People who live below the Mason-Dixon line are at the greatest risk of contracting a sexually transmitted disease
State statistics from the Centers for Disease Control and Prevention (CDC) show that the top two states where residents face the highest rates of STDs are Mississippi and Louisiana.
In the state, there is one sexually transmitted disease for about every 79 people, the highest incidence in the country. Mississippi is also one of five states on the CDC list where STD rates are higher than 1,000 cases per 100,000 people.
According to the most recent data available, 1,266 per 100,000 people had an STD in 2021.
Louisiana lags behind, with a rate of 1,160 STD cases per 100,000 residents.
The rankings made a regional shift to place three, with Alaska reporting 1,091 cases.
But returned south for a fourth time, with South Carolina recording 1,052 STD cases per 100,000 people.
Of the top 10 states, seven are in the Southeast.
In 2021, Mississippi topped the list with a total of 1,266 STDs per 100,000 people. Gonorrhea rates were the highest in the country at 427.7 infections per 100,000
Alaska, a largely rural state where access to health care may be limited, had the highest rate of Chlamydia. It has a relatively young population, which is generally more likely to contract STDs
The Covid pandemic left millions of people isolated and unable to seek preventive screenings for STDs. Infections declined early in the pandemic but rebounded in the summer
The data reinforces what public health experts have emphasized in recent years: America is in the midst of an epidemic of sexually transmitted diseases.
Federal disease surveillance data shows that between 2017 and 2021, every state in the US saw a spike in cases of syphilis, a disease that can lead to organ damage, and gonorrhea, which can cause infertility.
In 2021, the most recent year for which data is available, a total of 2.5 million STDs were reported in the US.
The STD epidemic has resulted in a combined rate of 763 cases per 100,000 people in the 50 states and the District of Columbia, a six percent increase from the 2020 rate of about 722.
STD surveillance was disrupted in the early days of the Covid-19 pandemic when shelter-in-place orders were imposed on much of the U.S. population. But overall, the number of new diseases did not decrease in 2020.
The impact of disease monitoring was most acute in March and April 2020, the only time the numbers fell.
While cases of gonorrhea and syphilis fell below 2019 levels during that two-month period, cases of both STDs rose sharply for the rest of the year.
Research by the CDC found that the number of cases of gonorrhea increased by 15 percent between 2019 and 2021, and the number of reported cases of both early and advanced syphilis increased by 38 percent.
Also Mississippi in 2021 was at the top of the list for the highest gonorrhea rates in the country, with 427.7 infections per 100,000 people.
The rate of chlamydia, a bacterial infection, was also high: 750 per 100,000. And the cumulative syphilis rate that year was 88.3 per 100,000.
Chlamydia is the most common STD in the US, followed by gonorrhea.
After Mississippi, Louisiana was the state with the second highest STD rate. The The state’s chlamydia rate was 730.1 per 100,000, while the gonorrhea rate was 354.5 per 100,000 residents.
Alaska had the third highest rate of STDs overall, but rates of gonorrhea and syphilis have been rising there for years, according to the state’s Department of Health and Human Services.
And in 2021, state health officials counted 447 cases of syphilis, an increase of 24 percent above the 2020 total.
The likely contributors include a relatively young population – which accounts for more than 50 percent of all STD cases in the US. Much of Alaska is also remote, limiting the availability of health care, and public health infrastructure is severely lacking.
After Alaska came South Carolina, which registered 1,052 STDs per capita in 2021. The country recorded the fourth highest rates of chlamydia with 703 cases per capita.
The state had the lowest rates of syphilis on the list with 40.1 cases per capita.
In South Dakota, which rounded out the top five states, there is limited access to health care in rural and tribal areas. There, syphilis has exploded by more than 1,800 percent, from 41 cases in 2016 to 785 in 2021.
The rest of the top 10 states on the list, with the exception of New Mexico in ninth place, were in the Southeast and included Alabama, Georgia, Arkansas and North Carolina.
Sixth-ranked Alabama had a total of 989.6 STDs per 100,000 people, followed by Georgia at 987.5 per 100,000 and Arkansas at 942.4 per 100,000.
However, Alabama had the highest rate of syphilis infections in the country of any state on the list: 321.3 infections per 100,000 people.
Georgia, meanwhile, reported 62.1 cases of syphilis per capita, while Arkansas had a rate of 79.4 per 100,000.
There are two types of syphilis infections: a preventable syphilis infection is an infection that an adult acquires during sexual contact, and a congenital infection is when a mother passes the disease to her baby during pregnancy.
It increases a child’s risk for bone damage, anemia, jaundice, nerve damage and meningitis. It can be treated with antibiotics, but it kills about 40 percent of babies born with it.
One possible explanation for the rise in syphilis cases is the fact that many people with the disease are asymptomatic or have no symptoms. Their lack of symptoms leads to them unknowingly passing on the disease.
About half of syphilis and chlamydia patients are asymptomatic, estimates suggest, while up to 90 percent of people with gonorrhea have no symptoms.
North Carolina rounded out the rankings at 10th, with 922.2 STDs per 100,000 residents. The number of chlamydia infections was 603.3 per capita and the number of gonorrhea cases was 271.2 cases per capita.
North Carolina had the second-lowest syphilis rate, with 47.7 infections per 100,000.
Overall, syphilis infection rates in the US have increased by 70 percent since 2017
For gonorrhea, rates have increased by 25 percent
Chlamydia infections have fallen by five percent since 2017
A majority of STDs in the US occur in youth ages 15 to 24. This may be due to fear when it comes to discussing their sex life with parents or doctors and the lack of informative sex education in the US.
Only 38 states and DC mandate sex education in schools, leaving approximately 11 million U.S. public school students without this drug.
Twenty-nine states require sex education programs to prioritize abstinence before marriage as a means of preventing STDs and unplanned pregnancies. This course teaches children, often in a religious context, to wait to have sex until they have entered into a committed monogamous relationship.
However, teens who have made abstinence pledges are at increased risk of being exposed to the human papillomavirus, and are also less likely to use safe sex methods such as condoms if they decide to be sexually active, according to a 2016 report published in the Magazine for marriage and family.
The authors of that report said: ‘Abstinent healthcare providers are more likely to receive cultural messages downplaying the effectiveness of condoms and contraceptives, and to be exposed to framing premarital sexual activity as a form of failure.”