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The United States is the world's largest provider of official development assistance, with most funds directed through the United States Agency for International Development (USAID).
Trump froze the bulk of U.S. foreign assistance for three months on returning to office in January, leaving global humanitarians scrambling to deal with the fallout.
"It's dramatic in many countries," UNAIDS executive director Winnie Byanyima told AFP.
"I need to sound the alarm so that it's very clear that this is a big part [of AIDS relief funding]. If it goes away, people are going to die."
The U.S. move included a 90-day suspension of all work by the President's Emergency Plan for AIDS Relief (PEPFAR).
That program supports more than 20 million HIV patients and 270,000 health workers, according to an analysis from the Foundation for AIDS Research (amfAR).
"We could see additional deaths increasing by tenfold" to 6.3 million in five years, Byanyima said, citing figures estimated by UNAIDS.
"Or we could see new infections increase up to 8.7 million" in the same period, she said.
The United States has said that "life-saving treatments" would be exempt from the freeze, although front-line workers in Africa say facilities have already closed.
Founded in 1961, USAID has an annual budget of more than $40 billion, used to support development, health and humanitarian programmes around the world, especially in poor countries.
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