The United States has recorded four straight years of increasing rates of several common sexually transmitted diseases, such as chlamydia, syphilis and gonorrhea. In Hawaii, the situation is a little more complex. While some rates are climbing and most are higher than they were a half-decade ago, the past couple of years have seen declines here in Hawaii.

Which STDs are most prevalent here in Hawaii, how does the state stack up with others, what has happened to STD rates over the past several years, and which locales in Hawaii are the biggest hotbeds of sexually transmitted diseases and infections? To answer all those questions, we’ll check out data from the federal Centers for Disease Control and Prevention.

Chlamydia Rates in Hawaii

Hawaii’s population-adjusted chlamydia infection rate ranks the state No. 32 among the 50 states, and Hawaii’s rate is just under 10% less than the overall U.S. rate. Still, Hawaii’s rate is more than twice as high as that of West Virginia, the state with the lowest rate.

Chlamydia infections per 100,000 people, bottom 20

Colorado 481.3
Hawaii 479.5
Iowa 467
Nebraska 450.7
Oregon 450
Minnesota 444
Washington 444
Pennsylvania 441.5
Montana 437.4
Kentucky 435.4
North Dakota 432.5
Massachusetts 425.7
New Jersey 392
Idaho 368.4
Wyoming 365.8
Maine 342.1
New Hampshire 330.5
Utah 323.7
Vermont 297.5
West Virginia 226.1
Total 528.8

Hawaii has seen two consecutive years of decline in the chlamydia rate, but the rate has risen about 5% since 2012.

Hawaii chlamydia rate by year (cases per 100,000 people)

2012 455.4
2013 472.9
2014 452.2
2015 494.1
2016 482.1
2017 479.5

Two Western states are among the 10 states with the highest chlamydia rates, including Alaska, which leads the nation. Hawaii’s rate places the state in the middle of the region.

Chlamydia infection rate, Western states (cases per 100,000 people)

Alaska 799.8
New Mexico 645
Arizona 571.8
California 557.4
Nevada 544.7
Colorado 481.3
Hawaii 479.5
Oregon 450
Washington 444
Montana 437.4
Idaho 368.4
Wyoming 365.8
Utah 323.7

Gonorrhea Rates in Hawaii

The population-adjusted rate of gonorrhea in Hawaii is low enough to put the state at No. 42 overall, and Hawaii is one of only nine states with rates below 100 per 100,000 people. Hawaii’s rate is more than three times lower than that of Mississippi, the national leader, but is nearly three times higher than that of Vermont, which has the lowest rate in the country.

Gonorrhea infections per 100,000 people

Highest
Mississippi 310
Alaska 295.1
Louisiana 256.7
South Carolina 254.4
Alabama 245.7
Oklahoma 231.4
Arkansas 223.5
North Carolina 220.9
Georgia 217.5
Ohio 216.3
Total 171.9
Lowest
Rhode Island 102.9
Hawaii 95.1
Utah 81.2
Montana 75
West Virginia 70.8
Wyoming 70.4
Idaho 58.6
Maine 46.6
New Hampshire 38.4
Vermont 32.5

Between 2016 and 2017, Hawaii’s gonorrhea rate fell, but taking a longer view shows that the rate has climbed more than 60% since 2012.

Hawaii gonorrhea rate by year (cases per 100,000 people)

2012 58.5
2013 51.1
2014 71.9
2015 86.5
2016 102.5
2017 95.1

Half of the 10 states with the lowest gonorrhea rates are in the West, and Hawaii ranks in the bottom half of the region.

Gonorrhea infection rate, Western region states (cases per 100,000 people)

Alaska 295.1
New Mexico 214
California 192
Nevada 184.9
Arizona 180.5
Colorado 151.1
Washington 137.1
Oregon 121.3
Hawaii 95.1
Utah 81.2
Montana 75
Wyoming 70.4
Idaho 58.6

Syphilis Rates in Hawaii

The rate at which primary and secondary syphilis infections occur in Hawaii is high enough to place the state in the top half nationally, though the state’s rate is still far behind Nevada, which leads the nation.

Primary and secondary syphilis infections per 100,000 people, top 25

Nevada 19.7
California 17.1
Georgia 14.5
Louisiana 14.5
Arizona 13.1
Maryland 12.2
New York 11.9
Florida 11.6
North Carolina 10.6
Mississippi 10
Illinois 9.6
Oklahoma 9.5
New Mexico 9.2
Washington 9.2
Alabama 8.7
Oregon 8.6
Missouri 8.3
Texas 8
Massachusetts 7.9
Arkansas 7.8
Alaska 7.6
Tennessee 7.3
South Carolina 7.3
Rhode Island 6.7
Hawaii 6.6
Total 9.5

Hawaii’s syphilis rate has varied somewhat over the past three years, but it’s virtually exploded since 2012, rising more than 288% since then.

Hawaii primary and secondary syphilis rate by year (cases per 100,000 people)

2012 1.7
2013 3.3
2014 4.8
2015 6.4
2016 7.8
2017 6.6

Three Western states are among the top 10 for syphilis, but Hawaii ranks in the bottom half of the region.

Primary and secondary syphilis infection rates, Western states (cases per 100,000 people)

Nevada 19.7
California 17.1
Arizona 13.1
New Mexico 9.2
Washington 9.2
Oregon 8.6
Alaska 7.6
Hawaii 6.6
Colorado 5.2
Montana 4.6
Idaho 3.8
Utah 3.7
Wyoming 0.7

HIV & Other STD Rates in Hawaii

HIV

More than 80 people were newly diagnosed with HIV in Hawaii in 2017, which represents a 4% increase from the previous year. Among the states, Hawaii ranks 33rd for its population-adjusted HIV rate. See best HIV test options.

Hepatitis B & C

The prevalence of acute hepatitis B has dropped in recent years here in Hawaii to a statistically insignificant rate. Acute hep B occurs in the U.S. at a rate of 1 per 100,000, and the most recent year in which Hawaii had a detectable rate, the viral infection occurred at the same rate as the national rate. Hawaii has not reported its rate of acute hep C for several years. See best hepatitis test options.

HPV

Human papillomavirus (HPV), while the most common STD in the world, is difficult to pinpoint. This is partially because it’s so very common, but it’s also because the vast majority of people who have it don’t have any signs of the disease. But untreated HPV can be very dangerous, or even deadly. That’s why examining a state’s rate of HPV-related cancers can be a window into understanding the virus. Nationally, the median rate for these cancers is 11.7 per 100,000, but Hawaii’s rate of 9.4 per 100,000 is the fourth-lowest in the nation. See best HPV test options.

STDs in Hawaii Cities & Counties

While Hawaii is generally not among the leaders when it comes to how common sexually transmitted diseases and infections are, the rates vary depending on the geography being examined, and the city of Honolulu accounts for the majority of cases.

Chlamydia

More than 3 in 4 chlamydia cases in Hawaii were diagnosed in people living in Honolulu.

Hawaii counties by chlamydia infection rate (cases per 100,000 people)

Honolulu 540.6
Maui 383.9
Hawaii 347.2
Kauai 256.5

Gonorrhea

Honolulu accounted for nearly 9 in 10 cases of gonorrhea.

Hawaii counties by gonorrhea infection rate (cases per 100,000 people)

Honolulu 126.6
Hawaii 69.7
Maui 31.6
Kauai 16.7

Primary and secondary syphilis

Nearly three-quarters of Hawaii’s syphilis cases occurred in Honolulu.

Hawaii counties by primary and secondary syphilis infection rate (cases per 100,000 people)

Kauai 18.1
Maui 9.7
Honolulu 8.3

Conclusion

Hawaii has managed to buck national trends in recent years when it comes to the prevalence and growth of sexually transmitted diseases and infections. But when comparing rates to those recorded 5-6 years ago, most diseases have grown in frequency in Hawaii, which means that it’s likely that many people who are infected are unaware. Through getting yourself tested and being vigilant about practicing safer sex, everyone has the power to keep making progress against STDs in Hawaii.

Additional References

Note: Some states have published more recent data for chlamydia, gonorrhea, and primary and secondary syphilis. For states in which that’s the case, we have substituted the individual state data for 2018 and used that in our rankings, while other states’ rankings are based on 2017 numbers. In some cases, we assume that when the full national dataset is published by the CDC, states’ positions relative to other states will change some, though those changes are unlikely to be dramatic, since the CDC data comes from the states.