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Bangor’s closure of the homeless encampment known as Tent City last year disrupted efforts to respond to the ongoing HIV outbreak in Penobscot County, according to the U.S. Centers for Disease Control and Prevention.
The federal agency cited that closure, as well as inconsistent access to syringe services and HIV case management, as challenges to responding to the growing outbreak in a draft report obtained by the Bangor Daily News through a Freedom of Access Act request.
It also noted there are not enough HIV clinicians “to meet the growing patient load in the county.”
The draft report is the first comprehensive look from an outside agency at the local response since the HIV outbreak began in 2023. It comes as the number of cases continues to grow, reaching 44 last month, and amid rising tensions in Bangor around homelessness and injection drug use, both risk factors for the outbreak.
Nearly all of the people infected have reported injecting drugs or being homeless within one year of their diagnosis, according to the Maine CDC. Public health officials have emphasized that the actual number of cases in the outbreak is likely higher than what’s been detected.
“Interruptions to SSP [syringe service provider] and HIV case management services and closure of encampments disrupted response efforts,” including outreach and linkage to care, the draft report stated.
The encampment closure in February 2025 displaced nearly 100 people who were living behind the Hope House shelter.
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The Health Equity Alliance, a major HIV and syringe service provider in the Bangor area, closed around the same time. Syringe exchange services during that period were also disrupted when Bangor city officials stopped plans for another service provider, Needlepoint Sanctuary, to offer mobile syringe services downtown.
The draft report also indicates that elements of the outbreak response by Bangor-area groups could be a model for other parts of the country, particularly the rollout of long-acting injectable PrEP, a medication that prevents HIV transmission. That step “could be transformative for HIV prevention” among people who inject drugs, the draft report stated.
There are two injectable forms of PrEP currently approved by the Food and Drug Administration, both additions to the market in the last five years. This medication, which is administered via injections every few months instead of a daily pill, can be taken more consistently, especially for people who use drugs or are homeless.
This medication has been introduced to outbreak response efforts through mobile clinics at syringe service providers and warming centers, according to the draft report.
“These efforts highlight the challenges of containing HIV and HCV [hepatitis C virus] transmission among persons dually affected by substance use and housing instability, especially in smaller cities with limited care capacity and prevention services,” the draft report stated.
The report was compiled based on research conducted by U.S. CDC staff during a visit to Penobscot County in December, which included interviews with 19 people, including those infected with HIV as part of the outbreak and others in the community.
Maine CDC requested help from its federal counterpart with this research in September. That came after the U.S. CDC provided “initial on-the-ground technical assistance” with the outbreak in August, an agency spokesperson previously told the BDN.
People interviewed by the CDC said they had positive experiences getting tested for HIV and hepatitis C through syringe service providers, according to the draft report, which also noted that many interviewees were hesitant to seek care in local emergency rooms.
There are still gaps in testing and treatment for hepatitis C in the area, the draft report stated.
It’s unclear when the final report will be published.
Spokespeople for the U.S. CDC and the Maine CDC did not immediately respond to requests for comment.
Bangor City Manager Carollynn Lear directed the BDN to Jennifer Gunderman, the city’s public health director, who did not immediately respond.