As the state agency responsible for responding to emergent public health threats, the Maine Department of Health and Human Services’ Center for Disease Control and Prevention (Maine CDC) has been working in partnership with federal and local partners to address the recent, rising spread of HIV and hepatitis C infections.
Since 2024, the increase in HIV and hepatitis C co-infection among people who inject drugs and who are experiencing homelessness has steadily increased, particularly in Penobscot County, prompting close and continuous collaboration between the Maine CDC, the local health department and providers, and community partners. Most recently, the Maine CDC expanded its on the ground team of experts to include federal partners from the U.S. Centers for Disease Control and Prevention (U.S. CDC).
Together with its local partners, the Maine CDC has expanded targeted outreach, boosted education efforts, and increased access to HIV and hepatitis C testing and treatment in Penobscot County. Focus areas of the response include:
- Increased testing for HIV and hepatitis C
- Rapid treatment initiation
- Linkage to care and other wraparound services such as housing stability, mental health services, and substance use disorder treatment
- Expanded access to pre- and post-exposure prophylaxis (PrEP and PEP)
- Expanded access to HIV treatment for people experiencing homelessness
- Increased provider knowledge and education
From the start, the Maine CDC has also worked with the U.S. CDC scientists who, with their knowledge of similar outbreaks in other parts of the country, have been able to provide insights, perspectives, and technical assistance as Maine responds to the outbreak and adjusts strategies to better tackle the outbreak. As the environment on the ground shifted over time, the Maine CDC, along with local partners, also shifted, moving to incentivize testing, treatment, and PrEP usage. In the fall of 2025, the Maine CDC escalated its response by requesting onsite assistance from the U.S. CDC.
The Maine CDC asked the U.S. CDC’s Epi-Aid program to support the State’s response to the HIV outbreak in Penobscot County. At the beginning of December 2025, the U.S. CDC sent a team of their epidemiologists and clinicians to Maine to bring their knowledge, skills, and hands-on expertise directly to the ongoing public health response.
Epi-Aid Takeaways
The Maine team’s engagement with the U.S. CDC Epi-Aid team reaffirmed a number of practices already underway in addressing the Penobscot County outbreak—and provided ideas for additional efforts. Preliminary considerations include the following:
- Overall: Continue to meet people where they are (e.g., street medicine, syringe services programs, events). Increase access to same-day services for HIV and hepatitis C testing and care.
- Testing: Expand patient reach and engagement in both clinical and non-clinical settings (e.g., emergency departments, jails, substance use treatment centers).
- Prevention: Continue supporting risk reduction and preventative care, including those offered by syringe services programs.
- Treatment: Expand the number of primary care providers offering HIV care services and hepatitis C treatment. Work to build capacity for street medicine services, case management, and care navigation services.
- Education: Continue to disseminate information and provide education through community partners and tele-mentoring services (e.g., Project ECHO).
The Maine CDC remains committed to disease prevention and surveillance as a core part of its mission to preserve, protect, and promote the health and well-being of all Maine people.
Learn more about Maine’s five-year Integrated HIV Prevention and Care Plan (PDF) on the Maine CDC website.