The Southeastern United States Has the Highest STI/STD Rates in the Country
The southeastern United States has the highest rates of sexually transmitted infections (STIs) and sexually transmitted diseases (STDs) in the country, with a significant geographic overlap between regions with high STD rates and those with rapidly expanding epidemics of heterosexual HIV infection. 1
Regional Distribution of STIs in the US
The geographic distribution of STIs in the United States shows a clear pattern:
- The southeastern United States consistently reports the highest rates of notifiable STDs, including gonorrhea and syphilis 1
- This regional concentration reflects long-standing disparities in STI burden that have persisted for decades
- There is a concerning correlation between areas with high STD rates and those experiencing rapid increases in heterosexual HIV transmission 1
Current STI Trends in the US
Recent data shows alarming increases in several STIs nationwide:
- From 2015 to 2019, rates of gonorrhea, chlamydia, and syphilis all increased in the United States 2
- In 2022, more than 2.5 million cases of gonorrhea, chlamydia, and syphilis were reported to the CDC 3
- Chlamydia remains the most commonly reported infectious disease in the United States 1
- Syphilis has shown particularly concerning increases, with an annual percentage change of 1.70% from 2010-2019 4
Population Disparities in STI Rates
Beyond geographic disparities, certain populations bear a disproportionate burden:
- Young adults under 25 years have particularly high STI rates 2
- African Americans experience approximately fiftyfold higher rates of primary and secondary syphilis compared to whites 1
- Men who have sex with men (MSM) continue to have high rates of bacterial and other STDs despite declines since the beginning of the AIDS epidemic 1
- Women, particularly young African-American women, are experiencing the most striking increases in AIDS cases, reflecting the disproportionate STD burden in this group 1
Public Health Implications
The high STI rates in the southeastern United States have significant public health implications:
- STIs are associated with increased HIV acquisition and transmission 2
- They are the leading cause of tubal factor infertility in women 2
- Untreated STIs can lead to serious complications including pelvic inflammatory disease, chronic pelvic pain, and pregnancy complications 3
- The geographic overlap between high STD rates and expanding HIV epidemics suggests an urgent need for strengthened early STD detection and treatment 1
Current Challenges in STI Prevention and Control
Several factors contribute to the ongoing STI epidemic:
- Limited access to STD preventive services, with only half of local public health departments providing these services 1
- Restricted hours of operation and lack of timely services where STD care is available 1
- Limited public awareness, with nearly one in five Americans believing all STDs are curable 1
- Insufficient screening in primary care settings, where providers often don't routinely obtain sexual histories or screen for STDs 1
The southeastern United States faces particular challenges in addressing its high STI burden, requiring targeted interventions that address both clinical services and the underlying social determinants that contribute to regional disparities in STI rates.