According to the federal Centers for Disease Control and Prevention, several common sexually transmitted diseases (STDs) are becoming more prevalent throughout the U.S. In fact, rates of chlamydia, gonorrhea, and primary and secondary syphilis all have risen for the past four straight years, CDC data finds. But what about here in North Dakota?

Which STDs are most common in North Dakota, how have their prevalence rates changed here over time, how does North Dakota stack up against other states, and which areas of our state are the biggest hotbeds of sexually transmitted diseases and infections? To understand all of that, we’ll dig deep in to CDC data for the past several years.

Chlamydia Rates in North Dakota

Chlamydia infections occur in North Dakota at a rate of 432.5 per 100,000, which puts the state at No. 41 among the 50 states. North Dakota’s rate is well below the overall U.S. rate (-30%), but it’s still nearly double the lowest rate, which was recorded in West Virginia.

Chlamydia infections per 100,000 people

Highest
Alaska 799.8
Louisiana 742.4
Mississippi 708.7
South Carolina 649.8
New Mexico 645
Georgia 623.7
Alabama 615.5
North Carolina 612.2
New York 591.6
Illinois 589.9
Total 528.8
Lowest
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

North Dakota’s chlamydia rate has varied widely year-by-year, rising and falling every other year. Between 2012 and 2017, the rate is up a total of 4%.

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

2012 415.6
2013 405.3
2014 466.7
2015 417.3
2016 456.5
2017 432.5

Illinois is the only Midwestern state with a chlamydia rate that’s among the 10 highest, and only one other Midwestern state has a rate that’s higher than the overall U.S. rate. North Dakota’s rate is the lowest 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 North Dakota

North Dakota’s population-adjusted gonorrhea rate of 127.4 puts the state at No. 35 nationally, and the rate is more than 25% lower than the overall U.S. rate. Still, North Dakota’s rate is considerably higher than that of Vermont (-74%), which has the nation’s lowest 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

North Dakota’s gonorrhea rate has increased pretty consistently since 2012, though the state did see a large one-year drop in 2017. Still, today the rate stands more than 13% higher than the rate in 2012.

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

2012 112.2
2013 108.3
2014 110.2
2015 118.5
2016 142.5
2017 127.4

Ohio is the only state in the Midwest with a rate that’s among the 10 highest, though four other states in the region have rates higher than the overall U.S. figure.

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 North Dakota

North Dakota’s rate of syphilis infections is 5.8 per 100,000, low enough for the state to come in at No. 31 nationally. The state’s rate is lower than both the overall U.S. rate (-39%) and the highest recorded rate, which occurred in Nevada (-71%).

Primary and secondary syphilis infections per 100,000 people, bottom 20

North Dakota 5.8
New Jersey 5.6
Minnesota 5.5
Colorado 5.2
Kansas 5
Maine 4.9
Michigan 4.8
Indiana 4.8
Montana 4.6
South Dakota 3.8
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
Total 9.5

Syphilis has become much more common in North Dakota over the past six years, climbing by more than 850% between 2012 and 2017.

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

2012 0.6
2013 1.7
2014 1.8
2015 1.5
2016 4.4
2017 5.8

No state in the Midwest is among the 10 with the highest syphilis rates, and only one, Illinois, posted a rate higher than the overall U.S. rate. Unlike with most STDs, North Dakota ranks relatively high in the region, placing in the top half.

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 North Dakota

HIV

More than 30 people were newly diagnosed with HIV in North Dakota in 2017, which puts the state at No. 35 after adjusting for population differences. Additionally, North Dakota saw the HIV rate fall by 20% between 2016 and 2017, the fourth-largest drop in the country. See HIV test options.

Hepatitis B & C

Acute infections of viral hepatitis B and C both occur at lower rates here than in the U.S. overall. Acute hep B is only about one-third as common in North Dakota than the U.S. as a whole, and the rate has remained steady, while hep C is about 90% less common but has seen a slight rate increase. See hepatitis test options.

HPV

North Dakota has the nation’s second-lowest rate of cancers caused by human papillomavirus, or HPV. The most common STD in the world, HPV is usually harmless, but if it goes untreated in some people, HPV can lead to many different types of cancer, most famously cervical cancer. In North Dakota, these cancers occur at a population-adjusted rate of 9.3 per 100,000, lower than the overall U.S. rate of 11.7 per 100,000. See HPV test options.

STDs in North Dakota Cities & Counties

Which areas of the state are the biggest hotbeds of STDs? Several counties have distressingly high rates of certain diseases, while the major metro areas of the state account for large percentages of overall cases.

Chlamydia

About 1 in 4 chlamydia cases in North Dakota were diagnosed in the Fargo area, Bismarck added another 16%, while Minot accounted for 13%.

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

Sioux 2,082.4
Benson 1,895.5
Rolette 1,058.1
Ramsey 877
Golden Valley 758.8
Hettinger 702.7
Mountrail 638.9
Ward 627.1
Grand Forks 507.6
Cass 504.9

Gonorrhea

About 22% of gonorrhea cases occurred in Fargo, and Bismarck added another 17%. About 1 in 10 cases of the disease were diagnosed in Minot.

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

Benson 1,318
Rolette 969.3
Sioux 572.1
Hettinger 554.7
Mountrail 290.4
Ramsey 275.2
Towner 264.1
Adams 169.6
Ward 144.5
Burleigh 139.8

Primary and secondary syphilis

About 1 in 3 syphilis cases occurred in Fargo, with Bismarck adding another 21%, Grand Forks accounting for 12% and Minot adding 10%.

North Dakota counties by primary and secondary syphilis infection rate (cases per 100,000 people), top 10

Sioux 22.9
McHenry 16.8
Benson 14.8
Mercer 11.3
Mountrail 9.7
Burleigh 7.5
Cass 7
Williams 5.7
Grand Forks 5.6
Morton 3.3

Conclusion

While North Dakota is in a better position than many states when it comes to the prevalence of sexually transmitted diseases and infections, as the data indicates, STD rates are inching upward in our state fairly consistently. The truth is that almost all sexually active people will contract at least one STD in their lives, and while most will never cause serious problems, some of them can be fatal or lead to lifelong problems. That’s why it’s crucial for anybody who is or has been sexually active to get tested so that they can get treated for any infections they have and so that they can avoid passing diseases along.

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.