NC among leading states in sexually transmitted disease

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North Carolina is seventh in the United States for sexually transmitted dieseases at 925.9 new cases per 100,000 people according to analysis by Invigor Medical using data from the Centers for Disease Control and Prevention.

North Carolina is a national leader in sexually transmitted diseases.

The Tar Heel State is among four southern states — Alabama, South Carolina, and Arkansas are the others — in the top 10 according to analysis from Invigor Medical identifying U.S. counties and states with the highest STD infection rates. Researchers analyzing data from the Centers for Disease Control and Prevention focused on chlamydia, gonorrhea, syphilis, and HIV. North Carolina has the seventh-highest rate of STD infections nationally at 925.9 newly reported cases per 100,000 residents.

The states tend to face persistent challenges in STD prevention, including gaps in healthcare access, limited sexual health education, and structural barriers to screening and treatment. Outside of the South, South Dakota and New York also report relatively high rates despite different demographic and policy contexts.

There were approximately 2.5 million new STD cases reported in 2023 alone, and researchers found disparities in age, race, and region. Cases spiked during the summer, when increased travel and social activity drive higher transmission.

There were 65,867 new chlamydia cases reported in North Carolina in 2023 — seventh highest in the U.S. and 26,353 new gonorrhea cases, No. 6 nationally. There were 6,475 syphilis cases and 1,394 new HIV cases, or 15.1 per 100,000 residents, the country’s ninth highest.

The number of newly reported sexually transmitted infections has climbed sharply over the last 10 years. In 2023, health officials recorded approximately 2.5 million new cases of chlamydia, gonorrhea, syphilis, and HIV—up from 1.8 million a decade earlier.

Chlamydia is still the most prevalent STD, with more than 1.6 million new cases in 2023, while gonorrhea nearly doubled over the decade, reaching almost 595,000 cases. Syphilis saw the sharpest increase with a sixfold spike from 34,279 cases in 2013 to over 205,000 in 2023. Part of the increase reflects a change in CDC reporting – before 2018, late-stage and unknown-stage syphilis cases were not included in national totals. But even when excluding those later-stage cases, syphilis diagnoses still tripled over the decade. In contrast, HIV diagnoses remained relatively flat over the same span, reflecting the impact of expanded testing, prevention tools like PrEP, and earlier treatment.

Although the long-term trend shows a sustained rise in STDs, data suggests the epidemic may be slowing. Although syphilis infections remain at record highs, reported cases of chlamydia, gonorrhea, and HIV have declined from peak levels in previous years.

Nationally, women are about 10% more likely than men to be diagnosed with an STD and across all age groups 13 years and over, there were 902 reported cases per 100,000 women, compared to 819 per 100,000 men. The gender gap is more pronounced among young adults, namely in biological differences that make women more susceptible to infection. In addition, women are more likely to be screened during routine reproductive health visits than men, who are typically only tested when symptoms are present, which leads to lower reported rates.

Females ages 13 to 24 have the highest STD diagnosis rate of any demographic group, with more than 3,000 cases per 100,000, nearly double the rate for males in the same age range. After age 25,

STD rates decline significantly for both sexes. Among women, the rate drops by nearly half in the 25–34 age group and continues to decline steeply with age. For men, diagnosis rates peak slightly later—between ages 25 and 34—before following a similar downward trend.

Racial and ethnic disparities in STD cases remain a persistent and pronounced feature of the epidemic. In 2023, Black Americans had a reported STD rate more than seven times higher than their white counterparts at 2,249.7 cases per 100,000 compared to 319. The gap reflects long-standing inequities in healthcare access, prevention resources, and social determinants of health.

Higher rates are also observed among indigenous and Alaska Native populations (1,442.6 per 100,000) and Native Hawaiian and Other Pacific Islander groups (1,057.2 per 100,000). By contrast, Asian Americans report the lowest rate at 195.5 cases per 100,000.

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