New Report: These 4 States Are Ranking Highest for Sexually Transmitted Infections

Updated: Jan. 31, 2024

Though case numbers are holding steady, a new national report suggests the diagnoses are shifting in worrying ways.

America, we have a problem. This is the message that a national report is conveying after annual review of sexually transmitted infection rates across the country.

On January 01, 2024, the Centers for Disease Control and Prevention (CDC) released its 2022 STI Surveillance Report, which “provides the most current and complete data for nationally notifiable [sexually transmitted infections] for federally funded control programs,” the CDC states. The report reveals trends related to 2.5 million cases of four of the most prevalent STIs reported nationwide.

That number hasn’t changed a great deal since 2018, but some new themes have emerged—specifically, the ratio of some of the most common conditions has changed for the worse. The agency urges that “STIs must be a public health priority,” with a notable rise in rates of syphilis and congenital syphilis (which is contracted by babies at birth to infected mothers). Authorities say these climbs signal “an urgent need for swift innovation and collaboration from all STI prevention partners.”

Rising rates for certain STIs

While rates of reported cases of chlamydia—the most common sexually transmitted infection in the country—increased slightly, and gonorrhea cases reportedly fell 8%, syphilis and congenital syphilis are said to have increased steeply. Syphilis saw an almost 17% increase in 2022, and it has an 80% increase over five years.

Congenital syphilis saw a 30% increase with a striking 183% increase over five years.

Outside of the congenital syphilis diagnoses, the rates for these conditions have disproportionately affected young people between the ages of 15 and 24. Nearly half of the reported cases were among this age group.

The CDC also highlights that community transmission is a big issue, stating, “in communities with higher prevalence of STIs, with each sexual encounter, people face a greater chance of encountering an infected partner.”

With that in mind, the organization released a ranking of the state for these most concerning four STIs. Here are the states with the highest STI rates based on the rate per 100,000 people and the number of cases.

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State with the highest rate: Louisiana (788.6 per 100,000)

State with the highest count: California (192,647)

State with the lowest rate: Vermont (198.0 per 100,000)

Chlamydia is the most prevalent STI in America, with over 1.6 million cases in 2022. That is a slight increase from the previous year, but rates have fallen 6% over five years. Chlamydia typically has no symptoms, so it relies on screening to be detected, though some people can experience discharge or pain when urinating.

Without screening, chlamydia will pass from person to person easily, and it can affect a woman’s fertility. Talk to your healthcare provider about whether you should be tested regularly for chlamydia, especially if you are younger than 25, as over half of the cases appear in this age group.

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State with the highest rate: Mississippi (371.9 per 100,000)

State with the highest count: California (80,257)

State with the lowest rate: Vermont (26.9 per 100,000)

Gonorrhea is the second most common sexually transmitted infection in America with 648,056 cases in 2022, though rates decreased nearly 9% over 2021. Again, it often has no symptoms so if you are in a susceptible population and meet certain criteria, you should be tested. 

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State with the highest rate: South Dakota (84.3 per 100,000)

State with the highest count: Texas (4,655)

State with the lowest rate: Vermont (0.5 per 100,000)

While overall rates of syphilis are lower than gonorrhea and chlamydia, its rise has been concerning. 2022 saw the largest number of cases (203,500) since the 1950s, an increase of over 17% compared to 2021. Symptoms of syphilis vary but typically start with a sore called a chancre. The second stage generally includes rashes, sores, and flu-like symptoms. An untreated infection can have serious consequences even decades later. 

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Congenital Syphilis

State with the highest rate: New Mexico  (355.3 per 100,000 live births)

State with the highest count: Texas (922)

States with the lowest rates: Vermont, Idaho, Wyoming (0 per 100,000 live births)

While the rates are low overall, congenital syphilis rose 30% in 2022. It doesn’t seem clear why New Mexico shows the most reported rates of congenital syphilis, when South Dakota is said to have the highest rates of syphilis itself. However, this report may serve as a broader tool for education: Babies born with congenital syphilis can suffer severe issues, so all pregnant women are routinely tested for syphilis. Keeping up with prenatal check-ups is essential.