The American cities with the highest rates of sexually transmitted diseases (STDs) have been revealed.
Memphis, Tennessee, comes out as America’s STD capital where around one in 70 people were estimated to have been infected with one in 2021.
In second and third place are Jackson, Mississippi, and Columbia, South Carolina, where the rate was around one in 75 during that year.
Health research firm Innerbody drew on federal data to compile an extensive list of 100 US cities with the highest rates of STDs, including HIV, chlamydia, gonorrhea, and syphilis.
The above map shows the rate of STDs per 100,000 population in America’s metropolitan areas
Southern cities were disproportionately represented in the roundup, which looked at metropolitan areas in the US.
And most of the top-scoring cities were located in states that spend less than the national average on healthcare for their citizens.
States that are among the lowest in healthcare spending per capita — Mississippi, Tennessee, and South Carolina — account for the three highest STD rates.
Southern cities account for 14 of the top 25 with the highest concentrations of STD cases.
And Florida was well-represented with three of the top 25 cities located there – Jacksonville, Miami, and Fort Lauderdale – which is actually an improvement from the previous year when the Sunshine State accounted for four of them.
Fifteen cities had STD rates higher than 1,000 infectious per 100,000 people: Memphis, TN, Jackson, MS, Columbia, SC, Baltimore, MD, Philadelphia, PA, New Orleans, LA, Milwaukee, WI, Little Rock, AR, Washington, DC, Norfolk, VA, Cleveland, OH, Greensboro, NC, Charlotte, NC, Charleston, SC, San Francisco, CA.
Broken down, Memphis’ total of over 1,400 STDs per 100,000 population were five HIV cases, 4,772 gonorrhea cases, 9,681 chlamydia cases, and 605 syphilis cases.
HIV took up a larger share of Jackson’s STDs per 100,000 people with 105 cases. Columbia recorded 1,350 STDs per 100,000 people.
By comparison, states that spent the most on healthcare typically had lower STD rates. The health expenditure argument was not perfect, though.
For instance, while the District of Columbia has the highest healthcare spending per capita at $14,381 — more than $4,000 above the national average.
The city nonetheless ranks 9th worst for STD infection rates in our city-focused study.
The lowest scorer at 100th place was Monmouth, New Jersey, with 239 STD cases per 100,000 people.
In 99th place was Provo, Utah with 265 STDs per 100,000 people.
In 98th place was Middlesex, New Jersey (278 per capita). Right above that is Santa Cruz, California with 378 cases per capita.
Total cases of STDs — chlamydia, gonorrhea and syphilis — have been trending upwards for the previous seven years in a row. Infections fell in 2020 with 2.4million recorded compared to the previous year, but CDC officials said it was likely that cases had in fact continued to rise but this was not detected due to a drop in testing
Public health experts have been eyeing a steady increase in STD rates for years, a trend that worsened during the pandemic when the bulk of diagnostic testing shifted to focus exclusively on Covid.
With fewer testing resources, more people went undetected, potentially spreading infection to sexual partners.
Worst of the Worst: Ten cities with the highest STD rates
- Memphis, TN: 1,460 STDs per 100,000
- Jackson, MS: 1,358 STDs per 100,000
- Columbia, SC: 1,350 STDs per 100,000
- Baltimore, MD: 1,327 STDs per 100,000
- Philadelphia, PA: 1,200 STDs per 100,000
- New Orleans, LA: 1,145 STDs per 100,000
- Milwaukee, WI: 1,142 STDs per 100,000
- Little Rock, AR: 1,126 STDs per 100,000
- Washington, DC: 1,081 STDs per 100,000
- Norfolk, VA: 1,069 STDs per 100,000
While STD cases initially declined during first months of the pandemic, they resurged by the end of 2020.
Scientists have since found that gonorrhea and syphilis cases surged to a 30-year high in the U.S. during the first year of the pandemic in spite of sweeping lockdowns.
Total cases of sexually transmitted diseases (STDs) hit 2.5 million in 2021, up from 2.4 million in 2020.
There were several notable shifts for the better and worse in the rankings. Norfolk, Virginia (1,069 per 100,000), which was at 29, has moved up to number 10.
Memphis shot to the top spot all the way from 12 while Little Rock, Arkansas (1,126 per 100,000) rose 11 spots from 19 to eight.
Jackson, Mississippi, moved from first to second place, followed by Columbia, South Carolina, which rose 15 spots from the previous year.
On the other hand, Atlanta, Georgia (811 per 100,000) improved significantly, moving from spot 22 to 42. New York, with 910 cases per 100,000 people, fell from seven to spot 26.
Denver, Colorado improved 19 spots from 32 to 51 while Cincinnati, Ohio improved 16 spots from 30 to 46th in the ranking, and San Fransisco improved from third to 15th.
The data, which came from the Centers for Disease Control and Prevention (CDC), also highlighted stark racial inequities, proving that the STD burden is not equal.
Minority racial and ethnic groups have consistently been hit the hardest, not because they are predisposed to certain illnesses but because of wealth and the conditions in the environments where they are born, live, and work, factors known as social determinants of health.
Innerbody found that although non-hispanic black people make up approximately 12 percent of the total US population, they account for a disproportionate 32 percent of chlamydia, syphilis, and gonorrhea infections.
People who cannot afford healthcare or are uninsured are less likely to be tested regularly for STDs or have access to sexual healthcare services.
Many racial and ethnic minorities may also distrust the healthcare system, which has historically proven discriminatory, often resulting in substandard care. This could create negative feelings around getting tested and treated for STDs.
The onset of the Covid pandemic worsened an already-lackluster STD surveillance system across states.
In 2020, diagnostic testing and a slim workforce able to carry it out were shifted to focus primarily on Covid detection.
Due to reduced access to care during the pandemic, many people are believed to have foregone check-ups and preventative care, harboring their infections undetected for longer, providing more opportunities to transmit the infection to their sexual partners.
Drug use is also believed to have played a role.
Drugs are often linked to risky sexual behavior, and using IV drugs greatly increases one’s risk of becoming infected with HIV.
It is also believed that, absent being able to partake in normal life activities such as going to parties and other fun social gatherings, sexual activity increased during the pandemic.
In 2021, the rate of syphilis in the U.S. surpassed 51 cases per 100,000 people, the highest rate since 1990 and the greatest number of overall cases (171,074) since 1951.
Cases of chlamydia and gonorrhea also increased significantly between 2020 and 2021, though not nearly as steep as those for syphilis.
|Rank (Worst to best)||State||STD cases per 100k||HIV cases||Chlamydia cases||Gonorrhea cases||Syphilis cases|
|6||New Orleans, LA||1,145||245||9,400||4,449||454|
|8||Little Rock, AR||1,126||17||4,553||2,420||291|
|15||San Francisco, CA||1,002||14||8,362||5,108||1,487|
|18||St. Louis, MO||957||104||14,846||8,306||627|
|19||Fort Lauderdale, FL||950||460||10,185||4,516||1,381|
|21||Oklahoma City, OK||944||183||8,098||4,558||495|
|26||New York, NY||910||1,083||60,776||26,388||6,521|
|28||Des Moines, IA||891||37||3,813||2,199||151|
|33||Los Angeles, CA||860||1,382||53,032||26,021||5,450|
|37||San Antonio, TX||834||297||13,105||5,615||1,013|
|47||Colorado Springs, CO||784||40||4,164||1,446||87|
|48||San Diego, CA||779||153||18,299||6,117||1,126|
|56||Las Vegas, NV||723||352||11,824||5,145||1,038|
|57||Grand Rapids, MI||712||38||5,805||2,946||121|
|63||El Paso, TX||670||109||4,390||1,180||123|
|67||New Haven, CT||647||47||3,766||1,636||140|
|70||Kansas City, KS||611||52||6,359||2,213||264|
|74||Boise City, ID||592||17||3,354||893||64|
|76||Fort Worth, TX||568||19||9,253||4,379||592|
|77||Salt Lake City, UT||552||8||7,346||2,486||160|
|82||Jersey City, NJ||534||123||2,760||749||226|
|83||West Palm Beach, FL||525||213||5,712||1,599||317|
|84||Orange County, CA||525||264||10,966||4,580||901|
|87||Daytona Beach, FL||480||10||2,109||939||165|
|91||Ann Arbor, MI||445||0||2,104||800||54|
|96||San Jose, CA||379||8||4,441||2,279||586|
|97||Santa Cruz, CA||378||0||752||213||57|