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 Oklahoma. 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 Oklahoma compare nationally, and the top counties.
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Emma Rubin // Stacker
1 / 51State-level statistics
- Chlamydia cases: 502.3 per 100K (#20 nationally, 20,190 cases)
- Gonorrhea cases: 223.2 per 100K (#13 nationally, 8,974 cases)
- Primary and secondary syphilis cases: 31.8 per 100K (#4 nationally, 1,278 cases)
#50. Kiowa County
- Chlamydia cases: 356.7 per 100K people (30 cases)
- Gonorrhea cases: 142.7 per 100K people (12 cases)
- Syphilis cases (non-congenital): 23.8 per 100K people (2 cases)
--- Primary and secondary syphilis: 0 cases
--- Nonprimary and nonsecondary early syphilis: 23.8 per 100K people (2 cases)
#49. Creek County
- Chlamydia cases: 358.2 per 100K people (258 cases)
- Gonorrhea cases: 177.7 per 100K people (128 cases)
- Syphilis cases (non-congenital): 38.9 per 100K people (28 cases)
--- Primary and secondary syphilis: 26.4 per 100K people (19 cases)
--- Nonprimary and nonsecondary early syphilis: 12.5 per 100K people (9 cases)
#48. Cotton County
- Chlamydia cases: 365.0 per 100K people (20 cases)
- Gonorrhea cases: 164.2 per 100K people (9 cases)
- Syphilis cases (non-congenital): 54.7 per 100K people (3 cases)
--- Primary and secondary syphilis: 18.2 per 100K people (1 case)
--- Nonprimary and nonsecondary early syphilis: 36.5 per 100K people (2 cases)
#47. Osage County
- Chlamydia cases: 367.0 per 100K people (168 cases)
- Gonorrhea cases: 163.9 per 100K people (75 cases)
- Syphilis cases (non-congenital): 35.0 per 100K people (16 cases)
--- Primary and secondary syphilis: 24.0 per 100K people (11 case)
--- Nonprimary and nonsecondary early syphilis: 10.9 per 100K people (5 cases)
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#46. Craig County
- Chlamydia cases: 375.5 per 100K people (53 cases)
- Gonorrhea cases: 148.8 per 100K people (21 case)
- Syphilis cases (non-congenital): 70.8 per 100K people (10 cases)
--- Primary and secondary syphilis: 42.5 per 100K people (6 cases)
--- Nonprimary and nonsecondary early syphilis: 28.3 per 100K people (4 cases)
#45. Nowata County
- Chlamydia cases: 376.2 per 100K people (35 cases)
- Gonorrhea cases: 107.5 per 100K people (10 cases)
- Syphilis cases (non-congenital): 21.5 per 100K people (2 cases)
--- Primary and secondary syphilis: 10.7 per 100K people (1 case)
--- Nonprimary and nonsecondary early syphilis: 10.7 per 100K people (1 case)
#44. Murray County
- Chlamydia cases: 379.1 per 100K people (52 cases)
- Gonorrhea cases: 145.8 per 100K people (20 cases)
- Syphilis cases (non-congenital): 7.3 per 100K people (1 case)
--- Primary and secondary syphilis: 0 cases
--- Nonprimary and nonsecondary early syphilis: 7.3 per 100K people (1 case)
Sabrina Janelle Gordon // Shutterstock
9 / 51#43. Mayes County
- Chlamydia cases: 390.7 per 100K people (153 cases)
- Gonorrhea cases: 189.0 per 100K people (74 cases)
- Syphilis cases (non-congenital): 40.9 per 100K people (16 cases)
--- Primary and secondary syphilis: 33.2 per 100K people (13 cases)
--- Nonprimary and nonsecondary early syphilis: 7.7 per 100K people (3 cases)
#42. Beckham County
- Chlamydia cases: 399.2 per 100K people (88 cases)
- Gonorrhea cases: 249.5 per 100K people (55 cases)
- Syphilis cases (non-congenital): 13.6 per 100K people (3 cases)
--- Primary and secondary syphilis: 9.1 per 100K people (2 cases)
--- Nonprimary and nonsecondary early syphilis: 4.5 per 100K people (1 case)
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#41. Texas County
- Chlamydia cases: 402.6 per 100K people (84 cases)
- Gonorrhea cases: 86.3 per 100K people (18 cases)
- Syphilis cases (non-congenital): 4.8 per 100K people (1 case)
--- Primary and secondary syphilis: 0 cases
--- Nonprimary and nonsecondary early syphilis: 4.8 per 100K people (1 case)
#40. Pushmataha County
- Chlamydia cases: 406.8 per 100K people (44 cases)
- Gonorrhea cases: 231.2 per 100K people (25 cases)
- Syphilis cases (non-congenital): 27.7 per 100K people (3 cases)
--- Primary and secondary syphilis: 18.5 per 100K people (2 cases)
--- Nonprimary and nonsecondary early syphilis: 9.2 per 100K people (1 case)
#39. Hughes County
- Chlamydia cases: 410.3 per 100K people (55 cases)
- Gonorrhea cases: 335.7 per 100K people (45 cases)
- Syphilis cases (non-congenital): 29.8 per 100K people (4 cases)
--- Primary and secondary syphilis: 29.8 per 100K people (4 cases)
--- Nonprimary and nonsecondary early syphilis: 0 cases
Charles Lemar Brown // Shutterstock
14 / 51#38. Jefferson County
- Chlamydia cases: 422.9 per 100K people (23 cases)
- Gonorrhea cases: 55.2 per 100K people (3 cases)
- Syphilis cases (non-congenital): 18.4 per 100K people (1 case)
--- Primary and secondary syphilis: 18.4 per 100K people (1 case)
--- Nonprimary and nonsecondary early syphilis: 0 cases
#36. Sequoyah County
- Chlamydia cases: 427.8 per 100K people (169 cases)
- Gonorrhea cases: 134.2 per 100K people (53 cases)
- Syphilis cases (non-congenital): 15.2 per 100K people (6 cases)
--- Primary and secondary syphilis: 12.7 per 100K people (5 cases)
--- Nonprimary and nonsecondary early syphilis: 2.5 per 100K people (1 case)
Mohammad Fuad Anshori // Shutterstock
17 / 51#35. Stephens County
- Chlamydia cases: 428.9 per 100K people (185 cases)
- Gonorrhea cases: 141.4 per 100K people (61 case)
- Syphilis cases (non-congenital): 18.5 per 100K people (8 cases)
--- Primary and secondary syphilis: 11.6 per 100K people (5 cases)
--- Nonprimary and nonsecondary early syphilis: 7.0 per 100K people (3 cases)
#34. Greer County
- Chlamydia cases: 437.4 per 100K people (24 cases)
- Gonorrhea cases: 145.8 per 100K people (8 cases)
- Syphilis cases (non-congenital): 18.2 per 100K people (1 case)
--- Primary and secondary syphilis: 18.2 per 100K people (1 case)
--- Nonprimary and nonsecondary early syphilis: 0 cases
#33. Okfuskee County
- Chlamydia cases: 437.6 per 100K people (49 cases)
- Gonorrhea cases: 232.2 per 100K people (26 cases)
- Syphilis cases (non-congenital): 35.7 per 100K people (4 cases)
--- Primary and secondary syphilis: 35.7 per 100K people (4 cases)
--- Nonprimary and nonsecondary early syphilis: 0 cases
#32. Kay County
- Chlamydia cases: 439.0 per 100K people (192 cases)
- Gonorrhea cases: 201.2 per 100K people (88 cases)
- Syphilis cases (non-congenital): 22.9 per 100K people (10 cases)
--- Primary and secondary syphilis: 16.0 per 100K people (7 cases)
--- Nonprimary and nonsecondary early syphilis: 6.9 per 100K people (3 cases)
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#31. Pittsburg County
- Chlamydia cases: 442.3 per 100K people (193 cases)
- Gonorrhea cases: 137.5 per 100K people (60 cases)
- Syphilis cases (non-congenital): 34.4 per 100K people (15 cases)
--- Primary and secondary syphilis: 29.8 per 100K people (13 cases)
--- Nonprimary and nonsecondary early syphilis: 4.6 per 100K people (2 cases)
#30. Cleveland County
- Chlamydia cases: 451.6 per 100K people (1,344 cases)
- Gonorrhea cases: 175.1 per 100K people (521 case)
- Syphilis cases (non-congenital): 32.6 per 100K people (97 cases)
--- Primary and secondary syphilis: 22.8 per 100K people (68 cases)
--- Nonprimary and nonsecondary early syphilis: 9.7 per 100K people (29 cases)
#29. Garvin County
- Chlamydia cases: 461.2 per 100K people (119 cases)
- Gonorrhea cases: 178.3 per 100K people (46 cases)
- Syphilis cases (non-congenital): 11.6 per 100K people (3 cases)
--- Primary and secondary syphilis: 3.9 per 100K people (1 case)
--- Nonprimary and nonsecondary early syphilis: 7.8 per 100K people (2 cases)
JohnDSmith // Shutterstock
24 / 51#28. Mcintosh County
- Chlamydia cases: 462.5 per 100K people (89 cases)
- Gonorrhea cases: 171.5 per 100K people (33 cases)
- Syphilis cases (non-congenital): 31.2 per 100K people (6 cases)
--- Primary and secondary syphilis: 15.6 per 100K people (3 cases)
--- Nonprimary and nonsecondary early syphilis: 15.6 per 100K people (3 cases)
RaksyBH // Shutterstock
25 / 51#27. Atoka County
- Chlamydia cases: 467.7 per 100K people (67 cases)
- Gonorrhea cases: 321.1 per 100K people (46 cases)
- Syphilis cases (non-congenital): 34.9 per 100K people (5 cases)
--- Primary and secondary syphilis: 27.9 per 100K people (4 cases)
--- Nonprimary and nonsecondary early syphilis: 7.0 per 100K people (1 case)
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#26. Haskell County
- Chlamydia cases: 482.7 per 100K people (56 cases)
- Gonorrhea cases: 137.9 per 100K people (16 cases)
- Syphilis cases (non-congenital): 34.5 per 100K people (4 cases)
--- Primary and secondary syphilis: 17.2 per 100K people (2 cases)
--- Nonprimary and nonsecondary early syphilis: 17.2 per 100K people (2 cases)
RaksyBH // Shutterstock
27 / 51#25. Choctaw County
- Chlamydia cases: 489.3 per 100K people (70 cases)
- Gonorrhea cases: 391.4 per 100K people (56 cases)
- Syphilis cases (non-congenital): 55.9 per 100K people (8 cases)
--- Primary and secondary syphilis: 55.9 per 100K people (8 cases)
--- Nonprimary and nonsecondary early syphilis: 0 cases
#24. Caddo County
- Chlamydia cases: 493.0 per 100K people (130 cases)
- Gonorrhea cases: 299.6 per 100K people (79 cases)
- Syphilis cases (non-congenital): 41.7 per 100K people (11 case)
--- Primary and secondary syphilis: 22.8 per 100K people (6 cases)
--- Nonprimary and nonsecondary early syphilis: 19.0 per 100K people (5 cases)
#23. Garfield County
- Chlamydia cases: 494.1 per 100K people (306 cases)
- Gonorrhea cases: 209.9 per 100K people (130 cases)
- Syphilis cases (non-congenital): 11.3 per 100K people (7 cases)
--- Primary and secondary syphilis: 8.1 per 100K people (5 cases)
--- Nonprimary and nonsecondary early syphilis: 3.2 per 100K people (2 cases)
#22. Cherokee County
- Chlamydia cases: 506.0 per 100K people (241 case)
- Gonorrhea cases: 222.6 per 100K people (106 cases)
- Syphilis cases (non-congenital): 65.1 per 100K people (31 case)
--- Primary and secondary syphilis: 52.5 per 100K people (25 cases)
--- Nonprimary and nonsecondary early syphilis: 12.6 per 100K people (6 cases)
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#21. Woodward County
- Chlamydia cases: 509.8 per 100K people (103 cases)
- Gonorrhea cases: 103.9 per 100K people (21 case)
- Syphilis cases (non-congenital): 9.9 per 100K people (2 cases)
--- Primary and secondary syphilis: 9.9 per 100K people (2 cases)
--- Nonprimary and nonsecondary early syphilis: 0 cases
Moab Republic // Shutterstock
32 / 51#20. Bryan County
- Chlamydia cases: 518.0 per 100K people (244 cases)
- Gonorrhea cases: 231.4 per 100K people (109 cases)
- Syphilis cases (non-congenital): 51.0 per 100K people (24 cases)
--- Primary and secondary syphilis: 38.2 per 100K people (18 cases)
--- Nonprimary and nonsecondary early syphilis: 12.7 per 100K people (6 cases)
#19. Pottawatomie County
- Chlamydia cases: 532.7 per 100K people (389 cases)
- Gonorrhea cases: 261.6 per 100K people (191 case)
- Syphilis cases (non-congenital): 47.9 per 100K people (35 cases)
--- Primary and secondary syphilis: 32.9 per 100K people (24 cases)
--- Nonprimary and nonsecondary early syphilis: 15.1 per 100K people (11 case)
#18. Mccurtain County
- Chlamydia cases: 534.3 per 100K people (165 cases)
- Gonorrhea cases: 278.5 per 100K people (86 cases)
- Syphilis cases (non-congenital): 16.2 per 100K people (5 cases)
--- Primary and secondary syphilis: 16.2 per 100K people (5 cases)
--- Nonprimary and nonsecondary early syphilis: 0 cases
#17. Custer County
- Chlamydia cases: 546.8 per 100K people (154 cases)
- Gonorrhea cases: 195.3 per 100K people (55 cases)
- Syphilis cases (non-congenital): 42.6 per 100K people (12 cases)
--- Primary and secondary syphilis: 28.4 per 100K people (8 cases)
--- Nonprimary and nonsecondary early syphilis: 14.2 per 100K people (4 cases)
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RaksyBH // Shutterstock
36 / 51#16. Coal County
- Chlamydia cases: 549.7 per 100K people (29 cases)
- Gonorrhea cases: 246.4 per 100K people (13 cases)
- Syphilis cases (non-congenital): 56.9 per 100K people (3 cases)
--- Primary and secondary syphilis: 37.9 per 100K people (2 cases)
--- Nonprimary and nonsecondary early syphilis: 19.0 per 100K people (1 case)
Dee Browning // Shutterstock
37 / 51#15. Adair County
- Chlamydia cases: 551.1 per 100K people (107 cases)
- Gonorrhea cases: 283.3 per 100K people (55 cases)
- Syphilis cases (non-congenital): 46.4 per 100K people (9 cases)
--- Primary and secondary syphilis: 30.9 per 100K people (6 cases)
--- Nonprimary and nonsecondary early syphilis: 15.5 per 100K people (3 cases)
#14. Latimer County
- Chlamydia cases: 551.6 per 100K people (52 cases)
- Gonorrhea cases: 275.8 per 100K people (26 cases)
- Syphilis cases (non-congenital): 10.6 per 100K people (1 case)
--- Primary and secondary syphilis: 10.6 per 100K people (1 case)
--- Nonprimary and nonsecondary early syphilis: 0 cases
Kit Leong // Shutterstock
39 / 51#13. Woods County
- Chlamydia cases: 570.9 per 100K people (49 cases)
- Gonorrhea cases: 58.3 per 100K people (5 cases)
- Syphilis cases (non-congenital): 0 cases
--- Primary and secondary syphilis: 0 cases
--- Nonprimary and nonsecondary early syphilis: 0 cases
Holly Cates // Shutterstock
40 / 51#12. Seminole County
- Chlamydia cases: 577.1 per 100K people (136 cases)
- Gonorrhea cases: 394.6 per 100K people (93 cases)
- Syphilis cases (non-congenital): 25.5 per 100K people (6 cases)
--- Primary and secondary syphilis: 8.5 per 100K people (2 cases)
--- Nonprimary and nonsecondary early syphilis: 17.0 per 100K people (4 cases)
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#11. Harmon County
- Chlamydia cases: 579.0 per 100K people (14 cases)
- Gonorrhea cases: 165.4 per 100K people (4 cases)
- Syphilis cases (non-congenital): 0 cases
--- Primary and secondary syphilis: 0 cases
--- Nonprimary and nonsecondary early syphilis: 0 cases
#10. Payne County
- Chlamydia cases: 597.6 per 100K people (490 cases)
- Gonorrhea cases: 139.0 per 100K people (114 cases)
- Syphilis cases (non-congenital): 25.6 per 100K people (21 case)
--- Primary and secondary syphilis: 17.1 per 100K people (14 cases)
--- Nonprimary and nonsecondary early syphilis: 8.5 per 100K people (7 cases)
Valiik30 // Shutterstock
43 / 51#9. Tulsa County
- Chlamydia cases: 604.3 per 100K people (4,066 cases)
- Gonorrhea cases: 346.0 per 100K people (2,328 cases)
- Syphilis cases (non-congenital): 57.7 per 100K people (388 cases)
--- Primary and secondary syphilis: 43.5 per 100K people (293 cases)
--- Nonprimary and nonsecondary early syphilis: 14.1 per 100K people (95 cases)
#8. Okmulgee County
- Chlamydia cases: 610.7 per 100K people (225 cases)
- Gonorrhea cases: 309.4 per 100K people (114 cases)
- Syphilis cases (non-congenital): 27.1 per 100K people (10 cases)
--- Primary and secondary syphilis: 24.4 per 100K people (9 cases)
--- Nonprimary and nonsecondary early syphilis: 2.7 per 100K people (1 case)
#7. Ottawa County
- Chlamydia cases: 626.2 per 100K people (190 cases)
- Gonorrhea cases: 395.5 per 100K people (120 cases)
- Syphilis cases (non-congenital): 49.4 per 100K people (15 cases)
--- Primary and secondary syphilis: 39.6 per 100K people (12 cases)
--- Nonprimary and nonsecondary early syphilis: 9.9 per 100K people (3 cases)
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#6. Carter County
- Chlamydia cases: 627.4 per 100K people (303 cases)
- Gonorrhea cases: 499.1 per 100K people (241 case)
- Syphilis cases (non-congenital): 72.5 per 100K people (35 cases)
--- Primary and secondary syphilis: 55.9 per 100K people (27 cases)
--- Nonprimary and nonsecondary early syphilis: 16.6 per 100K people (8 cases)
#5. Muskogee County
- Chlamydia cases: 635.0 per 100K people (420 cases)
- Gonorrhea cases: 347.7 per 100K people (230 cases)
- Syphilis cases (non-congenital): 84.7 per 100K people (56 cases)
--- Primary and secondary syphilis: 55.9 per 100K people (37 cases)
--- Nonprimary and nonsecondary early syphilis: 28.7 per 100K people (19 cases)
#4. Pontotoc County
- Chlamydia cases: 639.4 per 100K people (244 cases)
- Gonorrhea cases: 377.3 per 100K people (144 cases)
- Syphilis cases (non-congenital): 36.7 per 100K people (14 cases)
--- Primary and secondary syphilis: 18.3 per 100K people (7 cases)
--- Nonprimary and nonsecondary early syphilis: 18.3 per 100K people (7 cases)
#3. Jackson County
- Chlamydia cases: 661.9 per 100K people (164 cases)
- Gonorrhea cases: 205.8 per 100K people (51 case)
- Syphilis cases (non-congenital): 4.0 per 100K people (1 case)
--- Primary and secondary syphilis: 4.0 per 100K people (1 case)
--- Nonprimary and nonsecondary early syphilis: 0 cases
#2. Oklahoma County
- Chlamydia cases: 682.1 per 100K people (5,447 cases)
- Gonorrhea cases: 371.9 per 100K people (2,970 cases)
- Syphilis cases (non-congenital): 79.1 per 100K people (632 cases)
--- Primary and secondary syphilis: 48.7 per 100K people (389 cases)
--- Nonprimary and nonsecondary early syphilis: 30.4 per 100K people (243 cases)
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RaksyBH // Shutterstock
51 / 51#1. Comanche County
- Chlamydia cases: 712.7 per 100K people (870 cases)
- Gonorrhea cases: 423.6 per 100K people (517 cases)
- Syphilis cases (non-congenital): 54.1 per 100K people (66 cases)
--- Primary and secondary syphilis: 40.1 per 100K people (49 cases)
--- Nonprimary and nonsecondary early syphilis: 13.9 per 100K people (17 cases)
This story features data reporting and writing by Emma Rubin and is part of a series utilizing data automation across 49 states.
