Fear and worry in Lesotho: Photos show those affected as US aid cuts affect care for HIV patients

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Lisebo Lechela, 53, an HIV-positive sex worker, poses for a portrait in her house in Maputsoe, Lesotho, Thursday, July 17, 2025. Lechela lost her job at a USAID-funded organization that provided medical services and medication to people most vulnerable to HIV and AIDS, including sex workers and gay and transgender people. After her husband died of AIDS, Lechela vowed to work to end the stigma around HIV. "These American donations had changed people's lives," Lechela said. (AP Photo/Bram Janssen)

Rethabile Motsamai, 37, who lost her job as an HIV counselor after the USAID cuts, poses for a portrait in Maseru, Lesotho, Sunday, July 20, 2025. Motsamai, a mother of two, has worked since 2016 for U.S.-funded organizations helping people living with HIV across Lesotho. In January, her HIV counselor role was eliminated, leaving many of her patients in isolated communities without access to services. "They'll just stop taking their medication," she said. As of October, Motsamai remained unemployed but hoped she might be hired again. (AP Photo/Bram Janssen) — Lisebo Lechela, 53, an HIV-positive sex worker, poses for a portrait in her house in Maputsoe, Lesotho, Thursday, July 17, 2025. Lechela lost her job at a USAID-funded organization that provided medical services and medication to people most vulnerable to HIV and AIDS, including sex workers and gay and transgender people. After her husband died of AIDS, Lechela vowed to work to end the stigma around HIV. "These American donations had changed people's lives," Lechela said. (AP Photo/Bram Janssen)

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3:56 AM on Thursday, October 16

By BRAM JANSSEN

MAPUTSOE, Lesotho (AP) — For the 2.3 million residents of Lesotho, the announcement of massive cuts to the U.S. aid that sustained much of the small African nation’s health care system came as a shock. The country long had one of the world’s highest HIV infection rates but recently made notable progress and hit key milestones in its fight against the epidemic.

Still, an estimated 260,000 HIV-positive people live in Lesotho. And as organizations and clinics that relied on foreign assistance shut down, many here lost access to life-saving treatment, to testing, to preventative medication, to other crucial services. These patients say this year has been filled with fear and uncertainty, and they worry as they look to the future, even as some programs have been temporarily reinstated.

Throughout Lesotho — known as the kingdom in the sky, as it’s the only country in the world where all its territory is more than 1,000 meters (3,280 feet) above sea level — health workers have been losing their jobs due to the funding cuts. Officials and residents say it’s another blow to their country, after U.S.-imposed tariffs forced factory closures months ago.

A team of Associated Press journalists traveled around Lesotho — from the urban capital of Maseru to isolated rural villages in the mountains and the lowlands — to photograph those affected by the U.S. aid cuts. Sitting at their homes, wearing their traditional Seanamarena blankets and their Mokorotlo straw hats, they posed for portraits and spoke of their fears and hopes in this new reality.

This is a photo gallery curated by AP photo editors.

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