New data reveals that the epidemic of sexually transmitted diseases in America may be showing early signs of stabilizing after years of steady increases. According to the latest figures from 2023, the rates of certain STDs have begun to level off or slightly decrease compared to previous years.
National Overview: The Big Three STDs
More than 2.3 million cases of chlamydia, gonorrhea, and primary and secondary syphilis were reported in the United States in 2023. While these numbers remain alarmingly high, they represent a modest improvement from previous peaks.
Chlamydia continues to be the most commonly reported STD, with approximately 1.65 million cases diagnosed in 2023. Gonorrhea follows with 601,319 reported cases, showing a decline from the pandemic-era peak of 677,769 cases in 2020. Primary and secondary syphilis affected more than 53,000 people in 2023.
The Syphilis Resurgence Raises Alarms
The data shows a significant resurgence of syphilis, a disease once nearly eliminated in the United States. Between 2014 and 2023, primary and secondary syphilis cases increased by 165%, despite showing signs of leveling off in the most recent year.
South Dakota experienced the most dramatic increase in syphilis over the past five years, with rates jumping by more than 1,460% between 2018 and 2023. Other states with significant increases include Montana (up 554%), Delaware (up 461%), and Iowa (up 281%).
Unlike chlamydia and gonorrhea, which show more consistent regional patterns, syphilis presents a more complex picture. While the South has the highest overall burden, individual states across different regions have experienced concerning outbreaks.
Signs of Progress Amid Ongoing Challenges
The data shows some encouraging signs. Gonorrhea cases have declined from their pandemic-era peak, down from 677,769 cases in 2020 to 601,319 in 2023. This reverses what had been a generally upward trend since 2014.
However, public health experts caution that it’s too early to declare victory. The overall STD burden remains at crisis levels, with more than 2.3 million Americans diagnosed with chlamydia, gonorrhea, or syphilis in 2023 alone.
Regional Variations Tell an Important Story
The Northeast consistently shows lower STD rates compared to other regions, with an average gonorrhea rate of 112.8 per 100,000 and a chlamydia rate of 359.8 per 100,000. This stands in stark contrast to the South, which has gonorrhea rates 75% higher (196.7 per 100,000) and chlamydia rates 53% higher (550.4 per 100,000).
The Midwest and West fall between these extremes, with the Midwest showing slightly higher gonorrhea rates (158.2 per 100,000) compared to the West (138.1 per 100,000), while chlamydia rates are fairly similar between these regions (463.2 and 430.7 per 100,000 respectively).
Addressing the Crisis: A Public Health Imperative
The data suggests that increased awareness, testing, and treatment efforts may be beginning to yield results in some areas. However, sustained commitment is necessary to address the ongoing epidemic.
For individuals, regular STD screening remains one of the most important tools for prevention and early treatment. All sexually active individuals, regardless of perceived risk or geographic location, should consider STD testing as a routine part of their healthcare.
As we analyze these latest statistics, it’s clear that while there are encouraging signs of progress in some areas, STDs remain a significant public health challenge requiring continued attention, resources, and commitment at national, state, and local levels.
The Top 10 States with the Highest STD Rates
10. New York
Total STD Rate: 808.8 per 100,000
Change From 2022: 5.6% increase
Chlamydia Rate: 558.4 per 100,000
Gonorrhea Rate: 235.6 per 100,000
Syphilis Rate (cumulative): 14.8 per 100,000
Resources: New York State Department of Health | STD Testing in New York
9. Arkansas
Total STD Rate: 802.2 per 100,000
Change From 2022: 5.0% decrease
Chlamydia Rate: 579.6 per 100,000
Gonorrhea Rate: 193.4 per 100,000
Syphilis Rate (cumulative): 29.2 per 100,000
Resources: Arkansas Department of Health | STD Testing in Arkansas
8. South Carolina
Total STD Rate: 851.8 per 100,000
Change From 2022: 11.6% decrease
Chlamydia Rate: 612.1 per 100,000
Gonorrhea Rate: 222.4 per 100,000
Syphilis Rate (cumulative): 17.3 per 100,000
Resources: South Carolina Department of Health and Human Services | STD Testing in South Carolina
7. North Carolina
Total STD Rate: 871.0 per 100,000
Change From 2022: 0.6% decrease
Chlamydia Rate: 607.9 per 100,000
Gonorrhea Rate: 243.2 per 100,000
Syphilis Rate (cumulative): 19.9 per 100,000
Resources: North Carolina Department of Health and Human Services | STD Testing in North Carolina
6. Alabama
Total STD Rate: 906.6 per 100,000
Change From 2022: 1.0% increase
Chlamydia Rate: 651.1 per 100,000
Gonorrhea Rate: 226.9 per 100,000
Syphilis Rate (cumulative): 28.6 per 100,000
Resources: Alabama Department of Public Health | STD Testing in Alabama
5. Georgia
Total STD Rate: 941.2 per 100,000
Change From 2022: 3.4% decrease
Chlamydia Rate: 646.4 per 100,000
Gonorrhea Rate: 274.8 per 100,000
Syphilis Rate (cumulative): 20.0 per 100,000
Resources: Georgia Department of Public Health | STD Testing in Georgia
4. South Dakota
Total STD Rate: 858.3 per 100,000
Change From 2022: 13.2% decrease
Chlamydia Rate: 531.6 per 100,000
Gonorrhea Rate: 253.3 per 100,000
Syphilis Rate (cumulative): 73.4 per 100,000
Resources: South Dakota Department of Health | STD Testing in South Dakota
3. Alaska
Total STD Rate: 1,063.4 per 100,000
Total STD Rate: 1,031.1 per 100,000
Change From 2022: 3.1% decrease
Chlamydia Rate: 697.7 per 100,000
Gonorrhea Rate: 310.9 per 100,000
Syphilis Rate (cumulative): 22.5 per 100,000
Resources: New York State Department of Health | STD Testing in Alaska
2. Mississippi
Total STD Rate: 982.1 per 100,000
Change From 2022: 17.1% decrease
Chlamydia Rate: 700.9 per 100,000
Gonorrhea Rate: 251.1 per 100,000
Syphilis Rate (cumulative): 30.1 per 100,000
Resources: Mississippi State Department of Health | STD Testing in Mississippi
1. Louisiana
Total STD Rate: 1,106.9 per 100,000
Change From 2022: 3.1% decrease
Chlamydia Rate: 792.4 per 100,000
Gonorrhea Rate: 288.4 per 100,000
Syphilis Rate (cumulative): 26.1 per 100,000
Resources: Louisiana Department of Health | STD Testing in Louisiana
Sources:
CDC, Sexually Transmitted Infections Surveillance, 2023. (Nov ’24) https://www.cdc.gov/sti-statistics/annual/index.html
