Penobscot County is grappling with Maine’s largest HIV outbreak in its history. Looking back, the top public health official for the county seat of Bangor described how the conditions existed for such an outbreak and how it is now difficult to know the full scope. In a recent interview, Jennifer Gunderman, Bangor’s director of public health and community services, said HIV had dropped off the radar in Maine because the state has a low incidence of the disease, but then the risk factors started piling up: increased homelessness, wide drug use, disappearing syringe service providers and health care options, and fewer case management providers. The challenges that arose made it more likely that an outbreak would balloon. The first case in what was later determined to be a cluster was identified in October 2023. A year and a half later, Penobscot County had 21 confirmed cases. HIV is a virus that attacks the immune system and, if untreated, can lead to AIDS .…