Ryan White Title III HIV Capacity Development and Planning Grants - Category: HIV Care Innovation Activity: Strategic Partnerships/Partnership Development Request: $150,000 Penobscot Community Health Center, Inc. (PCHC) 103 Maine Ave, Bangor, ME 04401 www.pchc.com Program Director: Amy West, FNP-C, CARN-AP, amy.west@pchc.com, 207-404-8000 Contact: Heather Blackwell, hblackwell@pchc.com, 207-992-9200 ext. 1504 PCHC is the largest FQHC in Maine and the 6th largest in New England. While we serve 3 counties, our main offices and most of our service sites are located in Bangor, Penobscot County, which is centrally positioned in this geographically vast and rural state. Bangor is currently facing an HIV outbreak, and PCHC is at the forefront of efforts to contain it. Historically, HIV rates in our region and state have been low. Over the past 5 years, Penobscot County averaged 2 new HIV cases/year, with 1 new diagnosis annually among people who inject drugs (PWID). However, on 2/26/24, the Maine Department of Health and Human Services issued a public health advisory announcing a cluster of 3 new HIV diagnoses among PWID in Penobscot County. All cases traced back to a large encampment in Bangor, formed by individuals experiencing homelessness around the onset of the COVID-19 pandemic. In recent years, Bangor’s unhoused population has spiked, and the community has struggled to manage this increase, particularly during the pandemic, which complicated infection control efforts. The first HIV case was diagnosed in October 2023. Given we had historically been a low-case area, our healthcare systems and support services were unprepared for this situation. We lacked the infrastructure to effectively manage it, and the number of cases has continued to rise. As of 3/1/25, the Maine CDC reported 21 confirmed cases in this cluster. All 21 individuals had injected drugs within 1 year of their HIV diagnosis, 20 were co-infected with hepatitis C, and 19 had been unhoused within 1 year of diagnosis. The situation has escalated to the point where this is now classified as an outbreak. This outbreak is responsible for a 119% increase in new HIV diagnoses statewide in 2024 (compared to the previous 5 years' average) and a 750% increase in Penobscot County. Despite facing severe healthcare workforce shortages, financial challenges following the pandemic, and lack of funding assistance, PCHC and other key partners have worked tirelessly to contain this outbreak. HRSA funding will enable us to strengthen our response and develop the infrastructure necessary to manage current patients, address new diagnoses resulting from this outbreak, and prepare for potential future outbreaks. Since this outbreak primarily affects unhoused individuals and PWID—many of whom do not engage with shelter programs and are either living on the streets or in encampments—this group represents our target population. The main goals of our project are to (1) increase access to high-quality HIV primary healthcare services for low-income and underserved people living with HIV, and (2) strengthen organizational and regional capacity to respond to HIV. Key activities will include hiring a Partnership Systems-Building Consultant to provide short-term outbreak coordination and help build a long-term strategic system for managing HIV in our region. This consultant will formalize our current partnerships into a consortium, optimize each partner's expertise, and develop an infrastructure and action plan for ongoing work. We will create and maintain a comprehensive referral list and enhance provider education efforts. Additionally, PCHC will collaborate with partners to offer “street outreach” services to our target population, providing early linkage to care and support to engage “hard-to-reach” individuals in the HIV Care Continuum. Over the course of our one-year project, we aim to strengthen our capacity to address all five stages of the HIV care continuum and build a sustainable infrastructure to continue this work in the future.
