STD rates by state

Which states have the highest STD rates?

No state is number one for STDs. The CDC ranks chlamydia, gonorrhea, and primary and secondary syphilis as separate lists, and in the 2023 tables the leaders are Louisiana at 792.4 per 100,000, Alaska at 310.9 per 100,000, and South Dakota at 73.4 per 100,000.

The District of Columbia is left out of the numbered ranking, and for chlamydia and gonorrhea its footnote rates are higher than every state: 1,228.0 and 853.3. For primary and secondary syphilis, South Dakota’s 73.4 is above the District’s 39.9. South Dakota is 4th for gonorrhea, at 253.3 per 100,000, and 14th for chlamydia, at 531.6 per 100,000. If you were tested for one infection, use that infection’s list, because each list has its own leader.

In 2024, the combined total number of cases of chlamydia, gonorrhea, and syphilis declined 9% from 2023, down a third consecutive year. There were still more than 2.2 million reported STIs in 2024, and compared with a decade ago, overall cases are 13% higher, with congenital syphilis nearly 700% higher. Chlamydia cases were 1,515,985, down 8% since 2023, a second year in a row; gonorrhea cases were 543,409, down 10% since 2023, a third year in a row; and primary and secondary syphilis cases were 41,496, down 22% since 2023, a second year in a row. Congenital syphilis increased for the 12th year in a row, with nearly 4,000 reported cases in 2024.

While the STI epidemic touches nearly every community, some geographic areas and populations may experience increases or decreases not reflected by the newest 2024 national data. That is why your own state may have moved differently from that national drop.

The 2024 report is the latest national data on chlamydia, gonorrhea, and syphilis, including congenital syphilis, and it is provisional, with final 2024 data expected in 2026. However, anticipated fluctuations in case counts could affect demographic (e.g., race/Hispanic ethnicity) and state-level rates and trends more substantially, so those data will not be presented until final 2024 data are available.

What are chlamydia rates in each state?

This table lists 2023 chlamydia rates per 100,000 for all 50 states, plus the District of Columbia’s footnote rate. Louisiana’s rate, 792.4, is the highest, and New Hampshire’s 196.6 is the lowest.

The U.S. total is 492.2 per 100,000, from 1,648,568 cases. The District of Columbia is not in the numbered ranks. Its footnote lists 8,338 cases and a rate of 1,228.0, higher than every state.

The first table lists the first ten states in the CDC’s rank order. The second is every state and the District, alphabetical, with gonorrhea and primary and secondary syphilis on the same row, so you can look a place up once. Territories are not in either table.

What are gonorrhea rates in each state?

This table lists 2023 gonorrhea rates per 100,000 for all 50 states, plus the District of Columbia’s footnote rate. Alaska is highest at 310.9 per 100,000, and Vermont is lowest at 34.0 per 100,000.

The District of Columbia’s footnote rate, 853.3, is higher than every state. The U.S. total is 179.5 per 100,000, from 601,319 cases, and the footnote gives the District 5,794 cases.

Alaska is 3rd for chlamydia on these same tables, at 697.7 per 100,000. Every other state’s gonorrhea rate is in the full table above.

What are syphilis rates in each state?

This table lists 2023 primary and secondary syphilis rates per 100,000 for all 50 states, plus the District of Columbia’s footnote rate. South Dakota is highest at 73.4 per 100,000, and Vermont is lowest at 0.5 per 100,000.

New Mexico is second at 36.6 per 100,000. The U.S. total is 15.8 per 100,000, from 53,007 cases. The District’s footnote is 271 cases and a rate of 39.9, and South Dakota is above it.

For 2024, the CDC published national syphilis rates and did not publish a state ranking. Primary and secondary syphilis is 12.2 per 100,000 in the provisional report, and total syphilis is 55.9 per 100,000. The syphilis column in the state grid above is still the 2023 primary and secondary rate.

Which states have the highest HIV rates?

In 2024, the District of Columbia has the highest HIV diagnosis rate among people aged 13 and older, 30.8 per 100,000. Georgia is the highest of the 50 states, at 26 per 100,000 people aged 13 and older. The national rate for that age group is 13.3 per 100,000. The surveillance count among people aged 13 and older is 38,793 diagnoses in the United States and 7 territories and freely associated states, and the state table here leaves those territories out.

Among people aged 13 and older, males accounted for 30,975 of the diagnoses, 80%. Regionally, the South continued to account for more than half (51%) of all diagnoses. The rate for people aged 13 and older living in the South at the time of diagnosis was 17.7 per 100,000.

Data are provisional with a 12-month reporting delay for assessing diagnoses, deaths, and diagnosed prevalence for the year 2024. For diagnoses during 2020-2024, on average approximately 81% were reported to the CDC within the year of diagnosis, and approximately 98% by the end of the following year.

Data are presented for persons with diagnosed HIV reported to the Centers for Disease Control and Prevention (CDC) through December 2025.

The smallest diagnosis count in this table is Vermont at 15, so the small-count caution in the table note does not apply to any row.

Why don’t herpes and HPV have state rankings?

Because the state rankings come from reported case rates, and neither infection is tracked that way. HPV infection is not a nationally notifiable condition.

For genital herpes and genital warts, the CDC’s surveillance report says: Enhanced surveillance of these conditions and surveillance of other STDs and STD-related sequelae, such as genital herpes simplex virus, genital warts, and trichomoniasis, use data collected from other sources, including data from sentinel surveillance and national surveys.

The U.S. herpes numbers are in how common herpes is, and which STIs have no cure covers herpes, HIV, HPV and hepatitis B.

What do the rankings leave out?

Because of incomplete diagnosis and reporting, the number of STD cases reported to CDC undercounts the actual number of infections occurring in the U.S. population.

Most STDs are asymptomatic. Screening is necessary for timely diagnosis and treatment, and changes in access to sexual health care, along with disruptions in public health services, can affect the number of infections diagnosed and reported.

The COVID-19 pandemic led to disruptions in STI-related prevention and care, reduced STI screening, and redirection of STI program resources, and it significantly affected trends in diagnosed and reported STIs, with likely underreporting of infections and possibly increased transmission. Trends for data collected during the pandemic should be interpreted cautiously.

The 2023 chlamydia ranking report carries its own note about that period: This report includes data from years that coincide with the COVID-19 pandemic, which introduced uncertainty and difficulty in interpreting case data. Tennessee also transitioned its STI surveillance information systems in September 2023, which may have affected the state’s case counts.

Caution should be applied in interpretation of these data.

States were ranked by unrounded rate, then by case count, then in alphabetical order, with rates shown rounded to the nearest tenth. Gonorrhea and primary and secondary syphilis were ranked the same way. Case notifications reflect diagnosed cases from the 50 states, the District of Columbia, and outlying areas, for example U.S. territories, while the ranked tables exclude those territories and each U.S. total includes the District. This page is general information, not a diagnosis or a treatment plan: a chlamydia, gonorrhea, or syphilis rate here is reported cases per 100,000 people, the HIV rate is diagnoses per 100,000 people aged 13 and older, and your own test is a question for a clinician.