South Carolina has among the highest rates in the nation for multiple sexually transmitted diseases (STDs), placing in the top five for both chlamydia and gonorrhea and in the upper half of the country for syphilis and HIV. In addition to South Carolina’s relatively high rates of several STDs, the state has also seen rates of many sexually transmitted infections and diseases climb in recent years, a trend that’s mirrored nationally, with the U.S. posting four straight years of increases in chlamydia, gonorrhea, and primary and secondary syphilis.

Which sexually transmitted diseases and infections are most common here in South Carolina, how have disease rates changed in our state over the past few years, and which locales in South Carolina have the highest concentrations of certain STDs? To understand the answers to those questions, we’ll explore data from the federal Centers for Disease Control and Prevention and the South Carolina Department of Health and Environmental Control.

Chlamydia Rates in South Carolina

More than 32,000 people were diagnosed with chlamydia in South Carolina in 2017, putting the state 19th overall for the total number of people infected. But after adjusting for population differences among the states, South Carolina rises to No. 5 for the concentration of chlamydia cases. South Carolina’s chlamydia rate is nearly 25% higher than the overall national rate.

Chlamydia infections per 100,000 people

Highest
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
Total 528.8
Lowest
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

In addition to posting one of the highest chlamydia rates in the nation, South Carolina has seen the disease continue creeping up, with a 13% increase over the past half-decade or so.

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

2012 574.7
2013 536
2014 581.2
2015 562.4
2016 575.5
2017 649.8

Six of the 10 states with the highest chlamydia rates are in the South, and South Carolina is third among them.

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

Louisiana 742.4
Mississippi 707.6
South Carolina 649.8
Georgia 623.7
Alabama 615.5
North Carolina 612.2
Maryland 586.3
Arkansas 579.6
Delaware 566.3
Oklahoma 554.4
Texas 543.9
Tennessee 522.5
Virginia 488.3
Florida 485.2
Kentucky 435.4
West Virginia 226.1

 Gonorrhea Rates in South Carolina

South Carolina’s population-adjusted gonorrhea infection rate is the fourth-highest in the country and is nearly 50% higher than the overall national rate.

Gonorrhea infections per 100,000 people

Highest
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
Total 171.9
Lowest
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

The rate of gonorrhea infections in South Carolina has climbed by nearly 60% since 2012 and rose more than 35% in one year between 2016 and 2017.

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

2012 161.7
2013 150.7
2014 170.8
2015 167.6
2016 187.8
2017 254.4

Eight Southern states are among the 10 with the highest rates of gonorrhea, and South Carolina is third in the region.

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

Mississippi 309.8
Louisiana 256.7
South Carolina 254.4
Alabama 245.7
Oklahoma 231.4
Arkansas 224.5
North Carolina 220.9
Georgia 217.5
Delaware 187.4
Tennessee 185
Maryland 170.3
Texas 170.2
Kentucky 167.2
Florida 153.7
Virginia 143.3
West Virginia 70.8

Syphilis Rates in South Carolina

South Carolina’s rate of primary and secondary syphilis infections puts the state at No. 22, with a rate that’s about 23% lower than the overall national 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
Maryland 12.2
New York 11.9
Florida 11.6
North Carolina 10.6
Mississippi 10.4
Illinois 9.6
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

South Carolina ranks outside the top 10 when it comes to syphilis cases, but primary and secondary syphilis is making a rapid rise in our state, jumping more than 50% over the past six years.

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

2012 4.8
2013 5.7
2014 5.2
2015 6
2016 6.5
2017 7.3

Half of the top 10 syphilis states are in the Southern region, but South Carolina ranks near the bottom of the region.

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

Georgia 14.5
Louisiana 14.5
Maryland 12.2
Florida 11.6
North Carolina 10.6
Mississippi 10.4
Oklahoma 9.5
Alabama 8.7
Texas 8
Arkansas 7.8
Tennessee 7.3
South Carolina 7.3
Virginia 6
Delaware 6
Kentucky 5.9
West Virginia 3.4

HIV & Other STD Rates in South Carolina

HIV

More than 700 people were newly diagnosed with HIV in South Carolina in 2017, though this figure represents a decline of 5% between 2016 and 2017. Still, South Carolina’s population-adjusted rate of HIV is eighth-highest of all 50 states. See How to Test for HIV

Hepatitis B & C

Acute hepatitis B and hepatitis C are both less common in South Carolina than the U.S. as a whole, but the rates of both viral hepatitis infections have increased in recent years. South Carolina’s population-adjusted rate of acute hep B cases is about two-thirds of the national rate, and it’s gone up about 20%, while the acute hep C rate is about 80% lower than the national level but has doubled since 2015. See How to Test for Hepatitis

HPV

South Carolina’s rate of cancer cases related to human papillomavirus is No. 13 in the nation, about 12% higher than the national median. Pinpointing how many people in South Carolina have HPV at any given time is impossible because so few infected people display symptoms, so many people are unaware they have it. But HPV causes almost all cases of cervical cancer and many cases of several other cancers, such as penile and anal cancer, so understanding how common HPV-caused cancer is can help us understand how frequently HPV goes untreated in any given state. See How to Test for HPV

STDs in South Carolina Cities & Counties

STDs are more common generally in South Carolina than in much of the rest of the country, but the state’s placement near the top of most lists is owing largely to a handful of metro areas and counties where rates are much higher than the statewide levels.

Chlamydia

The Columbia and Greenville metro areas accounted for about 2 in 5 cases of chlamydia in South Carolina in 2017, but most of the counties with the highest rates aren’t in either of those areas.

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

Allendale 1,459.40
Orangeburg 1,094.40
Marlboro 1,054.00
Lee 1,032.00
Marion 1,005.50
Dillon 985.2
Richland 955.2
Bamberg 893.7
Greenwood 876.9
Darlington 873.1

Gonorrhea

Columbia, Greenville and Myrtle Beach accounted for more than half of all gonorrhea infections in the state in 2017.

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

Allendale 453.3
Marion 419.2
Richland 395.1
Orangeburg 386.8
Cherokee 365.4
Florence 351.7
Darlington 348
Georgetown 342
Lee 340.2
Jasper 326.7

Primary and secondary syphilis

About 53% of all cases of primary and secondary syphilis in South Carolina in 2017 were diagnosed among people living in the metro areas of Columbia, Greenville or Myrtle Beach.

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

Edgefield 19
Barnwell 14
Florence 13
Richland 12.5
Williamsburg 12.5
Greenwood 11.4
Aiken 11.3
Charleston 10.8
Marion 9.5
Chester 9.3

Conclusion

South Carolina’s place among some of the national leaders when it comes to sexually transmitted diseases (STDs) should give everyone in our state cause for concern. When you add the increases noted in many of the most common STDs, that concern grows even higher. But simple steps can help bring down the prevalence of STDs in our state, and that includes getting yourself tested to find out what your status is. The truth is that the vast majority of people who are infected with STDs are unaware they have been infected and they unknowingly pass their infection along to their sexual partners, so finding out your status is an important first step in battling the STD epidemic in South Carolina.

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.