Penobscot County, Maine, is grappling with the largest HIV outbreak in the state’s history. Home to Bangor, a city of roughly 32,000, the county has identified 28 new cases over nearly two years. That’s seven times the typical number for that length of time. Nearly all cases are among people who use drugs and are homeless.

Public health experts and local advocates say the outbreak is fueled by a confluence of on-the-ground factors: the sidelining and closing of programs that distributed sterile syringes to people who use drugs, a shortage of medical providers focused on HIV, and the clearing of the city’s largest homeless encampment, which upended care for newly diagnosed people living there.

But those issues may not remain local for long.

The Trump administration is pushing similar tac

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