under a 2021 law. That bill was successfully signed into law on May 28, 2025.
Central Oregon maintains HIV prevention and harm reduction services
Even as federal support remains uncertain, Central Oregon continues to deliver vital harm reduction and HIV prevention services. Crook, Deschutes and Jefferson counties offer free or low-cost STI and HIV testing. The Eastern Oregon Center for Independent Living offers services in all three counties. Ryan White Case Management Services, operated by the EOCIL, connects people with HIV to care, meds, housing help, mental health support and more.
In Oregon, anyone can consent to their own HIV testing, including teens.
“Everyone should be tested for HIV at least once in their lifetime, and more often if they have ongoing risk,” says Hunsaker.
Recommendations
Health officials recommend regular testing based on risk factors. Most people should be tested at least once for HIV due to recent increases in Central Oregon, with more frequent testing for those with potential exposure. Testing recommendations include:
- Annual screening for sexually active people under 25
- Annual screening for those over 25 with potential STI or HIV exposure
The message from public health experts is clear: prevention works. Condoms, safer sex practices, syringe exchange programs, pre-exposure medications and post-exposure medications can help stop transmission.
For testing, prevention, or support services:
Crook County Health Department, 541-447-5165
Deschutes County Health Services, 541-322-7155
Jefferson County’s Reproduction Health program, 541-475-4456
This article appears in the Source September 18, 2025.
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“Central Oregon’s HIV crisis reflects broader national challenges: the intersection of rural health disparities, funding cuts, pandemic disruptions and changing social behaviors.”
I disagree with all of the above unless by “changing social behaviors” you mean the continued dumbing down of the Oregon population. Abstinence is free, and condoms are nearly free. And yet my tax dollars continue to pay for a disease that is 100% preventable (and you don’t even need a vaccine).
“HIV affects people from all walks of life. Anybody can acquire it.”
I’m not sure I understand this. How do people who never use syringes, are in long-term monogamous relationships, or those who are not sexually active at all, acquire HIV?
Well here is an example of how, David. Perhaps a partner believes that they are in a monogamous relationship and are therefore not at risk, so that person does not get tested. Then that relationship ends, life goes on and the person has several other relationships and partners over a period of years. Then they start having health problems, seek care from their doctor trying to find out why. That person may be diagnosed with a number of illnesses which are treated. But they are not tested for HIV because they know they are not at risk. Then the learn that the original person they were partners with is dying of AIDS. Obviously that person was involved in sex outside the thought monogamous relationship. That’s when our person finally gets test and discovers they are HIV +.
In the intervening years this person has exposed and possibly infected any other sec partners they had.
Not only this but treatment that begins so late is not as effective.
That’s just one example of how a person not engaging in high risk behavior can squire the HIV and spread it to others unknowingly.
Tracy, your explanation of one way that HIV can be spread in a typically monogamous relationship is spot-on. Thank you for sharing your thoughts, and thank you for being a reader!