STDs in America

Despite the various preventative health care measures available, Americans are only using preventative services at about half the recommended rate. Infections and diseases contracted through sexual activity are highly preventable. Still, STD rates continue to hit record highs. The latest report from the Centers for Disease Control and Prevention (CDC) proved 2017 to be the year with the most reported STD cases to date, with rates of gonorrhea, syphilis, and chlamydia increasing dramatically.

We analyzed the CDC's 2017 STD Surveillance Report to see which states and demographics are most affected by these rising rates. How have STD rates changed in specific populations over time, and what might be contributing to such changes? Keep reading to find out.

Developing Diseases

 

When the CDC began collecting data on sexually transmitted diseases in 1941, there were only 679,028 reported cases of syphilis and gonorrhea, with syphilis being over twice as prevalent. Today, the total number of reported cases includes chlamydia and has reached a high of almost 2.4 million. However, chlamydia is now the most prevalent and has increased the most dramatically since the beginning of the data collection.

Between 1941 and 1945, rates of syphilis peaked and then steadily declined, likely due to the emergence of penicillin as a treatment. While curing syphilis involves antibiotic treatment, permanent damage can occur if the treatment is not prompt. Even with adequate measures to treat and cure the infection, cases of syphilis in all stages increased by 15.3 percent from 2016 to 2017.

Chlamydia had the most dramatic increase since the 1980s, soaring from only 7,594 cases to over 1.7 million in 2017. From 2016 to 2017, chlamydia cases increased by about 7 percent. Despite much fewer cases of gonorrhea (555,608) in 2017, there was an 18.6 percent increase from 2016 to 2017.

STDs may affect a great deal of the population, but stigmas about these infections are still present. Contracting STDs is often associated with promiscuity, but it simply doesn't hold. If that were the case, rising rates of STDs would correlate with a rise in sexual activity. However, Americans of all ages have been having less sex over the last 20 years.

With sexual activity decreasing nationwide, are specific states and demographics contracting STDs more than others?

Climbing Chlamydia Rates

 

In 2017, only two states reported fewer than 300 cases of chlamydia. With 297.5 and 226.1 cases per 100,000 residents respectively, Vermont and West Virginia were the states with the lowest prevalence of chlamydia in 2017.

Alaska topped the charts with almost 800 cases of chlamydia, followed by 742.4 cases per 100,000 residents in Louisiana.

Gonorrhea Isn't Gone

 

In 2017, Vermont, New Hampshire, and Maine had the lowest rates of gonorrhea. On the upper end of the scale, Mississippi had the most cases in 2017, with about 310 cases per 100,000 residents. Alaska wasn't too far behind with 295 cases, putting it among the top states for high rates of both chlamydia and gonorrhea.

While the change over time in cases of gonorrhea was not as drastic as chlamydia, the STD has certainly spread. This may be partly caused by the evolving nature of the infection itself. Studies have shown gonorrhea is becoming increasingly resistant to antibiotics, making treatment and a cure extremely difficult.

Syphilis-Affected States

 

While all stages of syphilis are much less common in the United States – the national average was only 31.4 cases per 100,000 residents in 2017 – Louisiana was the state with the most cases in 2017. With almost double the national average, Louisiana had 61 cases per 100,000 residents, followed by Nevada with 57.2.

Around 10 times less than the national average, however, was Wyoming with 3.2 cases. Alaska was not among the top 5 states, though, with only 3.8 cases per 100,000 residents in 2017, the state had the second-fewest cases of syphilis.

A Gendered Look

Looking at STD rates by gender, the top states slightly differed. Alaska topped the charts for overall rates of both chlamydia and gonorrhea and remained the highest state for both men and women with chlamydia, but was outnumbered by Mississippi for rates of gonorrhea in men. South Carolina had the third-highest rate for gonorrhea among women, while Alabama was the third highest state for rates among men.

For syphilis, the data were significantly different. The states with the highest syphilis rates among women remained under 10 per 100,000 residents, but the states with the highest syphilis rates among men were all greater than 20 cases. Louisiana was the state with the highest rates for women, with 7.8 cases per 100,000 residents, and Nevada was the state with the highest rates for men, with about 35 cases.

Top Transmitters

When looking at counties, Philadelphia County, Pennsylvania, had the highest rate of chlamydia, with 1,347 cases per 100,000 residents. For gonorrhea, St. Louis, Missouri, was the city with the greatest number of cases, coming in at 703.6 cases per 100,000 residents. That’s over six times more than the county with the fewest – Orange County, California, had 112.4 cases per 100,000 residents in 2017. California counties weren’t all on the lower end of the scale, however. San Francisco County and San Joaquin County, California, were the top counties for cases of syphilis in 2017.

The Highs and Lows

 

In 2016, record highs were made for reported cases of STDs, but when data from 2017 became available, those record highs were replaced. In just a year, the 2 million cases of chlamydia, gonorrhea, and syphilis increased drastically, and certain states and counties saw bigger changes than others. Connecticut and New Hampshire both saw a 27 percent increase in chlamydia from 2016 to 2017. Rates in West Virginia and North Dakota actually decreased by 14 and 5 percent, respectively, though.

Percentage increases were much higher for cases of gonorrhea. Vermont had an increase of about 61 percent, followed by 55.4 percent in Idaho. Each of the top five states had an increase of over 50 percent, leaving only three states with a decrease in cases of gonorrhea from 2016 to 2017. Cases decreased by 3.4 percent in North Dakota, 7.4 percent in Hawaii, and almost 10 percent in Montana.

Rates of syphilis between 2016 and 2017 were slightly more split, with greater decreases in cases than the other STDs. However, syphilis also saw the greatest increase in a single state – syphilis cases in Maine increased by 106.3 percent in one year. It is important to note, though, that the high percentage increase brought Maine's rate in 2017 to only 9.9 per 100,000 residents.

Biggest County Changes

Getting even more specific, Dallas County, Texas, had the highest percentage increase in cases of both chlamydia and gonorrhea between 2016 and 2017. For syphilis, Duval County, Florida, had a 64.3 percentage increase, followed by Tarrant County, Texas, with a 55.6 percentage increase. Additionally, Collin County, Texas, had the greatest decrease in cases of chlamydia and gonorrhea, with a 25.6 and 22.4 percentage decrease, respectively.

Who's Affected?

It's now clear where STDs are most prevalent and how the rates have changed over time, but who are STDs affecting most? All three STDs (chlamydia, gonorrhea, and syphilis) were most prevalent among 15- to 29-year-old men and women, for men in slightly older age groups than women. Chlamydia, gonorrhea, and syphilis were most common in women aged 20 to 24, affecting 38.5 percent, 32.1 percent, and 22.8 percent of the demographic, respectively. For men, chlamydia and gonorrhea were more common among those aged 20 to 24, but syphilis affected slightly older men. Twenty-three percent of men between the ages of 25 and 29 reported a diagnosis of syphilis, but rates increased again in men aged 45 to 54.

Take Preventative Action

With STD rates setting record highs and showing no sign of slowing down, it is up to the American public to take precautions regarding their sexual activity. While some STDs and STIs are treatable, many go unnoticed due to a lack of symptoms. That's why getting tested for STDs is vital to the health and safety of you and your partners, even if precautions are taken and protection is used. However, access to testing can be difficult and expensive. Luckily, at Health Testing Centers, we know how important safe sex is. We make it easy and affordable for you to order medical tests, including various STD packages, so you can stay on top of your health without breaking the bank. To learn more, visit us online today.

Methodology

For this project, we evaluated data from the Centers for Disease Control and Prevention's (CDC) 2017 Sexually Transmitted Disease Surveillance Report. It presents statistics and trends for selected STDs in the United States through 2017. The publication emphasizes chlamydia, gonorrhea, syphilis, and chancroid, which are nationally notifiable. State and local STD control programs provide the CDC with case reports for these conditions.

For this project, we decided not to focus on chancroid because only seven cases were reported in 2017. Cases of chlamydia weren't reported before 1984. We decided not to include years before 1996 in our state visualizations because 1996 is the first year that presents data for all states. The data breakdowns for cases of syphilis in counties are only available for the primary and secondary stages of syphilis. Primary and secondary (P&S) syphilis are the earliest and most transmissible stages of syphilis.

We used the bottom 5th percentile to exclude outliers to present changes in the rates of syphilis. The top 70 counties were ranked by the CDC by the number of cases reported in 2017. We used those 70 counties to compare their rates in 2017 and the percentage change from 2016 to 2017.

The Sexually Transmitted Disease Surveillance Report is published by the CDC annually. No statistical testing was used during the production of this project.

Sources

https://www.cdc.gov/healthcommunication/toolstemplates/entertainmented/tips/PreventiveHealth.html

https://www.cdc.gov/std/prevention/default.htm

https://www.smithsonianmag.com/smart-news/syphilis-cure-magic-bullet-180964644/

https://www.cdc.gov/std/syphilis/stdfact-syphilis.htm

https://www.verywellhealth.com/the-stigma-stds-have-in-society-3133101

https://www.theatlantic.com/family/archive/2018/08/why-are-stds-on-the-rise-if-people-are-having-less-sex/568909/

https://www.popsci.com/antibiotic-resistant-gonorrhea-getting-worse#page-3

https://www.cdc.gov/media/releases/2017/p0926-std-prevention.html

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