West Virginia has some of the lowest prevalence of several sexually transmitted diseases and infections, including chlamydia, gonorrhea, and primary and secondary syphilis. While that’s unquestionably a good thing for West Virginians, it doesn’t mean there are no reasons for concern. Because while the state currently has relatively low rates of several STDs, the prevalence of most of them have risen in recent years, in some cases quite dramatically. These trends largely mirror increases seen on the national level. In fact, the U.S. has seen rates of chlamydia, syphilis and gonorrhea rise overall for the past four straight years.

Which sexually transmitted infections are most common here in West Virginia, how do we stack up nationally, how have rates changed over the years, and where in West Virginia are infection rates the highest? To understand all of that, we’ll examine data from the federal Centers for Disease Control and Prevention.

Chlamydia Rates in West Virginia

West Virginia’s population-adjusted rate of chlamydia cases is the lowest in the nation, coming in at less than half the overall U.S. rate and about 75% lower than the highest rate, which was recorded in Alaska.

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

It’s thanks to a decline in the rate over the past few years that West Virginia has the nation’s lowest chlamydia rate. Between 2013 and 2017, West Virginia’s rate chlamydia rate dropped by more than 18%, making it the only state to record a decline in that time.

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

2012 258.2
2013 277.1
2014 255
2015 268.9
2016 261.4
2017 226.1

Six of the 10 states with the highest chlamydia rates are in the South, and 11 of the top 20 are in the region. West Virginia’s rate is more than 60% lower than region-leading Louisiana.

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

Louisiana 742.4
Mississippi 708.7
South Carolina 649.8
Georgia 623.7
Alabama 615.5
North Carolina 612.2
Maryland 586.3
Arkansas 576.7
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 West Virginia

West Virginia’s population adjusted rate of gonorrhea is the sixth-lowest in the nation, coming in at nearly 60% lower than the overall U.S. rate and more than 4 times lower than the highest rate, recorded in Mississippi.

Gonorrhea infections per 100,000 people

Highest
Mississippi 310
Alaska 295.1
Louisiana 256.7
South Carolina 254.4
Alabama 245.7
Oklahoma 231.4
Arkansas 223.5
North Carolina 220.9
Georgia 217.5
Ohio 216.3
Total 171.9
Lowest
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

West Virginia’s gonorrhea rate had been relatively steady before a huge spike in 2017. Since 2012, the rate is up by more than 58%.

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

2012 44.8
2013 57.3
2014 45.5
2015 41.7
2016 49.8
2017 70.8

Eight Southern states are among the 10 states with the highest gonorrhea rates, and West Virginia has the lowest rate in the region. In fact, the next-closest state, Virginia, has a rate that’s more than double that of West Virginia.

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

Mississippi 310
Louisiana 256.7
South Carolina 254.4
Alabama 245.7
Oklahoma 231.4
Arkansas 223.5
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 West Virginia

Primary and secondary syphilis infections occur at a rate of about 3.4 per 100,000 people in West Virginia, putting the state in the No. 43 spot nationally. West Virginia’s syphilis rate is about a third of the national rate and is about 82% lower than that of the nation’s leading state, Nevada.

Primary and secondary syphilis infections per 100,000 people

Highest
Nevada 19.7
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
Total 9.5
Lowest
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

The syphilis rate has risen steadily in West Virginia, climbing every year since at least 2013. In that time, the syphilis rate has surged by more than 300%.

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

2012 0.4
2013 0.8
2014 1.5
2015 2.8
2016 2.9
2017 3.4

Six Southern states are among the 10 with the highest syphilis rates, but West Virginia has the lowest rate in 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
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 West Virginia

HIV

Almost 80 people were newly diagnosed with HIV in West Virginia in 2017. That puts the state’s population-adjusted rate at 4.3 per 100,000, 11th-lowest in the country. But it’s not all good news; the state recorded a 16% increase in the HIV rate between 2016 and 2017. See How to Test for HIV

Hepatitis B & C

While West Virginia has relatively low rates of most of the STDs we’ve discussed so far, it leads the nation (by far) in the rate of acute hepatitis B infections. In fact, West Virginia’s hep B rate is more than 14 times higher than the overall national rate, though the state showed a slight drop in the rate in the most recent report. Acute hep C is also much more common in West Virginia than in the nation overall, with the state’s rate sitting at more than 5 times the national rate and about 50% higher than the previous year. See How to Test for Hepatitis

HPV

Cancers caused by human papillomavirus, or HPV, are much more common here in West Virginia than in the rest of the nation. In fact, the state’s 15 per 100,000 rate not only is higher than the national median of 11.7 per 100,000, but it’s the second-highest rate in the country, behind only Kentucky at 15.7 per 100,000. Most people who are exposed to HPV will never have serious problems, but for many people, untreated HPV can lead to major health problems, including several types of cancer, such as cervical, penile and anal cancer. See How to Test for HPV

STDs in West Virginia Cities & Counties

West Virginia’s low rates of STDs aren’t shared in every corner of the state. In fact, several counties have rates that are far higher than the state level, and some communities account for large percentages of cases.

Chlamydia

About 14% of chlamydia cases in West Virginia occurred in the Charleston metro area, while the Huntington area added another 11%.

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

Cabell 508
Kanawha 413.1
Monongalia 369.4
Ohio 332
Raleigh 325.1
Upshur 323.1
Wood 290.3
Mercer 284.5
Gilmer 281.8
Berkeley 277.9

Gonorrhea

Charleston accounted for about 24% of gonorrhea cases, Huntington added another 20%, and the West Virginia counties in the Washington, D.C. metro area accounted for another 13%.

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

Cabell 180.7
Kanawha 112.6
Ohio 102.2
Raleigh 83.9
Berkeley 76
Doddridge 61.2
Monongalia 56.6
Mercer 55.6
Jefferson 53.1
Hancock 43.6

Primary and secondary syphilis

About 1 in 2 cases of syphilis occurred in the Huntington area, and Charleston added another nearly 10%.

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

Cabell 25.8
Nicholas 7.8
Berkeley 6.3
Boone 4.3
Hampshire 4.3
Raleigh 3.9
Jefferson 3.5
Jackson 3.4
Kanawha 2.7
Wood 2.3

Conclusion

West Virginians are among the Americans least likely to be diagnosed with a sexually transmitted disease or infection. But as the CDC data shows, the state’s trends are largely moving in the wrong direction. Preventing the spread of STDs is up to each individual, which is why it’s so important to get yourself tested to find out what your status is. That way, not only can you ensure you’re as healthy as possible, but you can work to prevent the spread of sexually transmitted diseases and infections by taking precautions.

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.