Following significant cuts to United States foreign aid funding last year, more than 280,000 aid workers worldwide lost their employment, with particularly severe consequences for workers in Nepal. In the impoverished nation, where openly transgender individuals face severe legal employment barriers, approximately 100 LGBTQ+ aid workers have turned to sex work as a means of survival after losing their positions.
The funding cuts eliminated operations at organizations like Friends Hetauda, which provided HIV testing, counseling and prevention services to Nepal’s LGBTQ+ communities. The organization, which received 85 percent of its funding from the U.S. Agency for International Development, had to shut down its 20 clinics across the country and ceased distributing antiretroviral medication and PrEP, a preventative medication for HIV-negative individuals. Between 35 and 45 percent of the organization’s 350 staffers transitioned to sex work after losing their positions, according to its executive director. In Nepal overall, an estimated 35,000 aid workers lost their jobs due to the funding cuts.
The consequences extend beyond employment loss. Health experts warn of significant public health risks, as the elimination of aid funding has also cut access to condoms and HIV prevention medication. Global data released in June showed HIV testing fell by 22 percent in high-infection-rate countries, while condom funding was reduced by more than 90 percent in some locations. Workers who formerly provided HIV outreach now find themselves unable to access preventative medications themselves, with many forced into unprotected sexual encounters with clients.
Former aid workers describe experiencing widespread violence in their new circumstances. Multiple individuals reported beatings, gang rape, and threats with weapons. Despite their education and training in health prevention, these workers face dire circumstances with no apparent pathway to alternative employment. Health officials caution that the impacts transcend Nepal’s borders, noting potential regional health implications through migrant workers and cross-border movement.
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