Nationwide STD study ranks Texas #19 in U.S.

Sexually transmitted diseases (STDs), also referred to as sexually transmitted infections (STIs), remain a persistent public health challenge in the United States, affecting millions of people each year. The Centers for Disease Control and Prevention (CDC) estimates that at any given time, one in five Americans is living with an STI, contributing to billions of dollars in healthcare costs annually.

STD cases tend to peak during the summer, a trend attributed to increased social activity, travel, and sexual behavior during warmer months. However, the broader patterns that shape the spread of sexually transmitted infections are influenced by a more complex set of factors. These include disparities in access to healthcare, varying levels of sexual health education, differences in testing and screening practices, and persistent social and economic inequities. Together, these elements contribute to sustained transmission rates in certain populations and geographic areas, many of which experience disproportionately high rates of new infections year after year.

To better understand these trends, Invigor Medical, a telehealth company, analyzed newly reported STD cases using the most recent CDC surveillance data. The analysis focuses on four of the most consistently tracked infections: Chlamydia, Gonorrhea, Syphilis, and HIV, and examines how rates have changed over time, how they differ by demographic groups, and where they are most concentrated geographically.

The number of newly reported sexually transmitted infections in the U.S. has climbed sharply over the past decade. In 2023, health officials recorded approximately 2.5 million new cases of Chlamydia, Gonorrhea, Syphilis, and HIV, up from 1.8 million in 2013.

Chlamydia remains the most prevalent STD, with more than 1.6 million new cases in 2023, while Gonorrhea nearly doubled over the decade, reaching almost 595,000 cases. Syphilis saw the sharpest rise, increasing sixfold from 34,279 cases in 2013 to over 205,000 in 2023. Part of this increase reflects a change in CDC reporting: prior to 2018, late-stage and unknown-stage Syphilis cases were not included in national totals. But even when excluding those later-stage cases, Syphilis diagnoses still tripled over the decade. In contrast, HIV diagnoses remained relatively flat over the same time period, reflecting the impact of expanded testing, prevention tools like PrEP, and earlier treatment.

Although the long-term trend shows a sustained rise in STD cases, recent data suggests the epidemic may be starting to slow. While Syphilis infections remain at record highs, reported cases of Chlamydia, Gonorrhea, and HIV have declined from their peak levels in previous years, signaling a promising shift in the trajectory of the nation’s STD burden.

Nationally, women are about 10% more likely than men to be diagnosed with a sexually transmitted disease. Across all age groups 13 years and over, there were 902.0 reported STD cases per 100,000 women, compared to 819.0 per 100,000 men. This gender gap is especially pronounced among adolescents and young adults and reflects several overlapping factors. Biological differences make women more susceptible to infection than men. Additionally, women are more likely to be screened during routine reproductive health visits, often beginning in adolescence or early adulthood. By contrast, men are typically only tested when symptoms are present, which leads to lower reported rates.

As a result, females ages 13 to 24 have the highest STD diagnosis rate of any demographic group, with more than 3,000 cases per 100,000, nearly double the rate for males in the same age range. After age 25, STD rates decline significantly for both sexes. Among women, the rate drops by nearly half in the 25–34 age group and continues to decline steeply with age. For men, diagnosis rates peak slightly later—between ages 25 and 34—before following a similar downward trend.

Racial and ethnic disparities in STD cases remain one of the most persistent and pronounced features of the epidemic. In 2023, Black Americans had a reported STD rate more than seven times higher than that of White Americans—2,249.7 cases per 100,000 compared to 319.0, respectively. This gap reflects long-standing inequities in healthcare access, prevention resources, and social determinants of health.

High STD rates are also observed among American Indian and Alaska Native populations (1,442.6 per 100,000) and Native Hawaiian and Other Pacific Islander groups (1,057.2 per 100,000). In contrast, Asian Americans report the lowest rate at 195.5 cases per 100,000.

Public health experts caution that these disparities are not due to differences in behavior alone but are also shaped by systemic factors such as unequal access to testing and treatment, stigma, and community-level barriers to sexual health education and care. These data underscore the need for targeted prevention strategies that take into account these differences.

STD rates vary widely across the United States, with the highest concentrations currently found in the South. Louisiana and Mississippi report the highest rates, with 1,201.6 and 1,084.5 cases per 100,000 people, respectively. They are followed closely by Alaska (1,066.6) and Georgia (1,020.9), making them the only states where STD rates exceed 1,000 cases per 100,000 residents.

Several other Southern states, Alabama, North Carolina, South Carolina, and Arkansas, also rank among the top 10. These states tend to face persistent challenges in STD prevention, including gaps in healthcare access, limited sexual health education, and structural barriers to screening and treatment. Outside of the Southern U.S., South Dakota and New York also report relatively high rates despite different demographic and policy contexts. In South Dakota, higher rates may be influenced by concentrated outbreaks in Native American communities, which face elevated STD burdens due to systemic healthcare inequities and limited access to services on tribal lands. In New York, elevated case rates are largely driven by urban density, high concentrations of at-risk populations, and possibly more robust surveillance, which can result in higher reported case counts.

In contrast, states in New England consistently report the lowest STD rates nationwide. Vermont (241.0), New Hampshire (251.1), and Maine (276.6) sit at the bottom of the list, with rates less than one-fourth of those in the highest-burden states. Several demographic and structural factors help explain this pattern. New England states tend to be older and have less ethnic diversity, both of which are associated with lower STD risk. Additionally, the region has higher median household incomes and lower uninsured rates, making it easier for residents to access testing and treatment—and thus reducing the rate of spread.

Here is a summary of the data for Texas:

For reference, here are the statistics for the entire United States:

Methodology

This study analyzes newly reported cases of sexually transmitted infections (STIs) across the United States, using data from the Centers for Disease Control and Prevention’s National Center for HIV, Viral Hepatitis, STD, and TB Prevention (NCHHSTP). The focus is on four of the most consistently tracked STIs with available county- and state-level data: Chlamydia, Gonorrhea, Syphilis (including primary, secondary, early latent, and late/unknown stages), and HIV. While Human papillomavirus (HPV) is the most common STD nationally, it is excluded from this analysis due to the absence of a centralized case-reporting system and the typically asymptomatic nature of the infection.

The rankings are based on the number of newly reported cases tracked by the CDC in 2023 per 100,000 residents, not the total number of people currently living with each infection. For HIV, reporting is limited to individuals aged 13 years and older, whereas cases of Chlamydia, Gonorrhea, and Syphilis include individuals of all ages. To ensure reliable comparisons, only states and counties with complete reporting and a population of at least 200,000 were included in the analysis. Counties were further grouped by population size into three cohorts: small (200,000–499,999), midsize (500,000–999,999), and large (1,000,000 or more).

SOURCE Invigor Medical