Sexually transmitted diseases (STDs) are a huge problem here in Tennessee and around the U.S. As a state, Tennessee routinely ranks among the top half when it comes to how prevalent STDs are statewide, and the city of Memphis has the highest rates of both chlamydia and gonorrhea of all major metro areas in the U.S. Not only that, but the rates of most sexually transmitted infections are on the rise here in Tennessee, mirroring a trend happening nationally.

Which STDs are most common in the state of Tennessee, how has the frequency of them changed in our state over time, and which regions of the state are the biggest hotbeds of STDs? To answer those questions, we’ll turn to data from the federal Centers for Disease Control and Prevention and the Tennessee Department of Health.

Chlamydia Rates in Tennessee

More than 35,000 people were diagnosed with chlamydia in Tennessee in 2017, the 14th-highest number in the country. But after adjusting for population size, Tennessee falls in the rankings, though the state still has a chlamydia rate in the top 25 nationally.

Chlamydia infections per 100,000 people, top 25

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
Arkansas 579.6
Arizona 571.8
Delaware 566.3
California 557.4
Maryland 555.4
Oklahoma 554.4
Nevada 553.1
Texas 543.9
Missouri 536.4
Ohio 528.6
Tennessee 522.5
Indiana 514.2
South Dakota 512.7
Michigan 511.9
Rhode Island 500

Chlamydia is becoming more common in Tennessee, though the rate is down slightly from the level recorded in 2012.

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

2012 503.8
2013 469.5
2014 474.3
2015 479.3
2016 488.4
2017 514.2

Six of the 10 highest-rate states are in the South, which helps Tennessee rank in the bottom half of the region.

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
Arkansas 579.6
Delaware 566.3
Maryland 555.4
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 Tennessee

Tennessee ranks in the top 20 when it comes to both the prevalence of gonorrhea as well as the sheer numbers of people diagnosed. Additionally, the state’s rate of gonorrhea infections is higher than the national rate.

Gonorrhea infections per 100,000 people, top 25

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
New Mexico 215.7
Missouri 214.8
California 192
Nevada 187.8
Delaware 187.4
Illinois 186.4
Tennessee 185
Maryland 182.5
Arizona 180.5
Indiana 177.5
New York 172.7
Texas 170.2
Kentucky 167.2
Kansas 156.3
Michigan 154.7

Tennessee’s gonorrhea rate has increased by more than one-third since 2013, and the rate has climbed every year since then.

Tennessee 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 177.5

Tennessee ranks in the middle of its Southern regional neighbors for how prevalent gonorrhea is here in the state.

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 182.5
Texas 170.2
Kentucky 167.2
Florida 153.7
Virginia 143.3
West Virginia 70.8

Syphilis Rates in Tennessee

Tennessee ranks in the top half of the country for its rate of primary and secondary syphilis infections, but the state’s overall rate of syphilis is about 23% lower than the national level.

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
New York 11.9
Florida 11.6
North Carolina 10.6
Mississippi 10.4
Illinois 9.6
Maryland 9.5
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

Tennessee’s rate of syphilis infections has climbed steadily over the past five years and is up by more than 40% over the 2012 level.

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

2012 2.6
2013 2.6
2014 3.4
2015 4.2
2016 5.2
2017 5.6

Half of the 10 states with the highest syphilis rates are in the South, and Tennessee ranks in the bottom half among Southern states.

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

Georgia 14.5
Louisiana 14.5
Florida 11.6
North Carolina 10.6
Mississippi 10.4
Maryland 9.5
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 Tennessee

HIV

Nearly 700 people were newly diagnosed with HIV in Tennessee in 2017. The state’s population-adjusted rate ties Tennessee for No. 16 nationally, though the rate (10.3 per 100,000) is lower than the U.S. rate of 11.8 per 100,000. More good news, HIV is becoming less common in Tennessee, though it’s a small decrease — about 5% between 2016 and 2017. See How to Test for HIV

Hepatitis B & C

For both hepatitis B and hepatitis C, Tennessee ranks among the states with the highest rates of acute infections of both viruses. Tennessee is No. 4 with a hep B rate that’s about triple the national rate, though the rate has fallen over the past couple of years. Tennessee is No. 7 among all states for acute hep C infections, and Tennessee’s rate has gone up by more than 50% since 2013. See How to Test for Hepatitis

HPV

Measuring the prevalence of human papillomavirus (HPV) is notoriously difficult because the most common STD in the world usually does not cause any noticeable symptoms, so few infected people are diagnosed and seek treatment. But understanding how common HPV-caused cancer is can provide one way of understanding a state’s HPV situation, and HPV-caused cancer is, unfortunately, quite common in Tennessee, with the state ranking No. 8 overall. Tennessee’s rate of 13.8 per 100,000 is higher than the national median of 11.7 per 100,000. See How to Test for HPV

STDs in Tennessee Cities

The Memphis metro area, which includes counties in Mississippi, Arkansas and Tennessee, has the highest rate of both chlamydia and gonorrhea of any other major metro area in the country, and rates of chlamydia, gonorrhea and syphilis vary widely across the Volunteer State.

Chlamydia

Memphis accounted for more than one-quarter of all chlamydia cases in Tennessee in 2017.

Tennessee cities by chlamydia infection rate (cases per 100,000 people)

Memphis 961
Jackson 724.5
Nashville 660.7
Knoxville 562.9
Chattanooga 531.5
Blountville 276.2

Gonorrhea

Nearly 1 in 3 cases of gonorrhea in Tennessee were in people living in Memphis.

Tennessee cities by gonorrhea infection rate (cases per 100,000 people)

Memphis 394.3
Jackson 318.5
Knoxville 288.6
Chattanooga 256.6
Nashville 239.6
Blountville 48.4

Primary and secondary syphilis

About half of all primary and secondary syphilis cases in Tennessee in 2017 were in Memphis or Nashville.

Tennessee cities by primary and secondary syphilis infection rate (cases per 100,000 people)

Nashville 15.5
Memphis 14.4
Chattanooga 11.9
Jackson 8.2
Knoxville 8.2
Blountville 3.2

Conclusion

Not only does Tennessee rank in the top 25 (or even higher) of several common STDs, the rates of most sexually transmitted infections are on the rise here in Tennessee. Making progress against the tide of STDs means knowing what your STD status is. The only way to know for sure is to get tested. While that could seem like a scary prospect, especially if you’re in a high-risk group, the truth is the really scary thing is potentially passing along a serious STD just because you didn’t want to get tested.

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.