By Editor,Emily Joshu Sterne
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Idyllic small town in Maine hit with largest HIV outbreak in state’s history
READ MORE: Inside town overwhelmed by world’s most infectious disease
By EMILY JOSHU STERNE, US SENIOR HEALTH REPORTER
Published: 22:24 BST, 16 September 2025 | Updated: 22:36 BST, 16 September 2025
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.
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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.
There are about 1.1million Americans living with HIV and 38,000 new diagnoses every year, with over two and three new cases being in gay men. Federal data shows about 13 percent don’t know they have HIV and need to be tested for it.
Left untreated, HIV turns into AIDS, the most advanced form of HIV that severely damages the immune system and leaves patients prone to potentially deadly infections like hepatitis and tuberculosis.
The latest CDC data shows there were just under 4,500 HIV-related deaths in the US among people older than 13 in 2023.
According to local health data, the first positive HIV test in the Penobscot County outbreak came in October 2023, and two more followed in January 2024.
All three patients had previously been homeless and used injection drugs, both risk factors for HIV. And Dr Puthiery Va, director of the Maine CDC, said because homeless people generally lack access to medical care, the actual number of infections is likely larger.
The latest data from the Maine CDC shows all but one case used injected drugs within one year of diagnosis, and all but three had been homeless in that same timeframe.
The above CDC graphic shows the rates of HIV diagnoses by US region
She told the Portland Press Herald: ‘When we think about the population that’s impacted here, it speaks to all the societal and economic factors that make a population or a community more vulnerable to outbreaks.
‘When the conditions are right, it spreads.’
Cases were highest in February 2025 when six were reported. The latest data shows two cases in July.
In the years leading up to the HIV outbreak, the Bangor area had seen an increase in homelessness and drug use within encampments.
Fatal opioid overdoses increased 36 percent from 2019 and another 23 percent from 2020 to 2021, though the rates declined 16 percent from 2022 to 2023. Homelessness in Penobscot County, meanwhile, peaks in 2022 with 4,411 homeless people.
And in October 2024, the Bangor Health Equity Alliance, which provided clean syringes and HIV testing to drug users, abruptly closed, which experts have noted also contributed to the outbreak.
Jennifer Gunderman, director of Bangor’s health department, told the Portland Press Herald: ‘Everyone is already sort of overextending in a manageable way. 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.
‘But we can’t say that we can’t address this outbreak. That’s not an option. We have to focus our research and our efforts. There’s no other option here.’
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Idyllic small town in Maine hit with largest HIV outbreak in state’s history
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