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These States Have the Highest and Lowest STD Rates [2022]

Our research team dives deep into the CDC’s latest STD Surveillance Statistics and provides our analysis of current trends.

Last Updated: Jul 12, 2022
Map of STD infection rates by U.S. state - 2022

The Centers for Disease Control and Prevention (CDC) recently released its latest Sexual Transmitted Disease Surveillance Report along with new data on the number of reported sexually transmitted disease (STD) cases across the United States.

Innerbody’s research team analyzed and combined the latest statistics to develop our annual state rankings by STD rate from highest to lowest, along with key trends regarding the effects of the COVID-19 pandemic on STDs.

Before moving on to the rankings, let’s explore some key findings and trends we observed.

Key takeaways

  • Seven out of the top 10 states with the highest STD rates are in the South
  • Mississippi ranks #1 as the state with the highest rate of STD cases
  • Vermont has the lowest STD infection rate
  • New York ranks #1 as the state with the highest rate of HIV cases
  • Southern states are most affected by chlamydia and gonorrhea
  • California has the largest amount of total STD cases reported

Southern states suffering from high infection rates

The three states with the worst STD infection rates are Mississippi, Louisiana, and Georgia, and the South makes up a solid majority of the 10 most affected states. 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 a lack of access to affordable healthcare. “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.”

If you are sexually active, getting tested for STDs and STIs is highly encouraged. This is especially important for young people aged 15-24, as this group accounts for almost half of all STD cases per year, according to the CDC.

Chlamydia and gonorrhea infection rates seemed to mostly affect southern states, whereas syphilis rates varied throughout the country. Compared to our last report, three new states – Alaska, Oklahoma, and New Mexico – have replaced California, Georgia, and Arizona in the Top 5 states with the highest syphilis infection rates. Syphilis cases, in general, have risen since our last report, with those Top 5 states surpassing 20+ cases per 100,000 people.

State rankings by syphilis (primary and secondary) infection rate:

  1. Nevada (24.9 cases per 100K population)

  2. Mississippi (24.9 cases per 100K population)

  3. Alaska (24.1 cases per 100K population)

  4. Oklahoma (23.8 cases per 100K population)

  5. New Mexico (22.3 cases per 100K population)

Meanwhile, not surprisingly, California and Texas led all states with the largest number of cities with high STD rates, each having 14 cities in the top 150. Florida comes third with 13 cities, followed by Ohio with seven cities. For more information about how individual U.S. cities stack up, check out our recently published City STD Rankings.

Total infections by state

In terms of total STD cases, as one might expect, the largest states have the highest number of reported STD cases.

State rankings by total number of STDs reported:

  1. California (399,673 total cases reported)

  2. Texas (294,055 total cases reported)

  3. New York (268,674 total cases reported)

  4. Florida (259,033 total cases reported)

  5. Georgia (145,445 total cases reported)

Similar to our previous findings, California remains in the #1 spot for the total number of STD infections reported. This isn’t surprising, as California also has the largest state population with over 39.5 million residents. Texas, New York, and Florida have all stayed in their respective rankings, but there’s a new member in the Top 5: Georgia, which now surpasses Illinois by just over 8,000 cases.

According to the CDC, over 2.4 million combined STD cases are reported across the U.S. each year. These statistics do not even include those who have STDs but may not know it, don’t get tested, etc.

As an aside, the CDC stresses: “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.

Below are our rankings of each U.S. state based on STD cases (highest to lowest):

Top 10 States with Highest STD Rates

#1

Mississippi

Mississippi
  • STD Cases / 100K

    48,183

  • Total STD Cases

    1,784

  • Chlamydia Cases

    23,919

  • Gonorrhea Cases

    13,773

  • Syphilis Cases

    778

  • HIV Cases

    9,713

#2

Louisiana

Louisiana
  • STD Cases / 100K

    70,627

  • Total STD Cases

    1,718

  • Chlamydia Cases

    32,997

  • Gonorrhea Cases

    15,483

  • Syphilis Cases

    767

  • HIV Cases

    21,380

#3

Georgia

Georgia
  • STD Cases / 100K

    145,445

  • Total STD Cases

    1,535

  • Chlamydia Cases

    62,582

  • Gonorrhea Cases

    23,463

  • Syphilis Cases

    1,839

  • HIV Cases

    57,561

#4

New York

New York
  • STD Cases / 100K

    268,674

  • Total STD Cases

    1,512

  • Chlamydia Cases

    97,722

  • Gonorrhea Cases

    42,517

  • Syphilis Cases

    3,052

  • HIV Cases

    125,383

#5

Maryland

Maryland
  • STD Cases / 100K

    78,779

  • Total STD Cases

    1,449

  • Chlamydia Cases

    32,398

  • Gonorrhea Cases

    12,052

  • Syphilis Cases

    904

  • HIV Cases

    33,425

#6

South Carolina

South Carolina
  • STD Cases / 100K

    69,408

  • Total STD Cases

    1,438

  • Chlamydia Cases

    34,118

  • Gonorrhea Cases

    16,705

  • Syphilis Cases

    671

  • HIV Cases

    17,914

#7

Florida

Florida
  • STD Cases / 100K

    259,033

  • Total STD Cases

    1,355

  • Chlamydia Cases

    100,030

  • Gonorrhea Cases

    40,788

  • Syphilis Cases

    3,674

  • HIV Cases

    114,541

#8

North Carolina

North Carolina
  • STD Cases / 100K

    127,813

  • Total STD Cases

    1,299

  • Chlamydia Cases

    64,640

  • Gonorrhea Cases

    28,258

  • Syphilis Cases

    1,353

  • HIV Cases

    33,562

#9

Nevada

Nevada
  • STD Cases / 100K

    32,958

  • Total STD Cases

    1,260

  • Chlamydia Cases

    14,739

  • Gonorrhea Cases

    6,364

  • Syphilis Cases

    813

  • HIV Cases

    11,042

#10

Alabama

Alabama
  • STD Cases / 100K

    56,209

  • Total STD Cases

    1,235

  • Chlamydia Cases

    27,075

  • Gonorrhea Cases

    14,426

  • Syphilis Cases

    550

  • HIV Cases

    14,158

All States Ranked by STD Rate (Highest to Lowest)

Rank State STD Cases per 100K State Population HIV Cases Chlamydia Cases Gonorrhea Cases Syphilis Cases
1 Mississippi 1784 2976110 9713 23919 13773 778
2 Louisiana 1718 4648774 21380 32997 15483 767
3 Georgia 1535 10617917 57561 62582 23463 1839
4 New York 1512 19454907 125383 97722 42517 3052
5 Maryland 1449 6045531 33425 32398 12052 904
6 South Carolina 1438 5148333 17914 34118 16705 671
7 Florida 1355 21479493 114541 100030 40788 3674
8 North Carolina 1299 10488399 33562 64640 28258 1353
9 Nevada 1260 3080251 11042 14739 6364 813
10 Alabama 1235 4903115 14158 27075 14426 550
11 Texas 1230 28996567 97416 135124 58246 3269
12 New Mexico 1223 2096825 3934 12084 4608 509
13 Alaska 1194 731532 730 5090 1982 184
14 Arizona 1191 7278743 17695 37289 16342 1574
15 Tennessee 1189 6828860 18207 37907 18458 798
16 California 1184 39513268 134381 178679 78444 8169
17 Illinois 1154 12671215 35793 68716 31055 1493
18 Oklahoma 1151 3956716 6603 21208 11204 994
19 Arkansas 1111 3018049 6058 16053 7857 525
20 Missouri 1097 6137153 12864 31815 16855 859
21 Delaware 1091 973726 3439 4855 1503 99
22 Ohio 1048 11688924 23685 59520 30977 1117
23 Virginia 1013 8536153 24046 40965 15217 716
24 New Jersey 970 8882683 35136 31649 10060 788
25 Colorado 937 5758317 13249 26137 9686 662
26 Indiana 931 6732298 11873 33372 14111 533
27 Michigan 917 9986393 16881 44769 23412 816
28 Pennsylvania 905 12802351 36613 52272 18280 1060
29 Rhode Island 887 1059326 2672 4714 1399 90
30 Hawaii 884 1416010 2380 7005 1484 194
31 South Dakota 868 884708 693 4044 2424 70
32 Kansas 861 2913511 3354 14620 5626 158
33 Kentucky 852 4467477 7911 18750 8393 458
34 Massachusetts 847 6892056 21047 24901 7494 625
35 Connecticut 845 3564900 10569 12716 4604 282
36 Iowa 818 3155068 2940 15097 6919 195
37 Washington 806 7614408 14303 31181 11667 846
38 North Dakota 802 762088 526 3562 1660 35
39 Oregon 791 4217553 7347 15858 6412 647
40 Nebraska 790 1934383 2324 8844 3434 105
41 Wisconsin 784 5822885 6645 26564 10346 372
42 Minnesota 784 5639888 9001 22114 10320 424
43 Montana 643 1068787 687 4133 1698 47
44 West Virginia 590 1792409 2089 5431 1780 135
45 Utah 556 3205513 3265 10466 3112 132
46 Idaho 530 1787179 1265 6273 1480 68
47 Wyoming 497 578808 356 1961 392 12
48 Maine 440 1344453 1661 3466 520 38
49 New Hampshire 365 1359462 1328 2931 461 51
50 Vermont 334 624022 722 1117 139 3

Impact of COVID-19 on STDs

Even in the face of a global pandemic, STDs continue to persist as a significant public health concern. In fact, it is believed that COVID-19 possibly even increased STD transmission during this pandemic. Since the state of STDs have not improved in the U.S., prevention and control efforts remain as important as ever.

In the early months of 2020, before preventive measures were put in place to reduce the spread of COVID-19 in the U.S., the weekly number of diagnosed and reported cases of chlamydia, gonorrhea, and primary and secondary syphilis were all higher than in 2019. However, due to the quarantine and shelter-in-place orders, those numbers unsurprisingly fell in March and April of 2020.

Additionally, the overall number of HIV diagnoses in the U.S. in 2020 was 17% lower than in 2019. Data for the year 2020 should be interpreted with caution due to the impact of COVID-19 on access to testing, materials, and other case surveillance activities. STDs are still heavily affecting the nation and should be taken seriously, despite the rates decreasing due to the pandemic.

Here are some reasons why STD numbers initially decreased:

Reduced screening

Many healthcare clinics and facilities either closed entirely or limited in-person visits to symptomatic patients only. Screening is necessary in order to receive a timely diagnosis and treatments, especially since STDs often do not show symptoms. Other factors of reduced screening include laboratory supply shortages, increased unemployment (and therefore, loss of health insurance), and decreased healthcare visits due to the lockdown.

Limited resources

Many jurisdictions and STD programs redirected their staff and resources to help control the spread of COVID-19. As a result, the focus shifted to stopping COVID-19 rather than STD prevention and surveillance.

Social distancing measures

In order to minimize contact with one another, a social distance of at least 6 feet was implemented and strongly urged. Additionally, because COVID-19 can spread during sexual contact, these social distancing measures may have limited sexual activity or the number of new sexual partners, ultimately reducing the spread of STDs.

STD health equity

According to the CDC, health equity is achieved when everyone has an equal chance to be healthy regardless of race, ethnicity, income, gender, sexual identity, religion, and disability.

Research shows that the higher rates of STDs among some ethnic minority groups, as compared to white adults, are likely caused by factors of poverty, lower education levels, and fewer jobs. These factors can make it more difficult for people to stay sexually healthy.

For example, those who already cannot afford basic necessities may find it much more difficult to access quality sexual health services. Additionally, many ethnic minorities distrust the U.S. health care system, fearing discrimination from doctors and other health care providers. These environments could create negative and apprehensive feelings even about getting tested for STDs.

The first step in empowering STD-affected communities and improving their health status is to learn more about and increase STD awareness, especially among young people. By introducing STD/STI prevention interventions early in life, it is likely that people may engage in safer sex practicies throughout their lifetime.

How We Collected Data for This Report

All of the STD data found in this report, including case statistics for syphilis, gonorrhea, chlamydia, and HIV are from the CDC’s latest data release (covering 2020). Syphilis data includes primary and secondary syphilis cases, as well as congenital syphilis cases. Statistics for other relatively common STDs, such as herpes, are not collected by the CDC at this time and hence are left out of our analysis. For more information about which statistics the CDC does and does not track, see its STD Data & Statistics page.

No statistical testing was used during the production of this research.

Sources

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
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6313766/

Additional STD Resources

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

About Innerbody.com

Innerbody.com is the largest online medical testing guide. Over the past 20 years, we have helped over 100 million readers make more informed decisions involving staying healthy and living healthier lifestyles.

All of our expert writers and test reviewers have advanced degrees in relevant scientific fields. In the cases where our guides and reviews contain medical-related information, all such material is thoroughly reviewed by members of Innerbody’s Medical Review Board, which consists of board-certified physicians and medical experts from across the country.

If you have any questions or feedback regarding this research or any other material on our website, you can email us at questions@innerbody.com.