A decision by the state of Tennessee in January to forgo several pots of federal dollars for HIV-related programming was met across the state with shock and widespread concern about the potential impacts in a region with the highest transmission rate in the U.S.

Many worry the repercussions will be especially severe for Shelby County, which has a transmission rate high enough to qualify it for extra federal funding for HIV testing and surveillance. Without the federal dollars, advocates and nonprofits say the state’s surveillance network could fall apart and HIV could spread relatively unchecked. The organizations that relied on the dollars could be forced to cut staff and programming if new funding sources aren’t secured.

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