According to the federal Centers for Disease Control and Prevention, several sexually transmitted diseases (STDs) are becoming more common across the United States, and those trends largely can be seen here in North Carolina as well. Rates of chlamydia, gonorrhea, and primary and secondary syphilis have risen nationally, and the same is true in North Carolina.
Which STDs are most common in North Carolina, how does the state rank nationally, and which cities and counties in North Carolina have the highest rates of sexually transmitted diseases? To answer those questions, we’ll check out data from the CDC as well as the North Carolina Department of Health and Human Services.
Chlamydia Rates in North Carolina
North Carolina has the eighth-highest rate of chlamydia infections after adjusting for population differences among the states, and North Carolina’s rate is about 17% higher than the national rate.
Chlamydia infections per 100,000 people
North Carolina’s chlamydia rate rose slightly between 2016 and 2017, but the state has seen an increase of nearly 25% since 2013.
Percentage increase in chlamydia infection rate. 2013-2017 (top 15)
Chlamydia is most prevalent in the South, and North Carolina ranks in the top half of the region.
Chlamydia infection rate, Southern states (cases per 100,000 people)
Gonorrhea Rates in North Carolina
North Carolina has the eighth-highest rate of gonorrhea infections, and the state’s rate is more than one-quarter higher than the national frequency.
Gonorrhea infections per 100,000 people
Gonorrhea is more common today in our state than it was about a half-decade ago, and the state’s rate of gonorrhea infections has jumped by nearly 60%, but that’s far below the leaders nationally when it comes to rising gonorrhea rates. In fact, several states have seen their gonorrhea rates jump by more than 300% — New Hampshire (+322%), Idaho (+347%) and Wyoming (+523%).
Percentage increase in gonorrhea infection rate, 2013-2017 (bottom 15)
Eight of the 10 states with the highest rates of gonorrhea are in the South, and North Carolina ranks near the middle of the region.
Gonorrhea infection rate, Southern states (cases per 100,000 people)
Syphilis Rates in North Carolina
North Carolina’s rate of primary and secondary syphilis is No. 8 in the nation, though the state’s rate is only about 12% higher than the national level.
Primary and secondary syphilis infections per 100,000 people
Cases of primary and secondary syphilis have risen by nearly two-fold in North Carolina since 2013.
Percentage increase in primary and secondary syphilis infection rate, 2013-2017 (top 15)
North Carolina ranks fourth among all Southern states in the rate of syphilis infections.
Primary and secondary syphilis infection rates, Southern states (cases per 100,000 people)
HIV & Other STD Rates in North Carolina
North Carolina’s rate of new HIV cases ranks among the top in the nation at 15.2 infections per 100,000 people, quite a bit higher than the national rate of 11.8 per 100,000. In a spot of good news, though, the state has seen prevalence of HIV drop, declining by nearly 7% between 2016 and 2017. See also HIV test options.
Hepatitis B & C
Acute infections of hepatitis B are more common in North Carolina than the nation overall, as the state’s infection rate for hep B is about 41% higher than the national level. Acute infections of hep C also occurred at higher-than-national rates in North Carolina, with our state’s hep C rate sitting at more than double the national level. Rates of both types of hepatitis have risen in our state in recent years. See also hepatitis test options.
Human papillomavirus, the most common STD, causes most cases of cervical, penile, anal and vulvar cancer, among others. North Carolina has a higher-than-median rate of HPV-related cancer, 13.1 per 100,000 vs. the national median of 11.7 per 100,000. See also HPV test options.
STDs in North Carolina Counties
While STDs are more common in North Carolina than in many other states, a handful of the state’s counties are helping elevate the state’s national rankings.
More than 1 in 4 chlamydia cases in North Carolina occurred in Charlotte, Durham and Raleigh.
North Carolina counties by chlamydia infection rate (cases per 100,000 people), top 10
Charlotte, Durham and Raleigh accounted for more than 25% of gonorrhea cases in North Carolina, but the disease is more prevalent outside those cities.
North Carolina counties by gonorrhea infection rate (cases per 100,000 population), top 10
Primary and secondary syphilis
About one-quarter of syphilis cases in North Carolina in 2017 were in the Charlotte area, while the Raleigh-Durham area accounted for another 22%.*
North Carolina counties by primary, secondary and early latent syphilis infection rate (cases per 100,000 population), top 10
* In its county-by-county breakdown, the state of North Carolina separates syphilis into slightly different categories than the CDC does nationally, so this includes primary, secondary and early latent syphilis, which encompasses more cases than the CDC data, which our earlier rankings were based on.
While it’s, sadly, true that North Carolina has among the nation’s highest STD rates for several major conditions, every person in the state has it within their power to work to bring those rates down. Having safer sex and taking precautions against STD transmission are two big ways you can help, but responsible sexual behavior also must include finding out your STD status by getting yourself tested.
- North Carolina Department of Health and Human Services, 2017 North Carolina HIV/STD/Hepatitis Surveillance Report. (2018). Retrieved from https://epi.dph.ncdhhs.gov/cd/stds/figures/std17rpt_rev12142018.pdf
- Centers for Disease Control and Prevention, HIV Surveillance Report, Diagnoses of HIV Infection in the United States and Dependent Areas, 2017. (2018). Retrieved from https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-report-2017-vol-29.pdf
- Centers for Disease Control and Prevention, HPV-Associated Cancer Rates by State, 2011-2015. (2018). Retrieved from https://www.cdc.gov/cancer/hpv/statistics/state/index.htm
- Centers for Disease Control and Prevention, Sexually Transmitted Disease Surveillance 2017. (2018). Retrieved from https://www.cdc.gov/std/stats17/SRtables.pdf
- Centers for Disease Control and Prevention, Surveillance for Viral Hepatitis – United States, 2016. (2018). Retrieved from https://www.cdc.gov/hepatitis/statistics/2016surveillance/index.htm
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.