Sexually transmitted infections are on the rise, putting more people at risk as they spread. Chlamydia rates have nearly doubled since 2000, while the rate of gonorrhea went up by 50% over the same period. The Centers for Disease Control and Prevention reports that syphilis rates are reaching levels last seen in the 1950s.
But some regions of the U.S. are seeing higher rates than others.
Stacker used CDC data to look at which counties reported the highest rate of sexually transmitted infections in Minnesota. Counties are ranked by the rate of chlamydia infections, the most prominent STI at the national level, with gonorrhea and then syphilis rates serving as tiebreakers. This story focuses on bacterial infections, which can be cured, rather than viral infections such as HIV and herpes. At the county level, 2021 cases are the most recent available from the CDC, but state and national-level data for 2022 are also included. This story focuses on sexual transmissions and does not include congenital syphilis cases that were inherited from the mother.
Condoms are the most effective way to prevent the spread of STIs for people with multiple sexual partners, but research has found a decreasing rate of condom use among straight, bisexual, and gay male populations.
During the HIV/AIDS epidemic throughout the 1980s and 1990s, public health efforts advocating for condom use helped curb the spread of the virus. Today, however, condoms are no longer the only tool. Pills such as PrEP lower the risk of contracting HIV from sex by as much as 99%.
While more recent data is not available, the latest CDC survey from 2011-2015 showed less than half of unmarried men used condoms during the last time they had sex.
Among high school students having sex, the share using condoms has fallen from 60% in 2011 to 52% in 2021. While one-third of sexually active students used hormonal birth control, only 10% used both condoms and birth control. Methods like the pill and IUDs are effective at preventing pregnancy but do not stop the spread of STIs.
Chlamydia, gonorrhea, and syphilis are technically bacterial infections—meaning they can be cured with antibiotics—but they can still have lasting health impacts, including pelvic inflammatory disease and infertility. These risks are heightened when left untreated, which many STIs are as they don't obviously present themselves.
The CDC recommends annual testing for cisgender women, transgender men, and gender-nonconforming people with cervixes. It also recommends annual testing for males with male sexual partners. People in these groups who frequently have sex with anonymous partners should be tested every three to six months. Anyone with symptoms should always get tested according to the guidelines.
The CDC says there is little evidence that screening among straight men lowers the spread, and the agency's limited budget is put towards programs benefiting the most at-risk groups. However, some public health groups advocate for testing among all people regardless of sex and sexual orientation.
Data from the National Survey of Family Growth shows men on average have more opposite-sex sexual partners than women, and some argue that catching STIs throughout a sexual network rather than just for the most at-risk groups could curb their spread.
Soon, a pill may also help counter the spread of STIs. DoxyPEP can be taken 24 to 72 hours after unprotected sex and stops an STI before it becomes spreadable and symptomatic. The CDC has shared proposed guidelines recommending it for men who have sex with men and transgender women. The drug was originally approved for treating inhalation of anthrax, and doctors can prescribe it for off-label use.
Read on to see how STI infection rates in Minnesota compare nationally, and the top counties.
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Emma Rubin // Stacker
1 / 51State-level statistics
- Chlamydia cases: 386.1 per 100K (#37 nationally, 22,072 cases)
- Gonorrhea cases: 142.6 per 100K (#34 nationally, 8,152 cases)
- Primary and secondary syphilis cases: 11.8 per 100K (#33 nationally, 675 cases)
Debbie Center // Shutterstock
2 / 51#50. Hubbard County
- Chlamydia cases: 225.7 per 100K people (49 cases)
- Gonorrhea cases: 92.1 per 100K people (20 cases)
- Syphilis cases (non-congenital): 13.8 per 100K people (3 cases)
--- Primary and secondary syphilis: 4.6 per 100K people (1 case)
--- Nonprimary and nonsecondary early syphilis: 9.2 per 100K people (2 cases)
#49. Pope County
- Chlamydia cases: 228.0 per 100K people (26 cases)
- Gonorrhea cases: 52.6 per 100K people (6 cases)
- Syphilis cases (non-congenital): 0 cases
--- Primary and secondary syphilis: 0 cases
--- Nonprimary and nonsecondary early syphilis: 0 cases
Roger Siljander // Shutterstock
4 / 51#48. Mcleod County
- Chlamydia cases: 228.7 per 100K people (84 cases)
- Gonorrhea cases: 40.8 per 100K people (15 cases)
- Syphilis cases (non-congenital): 13.6 per 100K people (5 cases)
--- Primary and secondary syphilis: 5.4 per 100K people (2 cases)
--- Nonprimary and nonsecondary early syphilis: 8.2 per 100K people (3 cases)
Bob Pool // Shutterstock
5 / 51#47. Dodge County
- Chlamydia cases: 229.3 per 100K people (48 cases)
- Gonorrhea cases: 62.1 per 100K people (13 cases)
- Syphilis cases (non-congenital): 0 cases
--- Primary and secondary syphilis: 0 cases
--- Nonprimary and nonsecondary early syphilis: 0 cases
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Cory Hart // Shutterstock
6 / 51#46. Itasca County
- Chlamydia cases: 233.0 per 100K people (105 cases)
- Gonorrhea cases: 66.6 per 100K people (30 cases)
- Syphilis cases (non-congenital): 17.8 per 100K people (8 cases)
--- Primary and secondary syphilis: 15.5 per 100K people (7 cases)
--- Nonprimary and nonsecondary early syphilis: 2.2 per 100K people (1 case)
SevenMaps // Shutterstock
7 / 51#45. Swift County
- Chlamydia cases: 235.9 per 100K people (23 cases)
- Gonorrhea cases: 41.0 per 100K people (4 cases)
- Syphilis cases (non-congenital): 0 cases
--- Primary and secondary syphilis: 0 cases
--- Nonprimary and nonsecondary early syphilis: 0 cases
Titima Ying To // Shutterstock
8 / 51#44. Rice County
- Chlamydia cases: 243.8 per 100K people (164 cases)
- Gonorrhea cases: 77.3 per 100K people (52 cases)
- Syphilis cases (non-congenital): 10.4 per 100K people (7 cases)
--- Primary and secondary syphilis: 3.0 per 100K people (2 cases)
--- Nonprimary and nonsecondary early syphilis: 7.4 per 100K people (5 cases)
Joe Ferrer // Shutterstock
9 / 51#43. Brown County
- Chlamydia cases: 244.0 per 100K people (63 cases)
- Gonorrhea cases: 42.6 per 100K people (11 case)
- Syphilis cases (non-congenital): 3.9 per 100K people (1 case)
--- Primary and secondary syphilis: 3.9 per 100K people (1 case)
--- Nonprimary and nonsecondary early syphilis: 0 cases
Joe Ferrer // Shutterstock
10 / 51#42. Pine County
- Chlamydia cases: 245.7 per 100K people (72 cases)
- Gonorrhea cases: 105.8 per 100K people (31 case)
- Syphilis cases (non-congenital): 6.8 per 100K people (2 cases)
--- Primary and secondary syphilis: 0 cases
--- Nonprimary and nonsecondary early syphilis: 6.8 per 100K people (2 cases)
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11 / 51#41. Washington County
- Chlamydia cases: 247.6 per 100K people (674 cases)
- Gonorrhea cases: 72.4 per 100K people (197 cases)
- Syphilis cases (non-congenital): 3.7 per 100K people (10 cases)
--- Primary and secondary syphilis: 2.9 per 100K people (8 cases)
--- Nonprimary and nonsecondary early syphilis: .7 per 100K people (2 cases)
Joe Ferrer // Shutterstock
12 / 51#40. Goodhue County
- Chlamydia cases: 248.1 per 100K people (119 cases)
- Gonorrhea cases: 83.4 per 100K people (40 cases)
- Syphilis cases (non-congenital): 4.2 per 100K people (2 cases)
--- Primary and secondary syphilis: 4.2 per 100K people (2 cases)
--- Nonprimary and nonsecondary early syphilis: 0 cases
Jacob Boomsma // Shutterstock
13 / 51#39. Mille Lacs County
- Chlamydia cases: 253.1 per 100K people (68 cases)
- Gonorrhea cases: 48.4 per 100K people (13 cases)
- Syphilis cases (non-congenital): 7.4 per 100K people (2 cases)
--- Primary and secondary syphilis: 0 cases
--- Nonprimary and nonsecondary early syphilis: 7.4 per 100K people (2 cases)
#38. Crow Wing County
- Chlamydia cases: 255.7 per 100K people (172 cases)
- Gonorrhea cases: 55.0 per 100K people (37 cases)
- Syphilis cases (non-congenital): 8.9 per 100K people (6 cases)
--- Primary and secondary syphilis: 7.4 per 100K people (5 cases)
--- Nonprimary and nonsecondary early syphilis: 1.5 per 100K people (1 case)
#37. Douglas County
- Chlamydia cases: 257.4 per 100K people (101 case)
- Gonorrhea cases: 45.9 per 100K people (18 cases)
- Syphilis cases (non-congenital): 5.1 per 100K people (2 cases)
--- Primary and secondary syphilis: 2.5 per 100K people (1 case)
--- Nonprimary and nonsecondary early syphilis: 2.5 per 100K people (1 case)
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#36. Chippewa County
- Chlamydia cases: 259.0 per 100K people (32 cases)
- Gonorrhea cases: 56.6 per 100K people (7 cases)
- Syphilis cases (non-congenital): 0 cases
--- Primary and secondary syphilis: 0 cases
--- Nonprimary and nonsecondary early syphilis: 0 cases
#35. Martin County
- Chlamydia cases: 266.1 per 100K people (53 cases)
- Gonorrhea cases: 65.3 per 100K people (13 cases)
- Syphilis cases (non-congenital): 10.0 per 100K people (2 cases)
--- Primary and secondary syphilis: 5.0 per 100K people (1 case)
--- Nonprimary and nonsecondary early syphilis: 5.0 per 100K people (1 case)
Sam Wagner // Shutterstock
18 / 51#34. Scott County
- Chlamydia cases: 274.7 per 100K people (421 case)
- Gonorrhea cases: 80.3 per 100K people (123 cases)
- Syphilis cases (non-congenital): 9.1 per 100K people (14 cases)
--- Primary and secondary syphilis: 4.6 per 100K people (7 cases)
--- Nonprimary and nonsecondary early syphilis: 4.6 per 100K people (7 cases)
Jacob Boomsma // Shutterstock
19 / 51#33. Pennington County
- Chlamydia cases: 275.8 per 100K people (38 cases)
- Gonorrhea cases: 72.6 per 100K people (10 cases)
- Syphilis cases (non-congenital): 0 cases
--- Primary and secondary syphilis: 0 cases
--- Nonprimary and nonsecondary early syphilis: 0 cases
#32. Pipestone County
- Chlamydia cases: 279.2 per 100K people (26 cases)
- Gonorrhea cases: 64.4 per 100K people (6 cases)
- Syphilis cases (non-congenital): 0 cases
--- Primary and secondary syphilis: 0 cases
--- Nonprimary and nonsecondary early syphilis: 0 cases
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#31. Todd County
- Chlamydia cases: 281.3 per 100K people (71 case)
- Gonorrhea cases: 39.6 per 100K people (10 cases)
- Syphilis cases (non-congenital): 15.8 per 100K people (4 cases)
--- Primary and secondary syphilis: 11.9 per 100K people (3 cases)
--- Nonprimary and nonsecondary early syphilis: 4.0 per 100K people (1 case)
#30. Morrison County
- Chlamydia cases: 282.4 per 100K people (96 cases)
- Gonorrhea cases: 64.7 per 100K people (22 cases)
- Syphilis cases (non-congenital): 2.9 per 100K people (1 case)
--- Primary and secondary syphilis: 2.9 per 100K people (1 case)
--- Nonprimary and nonsecondary early syphilis: 0 cases
PBouman // Shutterstock
23 / 51#29. Lyon County
- Chlamydia cases: 289.3 per 100K people (73 cases)
- Gonorrhea cases: 87.2 per 100K people (22 cases)
- Syphilis cases (non-congenital): 0 cases
--- Primary and secondary syphilis: 0 cases
--- Nonprimary and nonsecondary early syphilis: 0 cases
SevenMaps // Shutterstock
24 / 51#28. Watonwan County
- Chlamydia cases: 296.4 per 100K people (33 cases)
- Gonorrhea cases: 18.0 per 100K people (2 cases)
- Syphilis cases (non-congenital): 0 cases
--- Primary and secondary syphilis: 0 cases
--- Nonprimary and nonsecondary early syphilis: 0 cases
#27. Jackson County
- Chlamydia cases: 300.3 per 100K people (30 cases)
- Gonorrhea cases: 40.0 per 100K people (4 cases)
- Syphilis cases (non-congenital): 0 cases
--- Primary and secondary syphilis: 0 cases
--- Nonprimary and nonsecondary early syphilis: 0 cases
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#26. Becker County
- Chlamydia cases: 301.0 per 100K people (106 cases)
- Gonorrhea cases: 102.2 per 100K people (36 cases)
- Syphilis cases (non-congenital): 19.9 per 100K people (7 cases)
--- Primary and secondary syphilis: 11.4 per 100K people (4 cases)
--- Nonprimary and nonsecondary early syphilis: 8.5 per 100K people (3 cases)
#25. Faribault County
- Chlamydia cases: 302.0 per 100K people (42 cases)
- Gonorrhea cases: 71.9 per 100K people (10 cases)
- Syphilis cases (non-congenital): 7.2 per 100K people (1 case)
--- Primary and secondary syphilis: 7.2 per 100K people (1 case)
--- Nonprimary and nonsecondary early syphilis: 0 cases
#24. Winona County
- Chlamydia cases: 304.3 per 100K people (151 case)
- Gonorrhea cases: 60.4 per 100K people (30 cases)
- Syphilis cases (non-congenital): 2.0 per 100K people (1 case)
--- Primary and secondary syphilis: 2.0 per 100K people (1 case)
--- Nonprimary and nonsecondary early syphilis: 0 cases
SevenMaps // Shutterstock
29 / 51#23. Red Lake County
- Chlamydia cases: 305.1 per 100K people (12 cases)
- Gonorrhea cases: 76.3 per 100K people (3 cases)
- Syphilis cases (non-congenital): 0 cases
--- Primary and secondary syphilis: 0 cases
--- Nonprimary and nonsecondary early syphilis: 0 cases
#22. Wadena County
- Chlamydia cases: 310.4 per 100K people (44 cases)
- Gonorrhea cases: 134.0 per 100K people (19 cases)
- Syphilis cases (non-congenital): 7.1 per 100K people (1 case)
--- Primary and secondary syphilis: 7.1 per 100K people (1 case)
--- Nonprimary and nonsecondary early syphilis: 0 cases
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31 / 51#21. Renville County
- Chlamydia cases: 314.9 per 100K people (46 cases)
- Gonorrhea cases: 61.6 per 100K people (9 cases)
- Syphilis cases (non-congenital): 0 cases
--- Primary and secondary syphilis: 0 cases
--- Nonprimary and nonsecondary early syphilis: 0 cases
#20. Sherburne County
- Chlamydia cases: 319.0 per 100K people (316 cases)
- Gonorrhea cases: 110.0 per 100K people (109 cases)
- Syphilis cases (non-congenital): 7.1 per 100K people (7 cases)
--- Primary and secondary syphilis: 3.0 per 100K people (3 cases)
--- Nonprimary and nonsecondary early syphilis: 4.0 per 100K people (4 cases)
#19. Dakota County
- Chlamydia cases: 328.9 per 100K people (1,454 cases)
- Gonorrhea cases: 109.5 per 100K people (484 cases)
- Syphilis cases (non-congenital): 7.9 per 100K people (35 cases)
--- Primary and secondary syphilis: 5.0 per 100K people (22 cases)
--- Nonprimary and nonsecondary early syphilis: 2.9 per 100K people (13 cases)
Joe Ferrer // Shutterstock
34 / 51#18. Carlton County
- Chlamydia cases: 329.6 per 100K people (120 cases)
- Gonorrhea cases: 57.7 per 100K people (21 case)
- Syphilis cases (non-congenital): 19.2 per 100K people (7 cases)
--- Primary and secondary syphilis: 16.5 per 100K people (6 cases)
--- Nonprimary and nonsecondary early syphilis: 2.7 per 100K people (1 case)
#16. Anoka County
- Chlamydia cases: 332.1 per 100K people (1,219 cases)
- Gonorrhea cases: 120.7 per 100K people (443 cases)
- Syphilis cases (non-congenital): 7.9 per 100K people (29 cases)
--- Primary and secondary syphilis: 4.6 per 100K people (17 cases)
--- Nonprimary and nonsecondary early syphilis: 3.3 per 100K people (12 cases)
#15. Olmsted County
- Chlamydia cases: 351.8 per 100K people (575 cases)
- Gonorrhea cases: 113.2 per 100K people (185 cases)
- Syphilis cases (non-congenital): 8.0 per 100K people (13 cases)
--- Primary and secondary syphilis: 4.3 per 100K people (7 cases)
--- Nonprimary and nonsecondary early syphilis: 3.7 per 100K people (6 cases)
#14. Kandiyohi County
- Chlamydia cases: 351.9 per 100K people (154 cases)
- Gonorrhea cases: 93.7 per 100K people (41 case)
- Syphilis cases (non-congenital): 2.3 per 100K people (1 case)
--- Primary and secondary syphilis: 2.3 per 100K people (1 case)
--- Nonprimary and nonsecondary early syphilis: 0 cases
#13. Cass County
- Chlamydia cases: 352.5 per 100K people (108 cases)
- Gonorrhea cases: 117.5 per 100K people (36 cases)
- Syphilis cases (non-congenital): 58.7 per 100K people (18 cases)
--- Primary and secondary syphilis: 35.9 per 100K people (11 case)
--- Nonprimary and nonsecondary early syphilis: 22.8 per 100K people (7 cases)
GagliardiPhotography // Shutterstock
40 / 51#12. Benton County
- Chlamydia cases: 369.0 per 100K people (153 cases)
- Gonorrhea cases: 188.1 per 100K people (78 cases)
- Syphilis cases (non-congenital): 4.8 per 100K people (2 cases)
--- Primary and secondary syphilis: 2.4 per 100K people (1 case)
--- Nonprimary and nonsecondary early syphilis: 2.4 per 100K people (1 case)
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Barbarajo // Shutterstock
41 / 51#11. Kanabec County
- Chlamydia cases: 383.7 per 100K people (62 cases)
- Gonorrhea cases: 105.2 per 100K people (17 cases)
- Syphilis cases (non-congenital): 6.2 per 100K people (1 case)
--- Primary and secondary syphilis: 0 cases
--- Nonprimary and nonsecondary early syphilis: 6.2 per 100K people (1 case)
JTrnka // Shutterstock
42 / 51#10. Mahnomen County
- Chlamydia cases: 387.9 per 100K people (21 case)
- Gonorrhea cases: 184.7 per 100K people (10 cases)
- Syphilis cases (non-congenital): 184.7 per 100K people (10 cases)
--- Primary and secondary syphilis: 129.3 per 100K people (7 cases)
--- Nonprimary and nonsecondary early syphilis: 55.4 per 100K people (3 cases)
#9. St. Louis County
- Chlamydia cases: 391.6 per 100K people (780 cases)
- Gonorrhea cases: 181.2 per 100K people (361 case)
- Syphilis cases (non-congenital): 20.6 per 100K people (41 case)
--- Primary and secondary syphilis: 12.6 per 100K people (25 cases)
--- Nonprimary and nonsecondary early syphilis: 8.0 per 100K people (16 cases)
Virrage Images // Shutterstock
44 / 51#8. Mower County
- Chlamydia cases: 408.4 per 100K people (164 cases)
- Gonorrhea cases: 114.5 per 100K people (46 cases)
- Syphilis cases (non-congenital): 10.0 per 100K people (4 cases)
--- Primary and secondary syphilis: 5.0 per 100K people (2 cases)
--- Nonprimary and nonsecondary early syphilis: 5.0 per 100K people (2 cases)
#7. Stearns County
- Chlamydia cases: 436.0 per 100K people (693 cases)
- Gonorrhea cases: 174.3 per 100K people (277 cases)
- Syphilis cases (non-congenital): 8.8 per 100K people (14 cases)
--- Primary and secondary syphilis: 4.4 per 100K people (7 cases)
--- Nonprimary and nonsecondary early syphilis: 4.4 per 100K people (7 cases)
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Jacob Boomsma // Shutterstock
46 / 51#6. Nobles County
- Chlamydia cases: 436.5 per 100K people (96 cases)
- Gonorrhea cases: 104.6 per 100K people (23 cases)
- Syphilis cases (non-congenital): 4.5 per 100K people (1 case)
--- Primary and secondary syphilis: 4.5 per 100K people (1 case)
--- Nonprimary and nonsecondary early syphilis: 0 cases
Jacob Boomsma // Shutterstock
47 / 51#5. Clay County
- Chlamydia cases: 466.6 per 100K people (306 cases)
- Gonorrhea cases: 259.2 per 100K people (170 cases)
- Syphilis cases (non-congenital): 4.6 per 100K people (3 cases)
--- Primary and secondary syphilis: 1.5 per 100K people (1 case)
--- Nonprimary and nonsecondary early syphilis: 3.0 per 100K people (2 cases)
#4. Beltrami County
- Chlamydia cases: 515.3 per 100K people (239 cases)
- Gonorrhea cases: 135.8 per 100K people (63 cases)
- Syphilis cases (non-congenital): 103.5 per 100K people (48 cases)
--- Primary and secondary syphilis: 41.0 per 100K people (19 cases)
--- Nonprimary and nonsecondary early syphilis: 62.5 per 100K people (29 cases)
#3. Blue Earth County
- Chlamydia cases: 541.3 per 100K people (375 cases)
- Gonorrhea cases: 116.9 per 100K people (81 case)
- Syphilis cases (non-congenital): 4.3 per 100K people (3 cases)
--- Primary and secondary syphilis: 2.9 per 100K people (2 cases)
--- Nonprimary and nonsecondary early syphilis: 1.4 per 100K people (1 case)
#2. Ramsey County
- Chlamydia cases: 577.8 per 100K people (3,139 cases)
- Gonorrhea cases: 308.0 per 100K people (1,673 cases)
- Syphilis cases (non-congenital): 25.0 per 100K people (136 cases)
--- Primary and secondary syphilis: 17.3 per 100K people (94 cases)
--- Nonprimary and nonsecondary early syphilis: 7.7 per 100K people (42 cases)
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51 / 51#1. Hennepin County
- Chlamydia cases: 602.2 per 100K people (7,632 cases)
- Gonorrhea cases: 329.3 per 100K people (4,174 cases)
- Syphilis cases (non-congenital): 38.7 per 100K people (491 case)
--- Primary and secondary syphilis: 21.3 per 100K people (270 cases)
--- Nonprimary and nonsecondary early syphilis: 17.4 per 100K people (221 case)
This story features data reporting and writing by Emma Rubin and is part of a series utilizing data automation across 49 states.
