Bangor public health director reflects on conditions that escalated Maine HIV outbreak

Maine’s Penobscot County is experiencing its largest HIV outbreak on record, with 41 confirmed cases since October 2023, far exceeding the state’s annual average of fewer than 40 new diagnoses. Jennifer Gunderman, Bangor’s director of public health and community services, attributes the surge to rising homelessness, widespread drug use, and reduced access to syringe services and healthcare providers. The outbreak began with the first confirmed case in October 2023, but its scale became apparent by mid-2024, with most cases linked to injection drug use and homelessness. Gunderman noted that additional cases likely exist among housed individuals who inject drugs, as well as those engaged in sex work for survival. The Maine Center for Disease Control and Prevention is collaborating with national experts to model the outbreak’s full extent, though Gunderman acknowledged uncertainty about its total reach. In response, the state has expanded HIV and hepatitis C testing, provided prevention services, and connected diagnosed individuals to medical care. Bangor’s public health department has also distributed HIV self-tests, assisted with housing placements, and launched an HIV case management program to help patients navigate appointments and health insurance. The Bangor City Council recently approved syringe service certification, allowing the department to distribute sterile syringes to affected individuals. Gunderman emphasized the role of local public health efforts in addressing the crisis, highlighting how Bangor’s expanded services could serve as a model for other Maine communities facing similar risks. She stressed the need for increased testing, prevention outreach, and early intervention to prevent further outbreaks. Gunderman’s background in epidemiology, including her work with the Maine CDC in the late 1990s, has informed her approach to the current challenge.