Sexually transmitted diseases (STDs) are on the rise in Texas and across much of the United States. According to the federal Centers for Disease Control and Prevention, nearly 2.3 million cases of three of the most common STDs, chlamydia, gonorrhea and syphilis, were reported in 2017, making it the fourth straight year of increases in those diseases.
Which STDs are most common in the state of Texas, where in the state are rates the highest, and how has the state made progress (or not) in the battle against sexually transmitted infections over the past few years?
Let’s explore data from the CDC as well as the Texas Department of State Health Services.
Chlamydia Rates in Texas
The state of Texas alone accounted for about 8% of all new chlamydia infections in 2017, and the state ranked second overall in total diagnoses. But while the state’s chlamydia rate has gone up by about 10% since 2013, Texas does not rank in the top 20 when it comes to the population-adjusted chlamydia rate. Still, Texas’ rate is higher than the overall national rate.
Chlamydia infections per 100,000 people, top 20
The rate of chlamydia infections in Texas has gone up every year since 2014 and has risen about 11% since 2012.
Texas chlamydia rate by year (cases per 100,000 people)
Texas ranks in the lower half among all Southern states and has the lowest rate of all bordering states.
Chlamydia infection rate, Southern states (cases per 100,000 people)
Gonorrhea Rates in Texas
Texas had the second-most gonorrhea infections of any state in 2017, just behind California with more than 47,000 infections. Adjusted for population, though, the state’s rate is actually lower than the national rate.
Gonorrhea infections per 100,000 people, top 25
In every state, the gonorrhea rate has risen over the past few years, and Texas is no exception to that. Between 2012 and 2017, Texas’ gonorrhea infection rate jumped by more than one-third.
Texas gonorrhea rate by year (cases per 100,000 people)
Texas ranks in the lower half when it comes to other Southern states, and all Southern states that border Texas have higher gonorrhea rates.
Gonorrhea infection rate, Southern states (cases per 100,000 people)
Syphilis Rates in Texas
More than 2,200 cases of primary or secondary syphilis were reported in Texas in 2017, putting the state in fourth place overall for total diagnoses. When adjusting for population, Texas falls to 18th and has a population-adjusted rate lower than the national rate.
Primary and secondary syphilis infections per 100,000 people (top 20)
The infection rate for primary and secondary syphilis has risen every year since 2013 and has surged by more than 40% since then.
Texas primary and secondary syphilis rate by year (cases per 100,000 people)
Texas ranks near the middle of all Southern states in syphilis rates, but the state’s rate is lower than most of its direct neighbors, with the exception of Arkansas.
Syphilis infection rates, Southern states (cases per 100,000 people)
HIV & Other STD Rates in Texas
More than 4,300 people were newly diagnosed with HIV in our state in 2017, the third-most in the country. While that number equates to a rate that places Texas in the top 10 (No. 8), it represents a drop in total HIV cases and the per-100,000 rate since 2016. See How to Test for HIV
Hepatitis B & C
Texas’ rates of acute infections of both hep B and hep C are below the national rates. Texas has seen a drop in acute hep C infections since 2012 (-50%), but the rate of acute hep B infections has risen slightly posting a low in 2013 (+20%). See How to Test for Hepatitis
Cancers related to human papillomavirus include cervical and penile cancer and cancers of the anus, vulva and back of the throat. A majority of all of these cases are caused by HPV, the single most common STD in the world. Texas’ HPV-related cancer rate of 11.4 per 100,000 is among the lowest in the nation. See How to Test for HPV
STDs in Texas Cities
Texas often ranks near the top when it comes to overall infections of the three federally notifiable STDs, chlamydia, gonorrhea and syphilis. But this is driven largely by the number of major metro areas in the state, which often serve to skew the state’s health data thanks to population density.
About 1 in 5 chlamydia cases in Texas in 2017 were in people living in Houston.
Texas cities by percentage of all chlamydia cases, top 10
Houston, Dallas and San Antonio combined for nearly half of the gonorrhea cases in the entire state.
Texas cities by percentage of gonorrhea cases, top 10
Primary and secondary syphilis
San Antonio and Houston each accounted for 16% of primary and secondary syphilis cases in Texas.
Texas cities by percentage of primary and secondary syphilis cases, top 10
Sexually transmitted diseases are becoming more and more common here in Texas and across the United States. That’s because many (maybe even most) STDs are difficult to diagnose through symptoms alone, as many of them often show no obvious signs in the body. So people unknowingly pass along infections to their sexual partners because they aren’t aware of their STD status. Getting tested is easy, and it means that you may be able to keep yourself and others from getting sick.
- Centers for Disease Control and Prevention, Sexually Transmitted Disease Surveillance 2017. (2018). Retrieved from https://www.cdc.gov/std/stats17/SRtables.pdf
- Texas Department of State Health Services, Texas STD Surveillance Report 2017. (2018). Retrieved from https://www.dshs.texas.gov/hivstd/reports/STDSurveillanceReport.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, Surveillance for Viral Hepatitis – United States, 2016. (2018). Retrieved from https://www.cdc.gov/hepatitis/statistics/2016surveillance/index.htm
Note: The CDC publishes comprehensive STD data on only three of the many conditions that are sexually transmitted — chlamydia, gonorrhea, and primary and secondary syphilis. Many other STDs are not classified as nationally notifiable diseases, meaning states are not legally obligated to report infection rates. Also, while the CDC collects data for the District of Columbia, the population density of the district prevents it from being included in rankings.