The Centers for Disease Control and Prevention (C.D.C.) recently released its latest Sexually Transmitted Disease Surveillance Report along with new data on the number of reported sexually transmitted disease (STD) cases across the United States. Innerbody.com’s research team analyzed and combined the latest statistics developed our annual state rankings by STD rate from highest to lowest along with key trends.
Before we get to the rankings, here are some findings and trends that we observed:
American southern states continue to dominate our state rankings with alarmingly high STD rates. In fact, 7 out of the Top 10 states are in the South.
What is going on in the South? According to Ronald Gray, MD, a professor of epidemiology at John Hopkins, the answer may simply come down to lack of access to affordable health care. “The South has more people living in poverty and in rural areas,” he says, “which may make it harder for them to get tested and treated for STDs.”
Unlike Chlamydia and Gonorrhea, Syphilis infection rates appeared to disproportionately affect western states:
State rankings by syphilis (primary and secondary) infection rate:

- Nevada (22.7 cases per 100K population)
- California (19.2 cases per 100K population)
- Mississippi (15.5 cases per 100K population)
- Georgia (15.4 cases per 100K population
- Arizona (14.9 cases per 100K population)
California led all states with the largest number of cities with high STD rates with seven cities. Ohio and Texas tied for the second most cities, both of which had six each. For more information about how individual U.S. cities stack up, check out our recently published City STD Rankings.
In terms of total STD cases, as one might expect, the largest states have the most number of reported STD cases.
State rankings by total number of STDs reported:
- California (318,214 total cases reported)
- Texas (196,279 total cases reported)
- New York (159,487 total cases reported)
- Florida (140,282 total cases reported)
- Illinois (104,155 total cases reported)
According to the CDC, over 2.4 million combined STD cases are reported across the U.S. each year. STD infections can persist for an extended period of time, and most people are not aware they are infected until advanced symptoms appear. Therefore, these statistics do not include millions of people who currently have an STD, but do not even know it.
As an aside, the CDC stresses that: “If you are sexually active, getting tested for STDs is one of the most important things you can do to protect your health. Make sure to speak with your doctor about your sexual history…” If you are uncomfortable talking with your doctor, or just can’t find the time to go get tested, an increasingly popular option is to take an at-home STD test.
Without further ado, below are our rankings of each U.S. state based on STD (highest to lowest):
Alaska

-
STD Cases / 100K
1,144
-
Total STD Cases
8,461
-
Chlamydia Cases
6,159
-
Gonorrhea Cases
2,247
-
Syphilis Cases
55
Mississippi

-
STD Cases / 100K
1,082
-
Total STD Cases
32,299
-
Chlamydia Cases
22,086
-
Gonorrhea Cases
9,749
-
Syphilis Cases
464
Louisiana

-
STD Cases / 100K
1,046
-
Total STD Cases
49,005
-
Chlamydia Cases
36,293
-
Gonorrhea Cases
12,043
-
Syphilis Cases
669
South Carolina

-
STD Cases / 100K
957
-
Total STD Cases
48,095
-
Chlamydia Cases
33,910
-
Gonorrhea Cases
13,801
-
Syphilis Cases
384
New Mexico

-
STD Cases / 100K
937
-
Total STD Cases
19,572
-
Chlamydia Cases
14,000
-
Gonorrhea Cases
5,268
-
Syphilis Cases
304
North Carolina

-
STD Cases / 100K
889
-
Total STD Cases
91,376
-
Chlamydia Cases
66,553
-
Gonorrhea Cases
23,725
-
Syphilis Cases
1,098
Alabama

-
STD Cases / 100K
855
-
Total STD Cases
41,656
-
Chlamydia Cases
28,437
-
Gonorrhea Cases
12,742
-
Syphilis Cases
477
Georgia

-
STD Cases / 100K
848
-
Total STD Cases
88,410
-
Chlamydia Cases
65,936
-
Gonorrhea Cases
20,867
-
Syphilis Cases
1,607
Arkansas

-
STD Cases / 100K
841
-
Total STD Cases
25,251
-
Chlamydia Cases
17,663
-
Gonorrhea Cases
7,300
-
Syphilis Cases
288
Missouri

-
STD Cases / 100K
828
-
Total STD Cases
50,624
-
Chlamydia Cases
34,728
-
Gonorrhea Cases
15,090
-
Syphilis Cases
806
Nebraska

-
STD Cases / 100K
565
-
Total STD Cases
10,841
-
Chlamydia Cases
8,026
-
Gonorrhea Cases
2,696
-
Syphilis Cases
119
Minnesota

-
STD Cases / 100K
563
-
Total STD Cases
31,403
-
Chlamydia Cases
23,569
-
Gonorrhea Cases
7,542
-
Syphilis Cases
292
New Jersey

-
STD Cases / 100K
513
-
Total STD Cases
46,151
-
Chlamydia Cases
36,514
-
Gonorrhea Cases
9,067
-
Syphilis Cases
570
Idaho

-
STD Cases / 100K
452
-
Total STD Cases
7,752
-
Chlamydia Cases
6,572
-
Gonorrhea Cases
1,134
-
Syphilis Cases
46
Utah

-
STD Cases / 100K
439
-
Total STD Cases
13,605
-
Chlamydia Cases
10,541
-
Gonorrhea Cases
2,895
-
Syphilis Cases
169
Wyoming

-
STD Cases / 100K
432
-
Total STD Cases
2,503
-
Chlamydia Cases
2,169
-
Gonorrhea Cases
311
-
Syphilis Cases
23
Maine

-
STD Cases / 100K
384
-
Total STD Cases
5,129
-
Chlamydia Cases
4,345
-
Gonorrhea Cases
710
-
Syphilis Cases
74
New Hampshire

-
STD Cases / 100K
327
-
Total STD Cases
4,392
-
Chlamydia Cases
3,734
-
Gonorrhea Cases
594
-
Syphilis Cases
64
Vermont

-
STD Cases / 100K
319
-
Total STD Cases
1,991
-
Chlamydia Cases
1,712
-
Gonorrhea Cases
268
-
Syphilis Cases
11
West Virginia

-
STD Cases / 100K
265
-
Total STD Cases
4,807
-
Chlamydia Cases
3,599
-
Gonorrhea Cases
1,143
-
Syphilis Cases
65
Rank | Metro Area | STD Cases / 100K | Metro Population | HIV Cases | Chlamydia Cases | Gonorrhea Cases | Syphilis Cases |
---|---|---|---|---|---|---|---|
1 | Alaska | 1,144 | 739,820 | 8,461 | 6,159 | 2,247 | 55 |
2 | Mississippi | 1,082 | 2,984,191 | 32,299 | 22,086 | 9,749 | 464 |
3 | Louisiana | 1,046 | 4,684,177 | 49,005 | 36,293 | 12,043 | 669 |
4 | South Carolina | 957 | 5,024,448 | 48,095 | 33,910 | 13,801 | 384 |
5 | New Mexico | 937 | 2,087,994 | 19,572 | 14,000 | 5,268 | 304 |
6 | North Carolina | 889 | 10,273,696 | 91,376 | 66,553 | 23,725 | 1,098 |
7 | Alabama | 855 | 4,874,357 | 41,656 | 28,437 | 12,742 | 477 |
8 | Georgia | 848 | 10,429,611 | 88,410 | 65,936 | 20,867 | 1,607 |
9 | Arkansas | 841 | 3,004,423 | 25,251 | 17,663 | 7,300 | 288 |
10 | Missouri | 828 | 6,113,008 | 50,624 | 34,728 | 15,090 | 806 |
11 | Nevada | 823 | 2,997,945 | 24,665 | 17,508 | 6,475 | 682 |
12 | Illinois | 814 | 12,802,152 | 104,155 | 77,325 | 25,422 | 1,408 |
13 | Delaware | 807 | 961,924 | 7,759 | 6,038 | 1,691 | 30 |
14 | California | 805 | 39,537,844 | 318,214 | 231,415 | 79,192 | 7,607 |
15 | New York | 804 | 19,849,104 | 159,487 | 119,571 | 37,262 | 2,654 |
16 | Oklahoma | 801 | 3,930,948 | 31,503 | 21,974 | 8,998 | 531 |
17 | Tennessee | 795 | 6,715,641 | 53,392 | 38,212 | 14,627 | 553 |
18 | Arizona | 780 | 7,016,334 | 54,724 | 40,807 | 12,870 | 1,047 |
19 | Maryland | 769 | 6,051,851 | 46,524 | 35,482 | 10,305 | 737 |
20 | Ohio | 764 | 11,657,754 | 89,106 | 63,220 | 25,146 | 740 |
21 | Indiana | 712 | 6,666,539 | 47,486 | 34,926 | 12,193 | 367 |
22 | South Dakota | 709 | 869,702 | 6,162 | 4,432 | 1,689 | 41 |
23 | Texas | 694 | 28,305,641 | 196,279 | 146,510 | 47,231 | 2,538 |
24 | Colorado | 684 | 5,607,239 | 38,355 | 29,124 | 8,894 | 337 |
25 | Michigan | 682 | 9,962,978 | 67,929 | 50,592 | 16,688 | 649 |
26 | Kansas | 674 | 2,913,204 | 19,639 | 14,231 | 5,256 | 152 |
27 | Florida | 669 | 20,985,176 | 140,282 | 104,758 | 32,644 | 2,880 |
28 | Virginia | 655 | 8,469,348 | 55,443 | 42,965 | 11,776 | 702 |
29 | North Dakota | 653 | 755,465 | 4,935 | 3,525 | 1,369 | 41 |
30 | Rhode Island | 653 | 1,059,676 | 6,919 | 5,487 | 1,336 | 96 |
31 | Hawaii | 653 | 1,427,649 | 9,322 | 7,735 | 1,495 | 92 |
32 | Washington | 627 | 7,405,202 | 46,458 | 34,449 | 11,207 | 802 |
33 | Iowa | 623 | 3,145,918 | 19,607 | 14,682 | 4,839 | 86 |
34 | Wisconsin | 622 | 5,795,492 | 36,061 | 28,027 | 7,882 | 152 |
35 | Oregon | 617 | 4,143,103 | 25,561 | 19,224 | 5,913 | 424 |
36 | Kentucky | 612 | 4,454,629 | 27,276 | 19,440 | 7,470 | 366 |
37 | Connecticut | 607 | 3,588,248 | 21,782 | 16,732 | 4,959 | 91 |
38 | Pennsylvania | 594 | 12,805,352 | 76,024 | 59,340 | 15,887 | 797 |
39 | Montana | 585 | 1,050,417 | 6,143 | 4,917 | 1,181 | 45 |
40 | Massachusetts | 570 | 6,860,360 | 39,088 | 30,460 | 8,076 | 552 |
41 | Nebraska | 565 | 1,920,096 | 10,841 | 8,026 | 2,696 | 119 |
42 | Minnesota | 563 | 5,577,142 | 31,403 | 23,569 | 7,542 | 292 |
43 | New Jersey | 513 | 9,004,686 | 46,151 | 36,514 | 9,067 | 570 |
44 | Idaho | 452 | 1,716,823 | 7,752 | 6,572 | 1,134 | 46 |
45 | Utah | 439 | 3,102,119 | 13,605 | 10,541 | 2,895 | 169 |
46 | Wyoming | 432 | 579,327 | 2,503 | 2,169 | 311 | 23 |
47 | Maine | 384 | 1,336,101 | 5,129 | 4,345 | 710 | 74 |
48 | New Hampshire | 327 | 1,342,682 | 4,392 | 3,734 | 594 | 64 |
49 | Vermont | 319 | 623,679 | 1,991 | 1,712 | 268 | 11 |
50 | West Virginia | 265 | 1,815,843 | 4,807 | 3,599 | 1,143 | 65 |
All of the STD data found in this report, including case statistics for HIV, syphilis, gonorrhea, and chlamydia, are from the C.D.C.’s latest data release (covering 2018). Syphilis data includes only primary and secondary syphilis cases and does not include congenital and early latent syphilis cases. HIV cases are not reported for some cities. Statistics for other relatively common STDs, such as herpes, are not collected by the C.D.C. at this time and hence are left out of our analysis. For more information about which statistics the C.D.C. does and does not track, see its STD Data & Statistics page.
No statistical testing was used during the production of this research.
https://www.cdc.gov/std/stats18/default.htm
https://www.cdc.gov/STD/
https://www.cdc.gov/std/stats17/appendix-c.htm
https://www.cdc.gov/nchhstp/newsroom/2019/2018-STD-surveillance-report.html
STD Information:
STD Symptoms & Causes from the Mayo Clinic
STD Guide from Planned Parenthood
STD Awareness for Teens from KidsHealth
STD Testing Resources:
Mayo Clinic: STD Testing Guide
Planned Parenthood: STD Testing
Finding the Best At Home STD Test
STD Testing Companies:
Lets Get Checked Reviews | MyLAB Box Reviews
STDcheck Reviews | Everlywell Reviews
BlueChew Reviews | BlueChew Free Trial
Support Resources:
BetterHelp Reviews
STD Dating Sites
BetterHelp vs Talkspace

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