The state of Nebraska has some of the lowest population-adjusted rates of sexually transmitted diseases (STDs), such as chlamydia, gonorrhea, and primary and secondary syphilis, among all states. But if rates continue trending as most of them are, the state’s position as one of the states with the lowest STD burden could change. Nebraska is one of many states seeing increases in rates of STDs, as the nation has seen rates of several infections rise for the past four straight years.

How common are sexually transmitted disease and infections here in the state of Nebraska, how have certain diseases become more common over the past several years, and which areas of the state are STD epicenters? To understand how serious the STD problem is in Nebraska, let’s examine data from the federal Centers for Disease Control and Prevention.

Chlamydia Rates in Nebraska

Just under 9,000 people were diagnosed with chlamydia in Nebraska in 2017, which puts the state in 34th position overall among the 50 states, after adjusting for differences in population. Nebraska’s chlamydia rate is nearly 15% lower than the overall U.S. rate.

Chlamydia infections per 100,000 people, bottom 20

Colorado 481.3
Hawaii 479.5
Iowa 467
Nebraska 450.7
Oregon 450
Washington 444
Minnesota 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

While Nebraska has a relatively low rate of chlamydia, that could change if trends hold. That’s because the rate of chlamydia in Nebraska has gone up every year since at least 2013, climbing nearly 24% in that time.

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

2012 363.7
2013 390.7
2014 398.6
2015 419.6
2016 432.3
2017 450.7

Illinois is the only Midwestern state that ranks among the top 10 in the nation for chlamydia prevalence, and Nebraska has the third-lowest rate in the 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
Kansas 488.9
Wisconsin 485
Iowa 467
Nebraska 450.7
Minnesota 444
North Dakota 432.5

Gonorrhea Rates in Nebraska

Nebraska’s population-adjusted rate of gonorrhea infections puts the state at No. 32 in the nation, and Nebraska’s rate is nearly 20% lower than the U.S. infection rate.

Gonorrhea infections per 100,000 people, bottom 20

Minnesota 142
Nebraska 139.1
Washington 137.1
Wisconsin 135
North Dakota 127.4
Oregon 121.3
Pennsylvania 119.2
Connecticut 109.4
Massachusetts 106.5
New Jersey 105.5
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
Total 171.9

Gonorrhea prevalence has climbed steadily over the past several years, rising by an incredible 88% since 2013.

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

2012 77
2013 74.1
2014 77.5
2015 89.8
2016 113.7
2017 139.1

Ohio is the sole state in the Midwest to rank among the 10 states with the highest gonorrhea rates, and Nebraska has the third-lowest rate in the entire region.

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

Ohio 216.3
Missouri 214.8
Illinois 186.4
Kansas 180.8
Indiana 177.5
Michigan 154.7
Iowa 154
South Dakota 149.1
Minnesota 142
Nebraska 139.1
Wisconsin 135
North Dakota 127.4

Syphilis Rates in Nebraska

Nebraska boasts the third-lowest rate of primary and secondary syphilis in the nation, and the state’s rate is nearly 76% lower than the overall national rate.

Primary and secondary syphilis infections per 100,000 people

Highest
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
Total 9.5
Lowest
Idaho 3.8
Utah 3.7
West Virginia 3.4
New Hampshire 3.2
Connecticut 3.1
Wisconsin 3
Iowa 2.7
Nebraska 2.3
Vermont 2.1
Wyoming 0.7

In addition to having one of the nation’s lowest syphilis rates, Nebraska managed to see a decline in syphilis prevalence between 2016 and 2017, which is something few states can say. Still, since 2012, syphilis has risen dramatically — by nearly 500%.

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

2012 0.4
2013 2.2
2014 2.7
2015 2.4
2016 3.5
2017 2.3

Syphilis is most common in the South, where 6 of the 10 states with the highest rates are located. No Midwestern state is among the top 10.

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 5.5
Kansas 5
Michigan 4.8
Indiana 4.8
South Dakota 3.8
Wisconsin 3
Iowa 2.7
Nebraska 2.3

HIV & Other STD Rates in Nebraska

HIV

Nebraska’s population-adjusted rate of new HIV infections is near the bottom quarter of the nation, as just under 90 people were diagnosed in 2017. Though Nebraska ranks near the bottom nationally, the state did see a modest increase from a rate of 4 per 100,000 in 2016 to 4.6 per 100,000 in 2017, which is a 15% jump. See also HIV test options.

Hepatitis B & C

Acute cases of both hepatitis B and hepatitis C are less common here in Nebraska than in the U.S overall. Hep B is about 60% less common in Nebraska, but the state has seen its rate rise, doubling between 2015 and 2016. Acute hep C is far less common here than nationally, with Nebraska’s rate falling about 90% lower than the overall national rate. The state also has seen its rate remain relatively steady outside of a one-year blip in 2015. See also hepatitis test options.

HPV

Cancers caused by human papillomavirus (HPV) occur at a lower rate here in Nebraska than in the nation overall. Nebraska’s rate of 11.4 per 100,000 is just under the national median of 11.7 per 100,000. Such cancers are a good marker of the seriousness of untreated HPV in a state, since several cancers (cervical, penile and anal, among others) are primarily caused by HPV, which is the most common STD in the world. See also HPV test options.

STDs in Nebraska Cities & Counties

Several Nebraska counties have rates of chlamydia, gonorrhea or syphilis that exceed the state’s rates, and even the national rates, for those diseases. In addition, there are a few cities in Nebraska that account for large percentages of infections.

Chlamydia

More than 1 in 2 cases of chlamydia in Nebraska occur in the Omaha metro area. Lincoln accounts for another 20%.

Nebraska counties by chlamydia infection rate (cases per 100,000 people), top 10

Thurston 1,160.80
Douglas 664.5
Dawes 563.2
Dakota 553.4
Lancaster 546.9
Buffalo 403.2
Saline 378.1
Lincoln 367.4
Hall 359.9
Platte 356.2

Gonorrhea

More than 7 in 10 gonorrhea cases in Nebraska are diagnosed in people living in the Omaha metro area, while Lincoln accounts for another 14%.

Nebraska counties by gonorrhea infection rate (cases per 100,000 people), top 10

Douglas 254.9
Dakota 129.9
Logan 128.7
Thurston 127.4
Lancaster 95.6
Scotts Bluff 93.8
Fillmore 89
Harlan 86.9
Buffalo 83.9
Box Butte 79.4

Primary and secondary syphilis

More than 60% of primary and secondary syphilis cases are diagnosed among people in Omaha, with Lincoln adding another 13%.

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

Sheridan 19.2
Boone 18.8
Dixon 17.3
Cherry 17.1
Howard 15.6
Hall 9.7
Saline 7
Douglas 6.4
Otoe 6.3
Adams 6.3

Conclusion

To be sure, it’s great news that Nebraska ranks so low among all states when it comes to how common sexually transmitted diseases are. But with most STDs seeing their rates rise, that position may not last long. That’s why it’s so important to be sure that you are not passing any infections along to sexual partners unknowingly. Did you know that data indicates that the vast majority of people who are infected with STDs are not aware? Learning your status can help you not only take control of your health but also can help prevent you from contributing to rising STD rates here in Nebraska.

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.