The picture of STDs, or sexually transmitted diseases and infections, in Oregon is quite mixed, with the state ranking among the lowest in some STDs and among the states with the highest rates for others. What’s not mixed, though, is that Oregon has seen rates of most STDs, including chlamydia, gonorrhea, and primary and secondary syphilis rise in recent years, reflecting a trend that’s also happening nationally with regard to rates of those diseases.

So which sexually transmitted disease and infections are most common here in Oregon, how has the prevalence of them changed over time, and how do geographic differences within the state impact how common STDs are? To understand more, we’ll examine data from the federal Centers for Disease Control and Prevention and the Oregon Health Authority.

Chlamydia Rates in Oregon

Oregon ranks No. 34 out of the 50 states for the population-adjusted rate of chlamydia infections. The state’s rate is about 14% lower than the overall U.S. rate.

Chlamydia infections per 100,000 people, bottom 20

Hawaii 479.5
Kansas 466.2
Nebraska 450.7
Oregon 450
Minnesota 444
Iowa 443.2
Washington 442.2
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
Utah 332.2
New Hampshire 330.5
Vermont 297.5
West Virginia 226.1
Total 528.8

While Oregon ranks in the bottom half when it comes to how common chlamydia is in the state, the reality is the rate of chlamydia is on the rise in our state. In fact, the chlamydia rate has risen every year since 2012, jumping more than 30% in that time.

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

2012 345
2013 360.8
2014 390.6
2015 404.7
2016 432.5
2017 450

Only two Western states, Alaska and New Mexico, are among the states with the 10 highest rates of chlamydia, but Oregon ranks near the middle of the Western region. Still, the region’s leader, Alaska, has a rate that’s about 77% higher than Oregon’s.

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

Alaska 799.8
New Mexico 651.6
Arizona 571.8
California 557.4
Nevada 553.1
Colorado 481.3
Hawaii 479.5
Oregon 450
Washington 442.2
Montana 437.4
Idaho 368.4
Wyoming 365.8
Utah 332.2

 Gonorrhea Rates in Oregon

When it comes to the prevalence of gonorrhea, Oregon ranks No. 35 among the 50 states with a population-adjusted rate nearly one-third lower than the overall U.S. rate.

Gonorrhea infections per 100,000 people, bottom 20

Nebraska 139.1
Washington 136
Wisconsin 135
North Dakota 127.4
Oregon 121.3
Iowa 119.9
Pennsylvania 119.2
Connecticut 109.4
Massachusetts 106.5
New Jersey 105.5
Rhode Island 102.9
Hawaii 95.1
Utah 83.3
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

The gonorrhea rate in Oregon has climbed dramatically over the past half-decade, more than tripling between 2012 and 2017.

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

2012 37.5
2013 44
2014 58.4
2015 80.2
2016 108
2017 121.3

Alaska is the only Western state in which the gonorrhea rate is among the 10 highest in the country, and Oregon ranks in the bottom half of the region with a rate that’s nearly 60% lower than Alaska’s infection rate.

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

Alaska 295.1
New Mexico 215.7
California 192
Nevada 187.8
Arizona 180.5
Colorado 151.1
Washington 136
Oregon 121.3
Hawaii 95.1
Utah 83.3
Montana 75
Wyoming 70.4
Idaho 58.6

Syphilis Rates in Oregon

Unlike with chlamydia and gonorrhea, Oregon’s rate of primary and secondary syphilis is closer to the overall U.S. rate, placing the state at No. 16 overall.

Primary and secondary syphilis infections per 100,000 people

Highest
Nevada 20
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 10.4
Oregon 8.6
Total 9.5
Lowest
South Dakota 3.8
West Virginia 3.4
New Hampshire 3.2
Iowa 3.2
Connecticut 3.1
Wisconsin 3
Nebraska 2.3
Vermont 2.1
Alaska 1.8
Wyoming 0.7

After a one-year decline in the syphilis rate between 2015 and 2016, Oregon’s rate is again inching up, and it’s risen nearly 60% since 2012.

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

2012 5.4
2013 6.8
2014 6.9
2015 8.6
2016 8.1
2017 8.6

Three Western states are among the top 10 syphilis states, and Oregon is sixth overall in the region.

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

Nevada 20
California 17.1
Arizona 13.1
Washington 9.3
New Mexico 9.3
Oregon 8.6
Hawaii 6.6
Colorado 5.2
Montana 4.6
Utah 3.8
Idaho 3.8
Alaska 1.8
Wyoming 0.7

HIV & Other STD Rates in Oregon

HIV

Just under 200 people were newly diagnosed with HIV in Oregon in 2017, placing the state at No. 36 for the population-adjusted HIV rate. Not only does Oregon rank among the states with the lowest prevalence of HIV, but the rate dropped by 13% between 2016 and 2017. See How to Test for HIV

Hepatitis B & C

Acute cases of both hepatitis B and hepatitis C occur at lower rates in Oregon than in the U.S. as a whole, but both viral infections have seen rates fluctuate widely over the past half-decade. Oregon’s acute hep C rate is about half the national rate, but the prevalence rose in 2016 after several years of decline. The rate of acute hep B has remained more steady but has dropped slightly recently. See How to Test for Hepatitis

HPV

Pinpointing the precise number of people in Oregon who are infected with human papillomavirus is impossible because so few people have been diagnosed with it. So to understand how common untreated HPV is in our state, it’s necessary to examine the rate of HPV-related cancers here in Oregon. That’s because HPV causes a large majority of several types of cancer, including cervical, penile and anal cancers. Such cancers occur at a rate of 12.1 per 100,000 in Oregon, which is slightly higher than the national median of 11.7 per 100,000. See How to Test for HPV

STDs in Oregon Cities & Counties

While Oregon mostly ranks among the states with the lowest rates of several different STDs, a few locales around the state have higher rates and account for more overall cases than others. In fact, the Portland metro area, in some cases, accounts for the vast majority of infections.

Chlamydia

The Portland metro area, including Clackamas, Columbia, Multnomah, Washington and Yamhill counties, accounted for more than half of all chlamydia cases in the state in 2017. The greater Portland metro area, including portions of Washington state, has seen it’s chlamydia rate rise by more than one-quarter over the past half-decade, the 12th-highest increase of any major metro area.

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

Jefferson 690.0
Multnomah 647.3
Malheur 606.1
Lane 495.4
Benton 492.6
Marion 490.0
Klamath 463.9
Union 453.5
Jackson 430.6
Clatsop 417.3

Gonorrhea

Nearly 60% of gonorrhea infections in Oregon in 2017 were diagnosed in people living in the Portland area, and the multi-state Portland metro has recorded the second-highest gonorrhea increase of any major U.S. metro area with the rate increasing by 174%.

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

Multnomah 259.8
Jefferson 207
Marion 154.8
Linn 126.6
Malheur 122.5
Lane 115.2
Jackson 100
Josephine 99.2
Coos 96.4
Klamath 88.6

Primary and secondary syphilis

The five Oregon counties that make up the Portland area accounted for close to 7 in 10 cases of syphilis in the state in 2017.

Oregon counties by early syphilis infection rate (cases per 100,000 people)*

Multnomah 31
Washington 15.6
Jackson 13.4
Marion 13
Lake 12.3
Josephine 11.7
Malheur 9.4
Lane 8.9
Jefferson 8.6
Linn 8.1

 * Also includes early-latent syphilis cases, in addition to all primary and secondary syphilis cases.

Conclusion

Oregon ranks near the bottom of the country in terms of how prevalent most sexually transmitted disease are here in our state. But as the increases in rates of several STDs illustrate, there is no room for complacency. Everyone has a role to play in reducing the STD epidemic in Oregon and across the nation, which is why it’s so important to get tested for the disease you are at risk of carrying. About half of all sexually active people will contract an STD by the age of 25, but the vast majority of infected people are unaware of their STD status.

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.