Cities with the Highest STD Rates in the US (2025): Where to Get Tested

The United States reported over 2.4 million cases of chlamydia, gonorrhea, and syphilis in 2023, according to the CDC's latest STI Surveillance Report. While rates declined slightly in 2024 for the third consecutive year, the overall burden remains 13% higher than a decade ago — and congenital syphilis has risen nearly 700%. Some cities and states are carrying a disproportionate share of this burden. If you live in one of the areas on this list, knowing where to get tested is not optional — it is essential.

• Philadelphia, PA leads all US cities with 1,504 STD cases per 100,000 residents

• Southern states dominate the top 10 — Mississippi, Louisiana, Georgia, and Alabama all rank in the highest tier

• Alaska has had the highest chlamydia rate in the US every year since 2001

• Congenital syphilis — entirely preventable with prenatal screening — rose for the 12th consecutive year in 2024

• Cities in high-prevalence areas should prioritise annual or more frequent STD testing

Methodology

This report draws on data from the CDC’s 2023 STI Surveillance Report (the most recent full-year data available), the 2024 Provisional STI Surveillance data released September 2025, and Innerbody Research’s annual city-level STD ranking, which analyses HIV, chlamydia, gonorrhea, and syphilis cases per 100,000 population across the 100 largest US metropolitan areas. State-level data is sourced directly from CDC state ranking tables. All rates are per 100,000 population unless otherwise noted.

The 10 US Cities with the Highest STD Rates

1. Philadelphia, Pennsylvania - 1,504 cases per 100,000

Philadelphia moved from fifth to first in the most recent annual city ranking, driven by significant increases across all four tracked infections. The city recorded over 15,000 chlamydia cases, nearly 11,000 gonorrhea cases, 618 new HIV diagnoses, and 170 syphilis cases in the most recent reporting year. Philadelphia’s rate reflects both genuine high prevalence and relatively comprehensive surveillance and testing infrastructure — more testing means more detected cases. If you live in Philadelphia, annual testing for chlamydia, gonorrhea, syphilis, and HIV is the minimum recommended frequency.

2. Memphis, Tennessee - 1,498 cases per 100,000

Memphis has consistently placed in the top three cities for STD rates. With over 9,300 chlamydia cases, 5,400 gonorrhea cases, 307 syphilis infections, and 308 new HIV diagnoses, Memphis reflects the concentration of STD burden in the urban South. Tennessee’s public health infrastructure underwent significant changes in 2023 when the state transitioned its STI surveillance system, which may affect case count accuracy for that year.

3. Jackson, Mississippi - 1,490 cases per 100,000

Jackson — located in Hinds County, which has one of the highest county-level STD rates in the country at over 2,253 cases per 100,000 — reflects Mississippi’s position as a state with some of the most severe STD burdens in the US. Mississippi has the highest gonorrhea rate nationally (428 per 100,000) and the second-highest chlamydia rate (750 per 100,000). Limited access to healthcare in rural areas surrounding Jackson contributes significantly to these figures.

4. New Orleans, Louisiana - 1,450 cases per 100,000

Louisiana as a whole ranks third in the nation for chlamydia (730 per 100,000) and third for gonorrhea (355 per 100,000). New Orleans reflects and amplifies these statewide trends, with high rates driven by a combination of concentrated poverty, limited healthcare access, and high population density in certain neighbourhoods. Louisiana had been making progress reducing gonorrhea and syphilis rates in the late 2010s but those gains have since been reversed.

5. St. Louis, Missouri - 1,423 cases per 100,000

St. Louis City — which is a separate jurisdiction from St. Louis County — has a county-level STD rate of over 2,100 cases per 100,000, one of the highest in the entire country. The concentrated urban poverty and limited access to sexual health services in parts of the city drive rates that far exceed the national average. St. Louis saw significant increases in its city ranking in the most recent data, jumping into the top five from outside the top ten the previous year.

6. Baton Rouge, Louisiana - 1,332 cases per 100,000

Louisiana places two cities in the top six — a reflection of a statewide public health challenge rather than city-specific factors. Baton Rouge, as the state capital and a major urban centre, sees the same structural drivers of high STD rates as New Orleans: inadequate sexual health infrastructure, limited access to affordable testing, and ongoing public health funding pressures.

7. Washington, D.C. - 1,266 cases per 100,000

Washington D.C. has historically had among the highest STD rates of any jurisdiction in the country, driven by significant health disparities between wealthier and lower-income neighbourhoods. The District recorded 764 HIV infections, nearly 15,000 chlamydia cases, 6,900 gonorrhea cases, and 491 syphilis cases. D.C.’s relatively comprehensive testing infrastructure means these numbers reflect genuine prevalence more accurately than in areas with limited testing access.

8. San Francisco, California - ~1,270 cases per 100,000

San Francisco has consistently ranked among the highest-rate cities in the country, driven primarily by gonorrhea and syphilis rates that substantially exceed national averages. The city’s gonorrhea rate of over 371 cases per 100,000 — compared to a national rate of around 179 — reflects disproportionate impact on men who have sex with men (MSM) and is compounded by the high density of the relevant demographic in the city. San Francisco’s sexual health testing infrastructure is relatively strong, which means high rates partly reflect high detection.

9. Detroit, Michigan - ~1,260 cases per 100,000

Detroit’s high STD rates reflect structural factors common to several high-ranking cities: concentrated urban poverty, a history of healthcare infrastructure decline, and significant racial health disparities. The city saw a notable increase in its STD ranking in the most recent data cycle, reflecting increases particularly in gonorrhea and syphilis.

10. Baltimore, Maryland — ~1,200 cases per 100,000

Baltimore rounds out the top ten, with particularly high rates of chlamydia and gonorrhea. The city has consistently ranked in the top tier of US cities for STD burden and faces similar structural challenges to other high-ranking cities in terms of healthcare access and economic inequality driving health outcomes.

The 10 US States with the Highest STD Rates

State-level data from the CDC’s 2023 STI Surveillance Report reveals strong geographic concentration of STD burden in the South and certain non-contiguous states.

1. Alaska — Chlamydia rate: 760 per 100,000

Alaska has ranked first in the US for chlamydia every year since 2001. State health officials attribute the persistently high rate to a combination of unprotected sex and significantly limited access to healthcare services across the state’s vast and sparsely populated geography. Gonorrhea rates are also among the highest in the country at approximately 270 per 100,000.

2. Mississippi — Chlamydia: 750 | Gonorrhea: 428 per 100,000

Mississippi has the highest gonorrhea rate and the second-highest chlamydia rate in the US. State health officials cite a fragmented public health infrastructure as the primary driver. South Dakota had the highest syphilis rate nationally in 2023 at 229 per 100,000, but Mississippi’s combined burden across all three infections places it at the top of overall state rankings.

3. Louisiana - Chlamydia: 730 | Gonorrhea: 355 per 100,000

Louisiana ranks third nationally for both chlamydia and gonorrhea. Despite periods of progress, rates have risen again in recent years. The state’s high burden is geographically concentrated in major cities but extends into rural parishes with very limited sexual health services.

4. South Carolina - Chlamydia: 612 | Gonorrhea: 222 per 100,000

South Carolina has the fourth-highest chlamydia rate and fifth-highest gonorrhea rate nationally. Columbia, SC has been identified as one of the cities with the highest STD rates in the country in multiple annual rankings. The state saw a significant decrease in rates between 2022 and 2023 but the baseline remains very high.

5. Georgia - Chlamydia: 646 | Gonorrhea: 275 per 100,000

Georgia’s high rates are heavily concentrated in Atlanta and the metro area surrounding it, but rural Georgia also shows elevated rates. California and Texas each have more cities in the top 150 highest-rate cities nationally than any other state, but Georgia’s per-capita rates are significantly higher.

6. Alabama - Chlamydia: 651 | Gonorrhea: 321 per 100,000

Alabama ranks sixth for chlamydia and fourth for gonorrhea nationally. The state has seen a slight increase in overall STD rates despite national trends showing modest declines. Birmingham is the state’s largest city and has consistently appeared in national city-level STD rankings.

7. North Carolina - Chlamydia: 608 | Gonorrhea: 243 per 100,000

North Carolina’s rates reflect both urban concentration (Charlotte, Raleigh, Durham) and rural areas with limited healthcare access. The state saw a slight decrease in overall rates between 2022 and 2023.

8. South Dakota - Syphilis: 229 per 100,000

South Dakota’s syphilis rate of 229 per 100,000 is by far the highest in the nation and reflects a statewide public health emergency that has been the subject of significant concern from state and federal health authorities. American Indian and Alaska Native populations — who experience congenital syphilis rates nearly twelve times higher than White populations nationally — are disproportionately affected in South Dakota.

9. Arkansas — Chlamydia: 580 | Gonorrhea: 193 per 100,000

Arkansas ranks among the highest states for both chlamydia and gonorrhea. Limited public health infrastructure in rural areas of the state contributes significantly to both high rates and limited access to testing and treatment.

10. New Mexico - Syphilis among the highest nationally

New Mexico has seen particularly sharp increases in syphilis rates in recent years and ranks among the states with the highest congenital syphilis rates — a reflection of inadequate prenatal care access in underserved communities across the state.

Why These Disparities Exist

The geographic concentration of STD burden in the US is not random. It reflects structural inequalities that drive both higher transmission rates and lower rates of testing and treatment. The states and cities with the highest STD rates share several common factors: limited access to affordable healthcare and sexual health services, concentrated poverty and racial health disparities (Black Americans account for 32% of all chlamydia, gonorrhea, and syphilis cases despite making up 12.6% of the population), inadequate sex education in public schools, reduced public health funding for STI surveillance and contact tracing, and geographic barriers to care in rural areas.

Understanding these structural drivers matters because it reframes high STD rates from a personal moral failing to a public health infrastructure problem with known, solvable causes.

What This Means for You If You Live in a High-Rate Area

If you live in or near any of the cities or states on this list, the CDC’s standard recommendation of annual testing is a floor, not a ceiling. For sexually active adults in high-prevalence areas, testing every 3–6 months for chlamydia, gonorrhea, and syphilis is more appropriate, and annual HIV testing is essential. The most important practical step is knowing where to access testing in your area. Most major US cities have public health department sexual health clinics providing free or low-cost testing. Planned Parenthood operates in most high-burden cities. Online testing services provide home-based options for people who prefer privacy or cannot access clinics.

STD Testing Resources by High-Priority City

For residents of the cities on this list, finding confidential, affordable testing is straightforward. Most areas have multiple options including local health department clinics (free, confidential), Planned Parenthood (sliding-scale fees), urgent care centres (same-day results), and online testing services with home collection and results in 24–48 hours. Use the search tool on this site to find testing options near you.

Tips for High-Prevalence Areas

• Test more frequently than once a year — in the highest-rate cities, testing every 3–6 months is the appropriate baseline for sexually active adults.

• Use free local services — health department clinics in Philadelphia, Memphis, New Orleans, and other high-rate cities provide free testing without insurance.

• Get tested for syphilis specifically — syphilis rates are rising sharply in many of the cities on this list and it requires a separate blood test not always included in standard panels.

• Ensure prenatal syphilis screening — congenital syphilis is entirely preventable with timely screening and treatment. If you are pregnant and live in a high-rate area, confirm syphilis screening is part of your prenatal care.

• Know your partners’ status — in high-prevalence areas, pre-relationship testing for both partners is more important, not less.

Frequently Asked Questions

Which US city has the highest STD rate?

Philadelphia, Pennsylvania currently leads all US cities with approximately 1,504 STD cases per 100,000 residents, based on combined rates of chlamydia, gonorrhea, syphilis, and HIV. Memphis, Tennessee and Jackson, Mississippi are close behind at 1,498 and 1,490 respectively.

Which US state has the highest STD rate?

Mississippi has the highest combined STD burden of any US state, with the highest gonorrhea rate (428 per 100,000) and the second-highest chlamydia rate (750 per 100,000). Alaska has had the highest chlamydia rate every year since 2001. South Dakota has the highest syphilis rate nationally at 229 per 100,000.

Are STD rates getting better or worse in the US?

Mixed picture. The CDC reported a 9% overall decline in chlamydia, gonorrhea, and syphilis cases in 2024 compared to 2023 — the third consecutive year of decrease. However, overall rates remain 13% higher than a decade ago, and congenital syphilis rose for the 12th consecutive year in 2024, with nearly 4,000 cases and approximately 279 stillbirths and infant deaths.

Why do Southern states have higher STD rates?

Southern states face a combination of structural factors: limited access to affordable healthcare, reduced public health investment in STI surveillance and testing, higher rates of poverty and uninsurance, and in many states, abstinence-focused sex education that does not provide adequate information about STD prevention and testing. These are systemic, not behavioural, drivers.

How often should I get tested if I live in a high-STD-rate city?

In the highest-rate cities — Philadelphia, Memphis, New Orleans, Jackson, St. Louis — the appropriate testing frequency for sexually active adults is every 3–6 months for chlamydia, gonorrhea, and syphilis, and at least annually for HIV. This exceeds the CDC’s national minimum recommendation of annual testing, but reflects the higher exposure probability in high-prevalence environments.

Find STD Testing Near You

Wherever you live in the US, fast, confidential STD testing is available. Use our location finder to find testing centres near you — including free and low-cost options in the highest-burden cities and states listed in this report.

Related reading: How Often Should You Get Tested? A CDC-Backed Guide · STI Epidemic 2025: Why Rates Are Surging · Syphilis: Why It’s Making a Comeback · Why Regular STD Screening Matters