Mainye asked the CDC for help with HIV.The agency answered no.

Maine has cited its HIV outbreak as a significant health concern, but the shutdown prevented the CDC team from coming to the state's aid.

BANGOR — Steven Cronk, 41, sleeps among rows of tattered, sun-bleached tents clinging to a small patch of land between the town's rusted railroad tracks and the Penobscot River.He estimates that most of the approximately five dozen people in this homeless camp have HIV.

Cronk is among them.He was certain that he had contracted an infection from a dirty needle, and he was still worried about the diagnosis he received about a year ago.

"Some days I think I'm good, some days it's just down," said Cronk, who has had too many memories of his life.

Penobscot County sees an average of two new HIV infections per year.In late September, Maine public health experts cited "significant public health concerns" and called for assistance from the Centers for Disease Control and Prevention.

But after initially approving the request, the CDC suspended it on Oct. 9 in response to a request from the Department of Health and Human Services, The Globe, for comment.

The decision to suspend the deployment of these aid teams, called AP-AIDS, has left Maine and other states in a state of public health emergency, making it the longest government shutdown in US history.

Government officials want the team to arrive after the shutdown ends, but have also been told that the team will not be available until October.

Federal authorities would not say how many EPI-AID deployments are pending, or whether pauses have occurred during previous shutdowns.

The virus, transmitted through the sting of dirty needles, has taken root in Maine's homeless population in a part of the state that lacks the resources to protect them.

Dr. Tom Friden, who led the CDC during Shutcon in 2013, said the agency did not stop contributing to the work during this two-week period.

"We can answer the tortoise," he said."Includes travel, of course."

Other former CDC officials said the travel freeze represented an alarming departure from the agency's standards.For decades, Epi-Aids have been readily available for health emergencies, both domestic and international, shipping dozens of times a year.

"When a state asks for help, the CDC always helps," said Dr. Dimitri Daskalakis, former director of the CDC's National Center for Immunology and Respiratory Diseases, who resigned in protest against the Robert F. Kennedy Jr. administration.

Epidemiologists typically stay for up to three weeks to provide training, education, and support.The Maine team hopes to make it easier for people with the disease to have conversations.

The goal is to determine how each deployment will work.

This is a large-scale work that is great native and local public work, focused on providing direct services, has never been done before.

"We're burning out the ground here," said Jennifer Gunderman, Bangor's director of public health.

Gunderman is eager for Epi-Aid's interviews, which could provide new clues about how far the virus is spreading.

"People in Bangor think this outbreak is just about the homeless," Gunderman said."I don't think we've seen the full implications."

The break in Epi-Aids comes as the Trump administration plans to gut the CDC's HIV prevention program.The National Institutes of Health has awarded nearly $800 million in HIV research grants this year.

Experts Dr. John Brooks, a retired CDC expert, declares that the first term of Tr.Trump,

"What changed in the minds of these people?"said Brooks, who led an Epi-Aid deployment to a similar HIV outbreak in Indiana a decade ago.

Health experts estimate that a person living with HIV needs at least $500,000 to survive.

Conduct HIV prevention and research to improve the country's response to other similar diseases.

Nationally, HIV rates are falling, but intravenous drug use is causing epidemics in rural areas of the country, such as Maine.Unlike big cities, these communities have few resources for homelessness, addiction, and harm prevention.Over the past decade, rural areas in Kentucky, Ohio, and West Virginia have reported increases in HIV infections.

In 2023, Penobscot County had the second-highest number of overdoses, both fatal and non-fatal, of any county in Maine, Gunderman said, which only hints at the extent of the region's drug addiction problems.

A homeless camp set up now has eased the spread of the virus, but its closure in February has made it difficult to contact and treat people at risk, health experts said.

These outbreaks are sustained and exacerbated by the lack of homelessness.For people who have nothing, sex becomes a substitute for drugs or shelter, Gunderman said, and viruses are replaced by it.

The closure of the region's main HIV case management provider and source of sterile syringes earlier this year also contributed to the epidemic.Among other services, Health Equity Alliance (HEAL) coordinated transportation to appointments, connected people with food and housing, and helped enroll them in programs that make drugs more affordable.

Patients with precarious lives often cannot keep up with prescriptions or can be targeted by thieves when they do, and have little access to medical care.

"I have patients who sometimes drive three or four hours to reach an appointment," said Dr.Scott Melton, a chief doctor at Northern Light Eastern Maine Infectious Disease Care, that this is the only practice specializing in infectious diseases in the area.

Maine's surge coincides with an outbreak of hepatitis C, a blood-borne disease that damages the liver.

"I didn't hear about the outbreak until a week or two ago," said Kira Jimenez, a 38-year-old Bangor woman who contracted hepatitis C last year from sharing needles.

He said it hasn't been used in a month, but the fi plan will soon allow testing to make sure it hasn't been exposed to HIV.

Bangor is trying to bridge the gap, including a $550,000 investment for character management services and a Thursday, second, second, necessary, and unbearable group, AllePoint Allypoint Appluation.

Willie Harley, the organization's executive director, said it was a struggle to convince the trafficked population to prevent HIV.

"HIV is abstract compared to poverty or drug addiction," he said.

For some, the effort paid off.Jessica Emery, who came across the gate of a bangor-bangor store last week, said she visits a ping exchange every three days.

"I had a life, I'm trying to get back to it," said Emery, 43, who worked as a residential medical assistant before becoming homeless about a year ago."I don't want to get anything while I'm here."

On a recent Friday, Cronk walked to his tent along a deserted railroad track.A nearby river reflected late-autumn orange and auburn flowers.He acknowledged a small piece of good news: his girlfriend, who is pregnant, recently tested negative for HIV.

The beautiful surroundings believe that there is precession, he said.A few nights ago, he and his girlfriend found a broken tent and stolen food.That night he slept in the corner of the tent, which served as a small shelter from the heavy rain.

Like it, he shall not use the tree, but for the day he can give to the tree.

"Every day I feel like I'm dying," he said.

Jason Laughlin can be reached at [email protected] him @jasmlaughlin.