What’s being done about Penobscot County’s ‘demoralizing’ HIV spike

The leader of a Bangor-based organization that offers HIV prevention, testing and treatment called the spike in HIV diagnoses in Penobscot County “demoralizing” and “defeating.”

Thirteen people in Penobscot County have tested positive for HIV between Oct. 1, 2023, and Aug. 15, 2024, the Maine Center for Disease Control and Prevention reported. Of those, all tested positive for hepatitis C and reported injecting drugs in the last year. Eleven of the 13 people were also unhoused in the last year.

The spike in cases far exceeds the annual average of two new HIV diagnoses that Penobscot County has typically seen over the last five years. This is also the only cluster of new HIV cases the Maine CDC is aware of, said Jackie Farwell, a spokesperson for the department.

The surge in HIV and hepatitis C diagnoses, especially among people who inject drugs and are experiencing homelessness, is a blow for a region that already has multiple organizations that offer testing, prevention, education and treatment for the diseases.

The rise in HIV diagnoses in Penobscot County is unique in that it appears to be spreading among people who inject drugs, said Josh D’Alessio, executive director of the Bangor Health Equity Alliance. Past outbreaks of HIV have happened primarily through unprotected sex.

The risk of contracting HIV through using a contaminated needle to inject drugs is 0.63 percent and someone has only a 0.23 percent chance of being infected through a needlestick, according to the U.S. Centers for Disease Control and Prevention.

D’Alessio said his nonprofit is continuing to offer education on how to protect against HIV, test for the virus, and help people access both post-exposure prophylaxis (PEP) and pre-exposure prophylaxis (PrEP).

PrEP is a medicine that can protect someone from contracting HIV before engaging in behavior that would put them at risk, whereas PEP is a medicine that can prevent HIV when taken soon after a possible exposure.

The Bangor Health Equity Alliance is also one of Penobscot County’s two certified syringe service programs that provides sterile needles and other supplies to people who inject drugs to prevent them from sharing syringes and potentially spreading HIV and other blood-borne diseases.

Bangor-based Wabanaki Public Health and Wellness is Penobscot County’s other certified syringe service program.

The Bangor Public Health Department offers both education and screenings for HIV, hepatitis C and other sexually transmitted infections both in its Texas Avenue clinic and through outreach efforts, according to Jennifer Gunderman, the department’s director.

Gunderman encouraged the public to learn how HIV is transmitted to avoid misinformation that furthers stigma associated with the disease. She also encouraged anyone who’s concerned they have HIV to get tested.

D’Alessio credited many local and statewide groups and organizations, including the Bangor Community Action Team, Penobscot Community Health Care and more, with providing testing, treatment and prevention to the public. All those efforts, he said, will help stop the spread of HIV in Penobscot County.

However, D’Alessio called on the state and federal government to provide more immediate funding so the Health Equity Alliance and other organizations can increase its outreach to people who are at risk of contracting HIV or have already.

Farwell said the Maine CDC is ”working with teams from across the department as well as external partners to support the local response.”

“This includes testing for HIV and other infectious diseases, HIV prevention services, connections to health care and social services, education, and access to and disposal of sterile syringes,” Farwell said.

D’Alessio referenced the ample and sustained funding the Health Equity Alliance received from the government during the pandemic that allowed the organization to protect people who were homeless against COVID-19.

“We need revenue and resources in order to have a bigger impact, but that doesn’t seem to be coming,” D’Alessio said. “We know how to affect a response, but without any gas in the engine, it’s hard to go anywhere. I feel like my hands are tied, and that’s discouraging. I feel defeated.”