The state of Missouri routinely ranks among the states with the highest prevalence of a handful of common sexually transmitted diseases (STDs), including chlamydia, gonorrhea and syphilis. In addition, the rates of all three of those infections have gone up in recent years in Missouri, which largely tracks with national trends identified by the CDC.

Which STDs are most common here in Missouri, how have rates changed over the past half-decade, and which areas of the state have the biggest concentrations of STDs? To get a broad picture of sexual health in Missouri, we’ll examine data from the federal Centers for Disease Control and Prevention and the Missouri Department of Health and Senior Services.

Chlamydia Rates in Missouri

More than 32,000 cases of chlamydia were diagnosed in Missouri in 2017, and even after adjusting for population, the state ranks in the top 20 when it comes to the rate of chlamydia. Additionally, the state’s chlamydia rate is higher than the overall U.S. rate, though not by much.

Chlamydia infections per 100,000 people, top 25

Alaska 799.8
Louisiana 742.4
Mississippi 707.6
New Mexico 651.6
South Carolina 649.8
Georgia 623.7
Alabama 615.5
North Carolina 612.2
New York 591.6
Illinois 589.9
Arkansas 579.6
Arizona 571.8
Delaware 566.3
California 557.4
Maryland 555.4
Oklahoma 554.4
Nevada 553.1
Texas 543.9
Missouri 536.4
Ohio 528.6
Tennessee 522.5
Indiana 514.2
South Dakota 512.7
Michigan 511.9
Rhode Island 500
Total 528.8

Prevalence of chlamydia in Missouri has risen every year since 2013 and is up 16% overall between 2012 and 2017.

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

2012 462.2
2013 452.1
2014 461.5
2015 475.8
2016 507
2017 536.4

Illinois is the only Midwestern state that ranks in the top 10 overall nationally, but Missouri has the second-highest chlamydia rate in the entire region.

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

Illinois 589.9
Missouri 536.4
Ohio 528.6
Indiana 514.2
South Dakota 512.7
Michigan 511.9
Wisconsin 480
Kansas 466.2
Nebraska 450.7
Iowa 443.2
North Dakota 432.5
Minnesota 426.4

Gonorrhea Rates in Missouri

Missouri ranks in the top 15 nationally for its population-adjusted gonorrhea rate, and it’s No. 11 for total cases in 2017. Also, Missouri’s rate is nearly 25% higher than the overall national rate for gonorrhea.

Gonorrhea infections per 100,000 people, top 25

Mississippi 309.8
Alaska 295.1
Louisiana 256.7
South Carolina 254.4
Alabama 245.7
Oklahoma 231.4
Arkansas 224.5
North Carolina 220.9
Georgia 217.5
Ohio 216.3
New Mexico 215.7
Missouri 214.8
California 192
Nevada 187.8
Delaware 187.4
Illinois 186.4
Tennessee 185
Maryland 182.5
Arizona 180.5
Indiana 177.5
New York 172.7
Texas 170.2
Kentucky 167.2
Kansas 156.3
Total 171.9

Missouri’s gonorrhea rate has gone up every year since 2014 after a period of decline. Between 2012 and 2017, the prevalence of gonorrhea in Missouri has jumped by almost 64%.

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

2012 131
2013 124.8
2014 121.8
2015 147
2016 188.7
2017 214.8

Only one Midwestern state, Ohio, has a higher gonorrhea rate than Missouri, and the Buckeye State is just barely in the lead.

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

Ohio 216.3
Missouri 214.8
Illinois 186.4
Indiana 177.5
Kansas 156.3
Michigan 154.7
South Dakota 149.1
Nebraska 139.1
Wisconsin 132.6
North Dakota 127.4
Iowa 119.9
Minnesota 118.1

Syphilis Rates in Missouri

Missouri ranks in the top 20 among the states for its rate of primary and secondary syphilis, but Missouri’s rate is lower than the overall U.S. rate.

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

Nevada 20
California 17.1
Georgia 14.5
Louisiana 14.5
Arizona 13.1
New York 11.9
Florida 11.6
North Carolina 10.6
Mississippi 10.4
Illinois 9.6
Maryland 9.5
Oklahoma 9.5
Washington 9.3
New Mexico 9.3
Alabama 8.7
Oregon 8.6
Missouri 8.3
Texas 8
Massachusetts 7.9
Arkansas 7.8
Tennessee 7.3
South Carolina 7.3
Rhode Island 6.7
Hawaii 6.6
Ohio 6.3
Total 9.5

The prevalence of syphilis nearly quadrupled between 2012 and 2017, and the rate has climbed every year for the past three years.

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

2012 2.6
2013 4.2
2014 5.8
2015 5
2016 6.6
2017 8.3

Missouri ranks second overall in the Midwest for the rate of primary and secondary syphilis, behind only Illinois.

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

Illinois 9.6
Missouri 8.3
Ohio 6.3
North Dakota 5.8
Minnesota 5.3
Michigan 4.8
Indiana 4.8
Kansas 4.6
South Dakota 3.8
Iowa 3.2
Wisconsin 3
Nebraska 2.3

HIV & Other STD Rates in Missouri

HIV

More than 500 people were newly diagnosed with HIV in Missouri in 2017, but the state’s population-adjusted rate of HIV infection is below the overall U.S. rate (8.3 per 100,000 vs. 11.8 per 100,000), and Missouri’s HIV rate declined about 2% between 2016 and 2017. See also HIV test options.

Hepatitis B & C

Acute cases of both hepatitis B and hepatitis C are less common in Missouri than they are on a national level, but things are trending in the wrong direction here in Missouri. The acute hep B rate has gone up 40% since 2014, and the rate of acute hep C infections has more than tripled in the same time frame. See also hepatitis test options.

HPV

Missouri has the eighth-highest rate among the 50 states in HPV-caused cancer with a rate of 13.6 per 100,000, compared to the national median of 11.7 per 100,000 cases. Human papillomavirus (HPV) is an incredibly common STD, so common, in fact, that it’s virtually impossible to know how many people become infected every year. Few infected people have symptoms, so one of the only ways to know how serious HPV is is by examining how many people have HPV-caused cancers, such as cervical cancer, penile cancer or anal cancer. See also HPV test options.

STDs in Missouri Cities & Counties

While Missouri mostly has higher-than-average rates of chlamydia, gonorrhea and syphilis, a few parts of the state are largely driving Missouri’s position on these lists, and the picture of sexual health in our state really changes when you zoom into the regional differences in the state.

Chlamydia

Nearly 4 in 10 chlamydia cases in Missouri were in people living in St. Louis, while Kansas City accounted for another 24%. The broader St. Louis metro area, which includes counties in Missouri and Illinois, ranks among the 25 major U.S. metros with the highest chlamydia rates.

Missouri metro areas and regions by chlamydia infection rate (cases per 100,000 people)

Kansas City 626.5
St. Louis 566.3
Central 430.3
Southwest 411
Northwest 390.9
Southeast 379.3

Gonorrhea

More than 47% of all chlamydia cases in the state in 2017 were in St. Louis, and more than one-quarter were in Kansas City. The greater Kansas City metro area, which includes counties in Missouri and Kansas, has the 12th-highest gonorrhea rate of any major U.S. metro area, while St. Louis comes in No. 16.

Missouri metro areas and regions by gonorrhea infection rate (cases per 100,000 people)

St. Louis 256.8
Kansas City 251.4
Northwest 169.5
Southeast 137.8
Southwest 109.4
Central 78

Primary and secondary syphilis

Almost all infections of primary and secondary syphilis (89%) were diagnosed in either St. Louis or Kansas City.

Missouri metro areas and regions by primary and secondary syphilis infection rate (cases per 100,000 people)

Kansas City 7.7
St. Louis 6.3
Southwest 2.6
Central 1.4
Southeast 1.4
Northwest 0.4

Conclusion

Missouri ranks in the top half of the states in measures of most STDs and is among the Midwestern leaders in several common STDs. And the rates are going up. Individuals can help push down the rates of STDs in Missouri by engaging in responsible practices, including getting themselves tested for a range of STDs, especially those for which they are at a higher risk based on their lifestyle and behaviors. It can seem intimidating to think about getting tested for a potentially serious STD, but the truth is that most common infections are easily cleared up and even the ones that can’t be cured often can be managed.

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.