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 Virginia. 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 Virginia compare nationally, and the top counties.
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Emma Rubin // Stacker
1 / 51State-level statistics
- Chlamydia cases: 469.7 per 100K (#28 nationally, 40,789 cases)
- Gonorrhea cases: 154.7 per 100K (#27 nationally, 13,437 cases)
- Primary and secondary syphilis cases: 10.8 per 100K (#38 nationally, 936 cases)
Carolyn M Carpenter // Shutterstock
2 / 51#50. Caroline County
- Chlamydia cases: 389.4 per 100K people (122 cases)
- Gonorrhea cases: 111.7 per 100K people (35 cases)
- Syphilis cases (non-congenital): 6.4 per 100K people (2 cases)
--- Primary and secondary syphilis: 0 cases
--- Nonprimary and nonsecondary early syphilis: 6.4 per 100K people (2 cases)
#49. Arlington County
- Chlamydia cases: 390.2 per 100K people (909 cases)
- Gonorrhea cases: 117.2 per 100K people (273 cases)
- Syphilis cases (non-congenital): 27.5 per 100K people (64 cases)
--- Primary and secondary syphilis: 14.2 per 100K people (33 cases)
--- Nonprimary and nonsecondary early syphilis: 13.3 per 100K people (31 case)
Joseph Sohm // // Shutterstock
4 / 51#48. Buckingham County
- Chlamydia cases: 401.3 per 100K people (68 cases)
- Gonorrhea cases: 141.6 per 100K people (24 cases)
- Syphilis cases (non-congenital): 0 cases
--- Primary and secondary syphilis: 0 cases
--- Nonprimary and nonsecondary early syphilis: 0 cases
#46. Prince William County
- Chlamydia cases: 412.6 per 100K people (1,999 cases)
- Gonorrhea cases: 100.3 per 100K people (486 cases)
- Syphilis cases (non-congenital): 11.6 per 100K people (56 cases)
--- Primary and secondary syphilis: 6.4 per 100K people (31 case)
--- Nonprimary and nonsecondary early syphilis: 5.2 per 100K people (25 cases)
Timothy L Barnes // Shutterstock
7 / 51#45. Surry County
- Chlamydia cases: 413.5 per 100K people (27 cases)
- Gonorrhea cases: 153.1 per 100K people (10 cases)
- Syphilis cases (non-congenital): 15.3 per 100K people (1 case)
--- Primary and secondary syphilis: 0 cases
--- Nonprimary and nonsecondary early syphilis: 15.3 per 100K people (1 case)
#44. Charlotte County
- Chlamydia cases: 419.3 per 100K people (48 cases)
- Gonorrhea cases: 139.8 per 100K people (16 cases)
- Syphilis cases (non-congenital): 8.7 per 100K people (1 case)
--- Primary and secondary syphilis: 0 cases
--- Nonprimary and nonsecondary early syphilis: 8.7 per 100K people (1 case)
#43. Southampton County
- Chlamydia cases: 422.1 per 100K people (76 cases)
- Gonorrhea cases: 138.8 per 100K people (25 cases)
- Syphilis cases (non-congenital): 5.6 per 100K people (1 case)
--- Primary and secondary syphilis: 0 cases
--- Nonprimary and nonsecondary early syphilis: 5.6 per 100K people (1 case)
OJUP // Shutterstock
10 / 51#42. Chesterfield County
- Chlamydia cases: 430.0 per 100K people (1,594 cases)
- Gonorrhea cases: 129.8 per 100K people (481 case)
- Syphilis cases (non-congenital): 9.4 per 100K people (35 cases)
--- Primary and secondary syphilis: 3.2 per 100K people (12 cases)
--- Nonprimary and nonsecondary early syphilis: 6.2 per 100K people (23 cases)
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Dan Kauffman // Shutterstock
11 / 51#41. Northumberland County
- Chlamydia cases: 432.3 per 100K people (52 cases)
- Gonorrhea cases: 83.1 per 100K people (10 cases)
- Syphilis cases (non-congenital): 8.3 per 100K people (1 case)
--- Primary and secondary syphilis: 0 cases
--- Nonprimary and nonsecondary early syphilis: 8.3 per 100K people (1 case)
#40. Dinwiddie County
- Chlamydia cases: 433.5 per 100K people (121 case)
- Gonorrhea cases: 179.1 per 100K people (50 cases)
- Syphilis cases (non-congenital): 10.7 per 100K people (3 cases)
--- Primary and secondary syphilis: 7.2 per 100K people (2 cases)
--- Nonprimary and nonsecondary early syphilis: 3.6 per 100K people (1 case)
ImagineerInc // Shutterstock
13 / 51#39. Charlottesville City
- Chlamydia cases: 442.3 per 100K people (202 cases)
- Gonorrhea cases: 238.7 per 100K people (109 cases)
- Syphilis cases (non-congenital): 43.8 per 100K people (20 cases)
--- Primary and secondary syphilis: 24.1 per 100K people (11 case)
--- Nonprimary and nonsecondary early syphilis: 19.7 per 100K people (9 cases)
Kristi Blokhin // Shutterstock
14 / 51#38. Waynesboro City
- Chlamydia cases: 456.8 per 100K people (103 cases)
- Gonorrhea cases: 363.6 per 100K people (82 cases)
- Syphilis cases (non-congenital): 26.6 per 100K people (6 cases)
--- Primary and secondary syphilis: 22.2 per 100K people (5 cases)
--- Nonprimary and nonsecondary early syphilis: 4.4 per 100K people (1 case)
Wileydoc // Shutterstock
15 / 51#37. Greensville County
- Chlamydia cases: 463.4 per 100K people (53 cases)
- Gonorrhea cases: 157.4 per 100K people (18 cases)
- Syphilis cases (non-congenital): 0 cases
--- Primary and secondary syphilis: 0 cases
--- Nonprimary and nonsecondary early syphilis: 0 cases
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Lekali Studio // Shutterstock
16 / 51#36. Prince George County
- Chlamydia cases: 464.1 per 100K people (199 cases)
- Gonorrhea cases: 149.3 per 100K people (64 cases)
- Syphilis cases (non-congenital): 4.7 per 100K people (2 cases)
--- Primary and secondary syphilis: 2.3 per 100K people (1 case)
--- Nonprimary and nonsecondary early syphilis: 2.3 per 100K people (1 case)
Steve Heap // Shutterstock
17 / 51#35. Alexandria City
- Chlamydia cases: 471.2 per 100K people (729 cases)
- Gonorrhea cases: 157.7 per 100K people (244 cases)
- Syphilis cases (non-congenital): 45.9 per 100K people (71 case)
--- Primary and secondary syphilis: 22.6 per 100K people (35 cases)
--- Nonprimary and nonsecondary early syphilis: 23.3 per 100K people (36 cases)
Khairil Azhar Junos // Shutterstock
18 / 51#34. Westmoreland County
- Chlamydia cases: 475.1 per 100K people (89 cases)
- Gonorrhea cases: 101.4 per 100K people (19 cases)
- Syphilis cases (non-congenital): 16.0 per 100K people (3 cases)
--- Primary and secondary syphilis: 10.7 per 100K people (2 cases)
--- Nonprimary and nonsecondary early syphilis: 5.3 per 100K people (1 case)
#33. Cumberland County
- Chlamydia cases: 495.8 per 100K people (48 cases)
- Gonorrhea cases: 206.6 per 100K people (20 cases)
- Syphilis cases (non-congenital): 10.3 per 100K people (1 case)
--- Primary and secondary syphilis: 10.3 per 100K people (1 case)
--- Nonprimary and nonsecondary early syphilis: 0 cases
EWY Media // Shutterstock
20 / 51#32. Colonial Heights City
- Chlamydia cases: 498.0 per 100K people (91 case)
- Gonorrhea cases: 136.8 per 100K people (25 cases)
- Syphilis cases (non-congenital): 16.4 per 100K people (3 cases)
--- Primary and secondary syphilis: 5.5 per 100K people (1 case)
--- Nonprimary and nonsecondary early syphilis: 10.9 per 100K people (2 cases)
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#31. Winchester City
- Chlamydia cases: 501.1 per 100K people (141 case)
- Gonorrhea cases: 99.5 per 100K people (28 cases)
- Syphilis cases (non-congenital): 10.7 per 100K people (3 cases)
--- Primary and secondary syphilis: 7.1 per 100K people (2 cases)
--- Nonprimary and nonsecondary early syphilis: 3.6 per 100K people (1 case)
#30. Mecklenburg County
- Chlamydia cases: 509.1 per 100K people (154 cases)
- Gonorrhea cases: 294.2 per 100K people (89 cases)
- Syphilis cases (non-congenital): 29.8 per 100K people (9 cases)
--- Primary and secondary syphilis: 16.5 per 100K people (5 cases)
--- Nonprimary and nonsecondary early syphilis: 13.2 per 100K people (4 cases)
refrina // Shutterstock
23 / 51#29. Manassas City
- Chlamydia cases: 526.8 per 100K people (225 cases)
- Gonorrhea cases: 107.7 per 100K people (46 cases)
- Syphilis cases (non-congenital): 7.0 per 100K people (3 cases)
--- Primary and secondary syphilis: 2.3 per 100K people (1 case)
--- Nonprimary and nonsecondary early syphilis: 4.7 per 100K people (2 cases)
#28. Accomack County
- Chlamydia cases: 538.4 per 100K people (179 cases)
- Gonorrhea cases: 126.3 per 100K people (42 cases)
- Syphilis cases (non-congenital): 6.0 per 100K people (2 cases)
--- Primary and secondary syphilis: 0 cases
--- Nonprimary and nonsecondary early syphilis: 6.0 per 100K people (2 cases)
#27. Fredericksburg City
- Chlamydia cases: 546.4 per 100K people (155 cases)
- Gonorrhea cases: 158.6 per 100K people (45 cases)
- Syphilis cases (non-congenital): 24.7 per 100K people (7 cases)
--- Primary and secondary syphilis: 17.6 per 100K people (5 cases)
--- Nonprimary and nonsecondary early syphilis: 7.1 per 100K people (2 cases)
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#26. Henrico County
- Chlamydia cases: 563.9 per 100K people (1,881 case)
- Gonorrhea cases: 208.1 per 100K people (694 cases)
- Syphilis cases (non-congenital): 18.3 per 100K people (61 case)
--- Primary and secondary syphilis: 7.8 per 100K people (26 cases)
--- Nonprimary and nonsecondary early syphilis: 10.5 per 100K people (35 cases)
#25. Brunswick County
- Chlamydia cases: 570.9 per 100K people (91 case)
- Gonorrhea cases: 282.3 per 100K people (45 cases)
- Syphilis cases (non-congenital): 12.5 per 100K people (2 cases)
--- Primary and secondary syphilis: 12.5 per 100K people (2 cases)
--- Nonprimary and nonsecondary early syphilis: 0 cases
#24. Essex County
- Chlamydia cases: 576.9 per 100K people (61 case)
- Gonorrhea cases: 66.2 per 100K people (7 cases)
- Syphilis cases (non-congenital): 0 cases
--- Primary and secondary syphilis: 0 cases
--- Nonprimary and nonsecondary early syphilis: 0 cases
Kyle J Little // Shutterstock
29 / 51#23. Northampton County
- Chlamydia cases: 579.2 per 100K people (70 cases)
- Gonorrhea cases: 256.5 per 100K people (31 case)
- Syphilis cases (non-congenital): 0 cases
--- Primary and secondary syphilis: 0 cases
--- Nonprimary and nonsecondary early syphilis: 0 cases
Lekali Studio // Shutterstock
31 / 51#21. Prince Edward County
- Chlamydia cases: 620.1 per 100K people (136 cases)
- Gonorrhea cases: 287.3 per 100K people (63 cases)
- Syphilis cases (non-congenital): 22.8 per 100K people (5 cases)
--- Primary and secondary syphilis: 4.6 per 100K people (1 case)
--- Nonprimary and nonsecondary early syphilis: 18.2 per 100K people (4 cases)
#20. Lynchburg City
- Chlamydia cases: 625.2 per 100K people (494 cases)
- Gonorrhea cases: 305.0 per 100K people (241 case)
- Syphilis cases (non-congenital): 10.1 per 100K people (8 cases)
--- Primary and secondary syphilis: 6.3 per 100K people (5 cases)
--- Nonprimary and nonsecondary early syphilis: 3.8 per 100K people (3 cases)
#19. Manassas Park City
- Chlamydia cases: 629.3 per 100K people (107 cases)
- Gonorrhea cases: 76.5 per 100K people (13 cases)
- Syphilis cases (non-congenital): 11.8 per 100K people (2 cases)
--- Primary and secondary syphilis: 0 cases
--- Nonprimary and nonsecondary early syphilis: 11.8 per 100K people (2 cases)
Sherry V Smith // Shutterstock
34 / 51#18. Virginia Beach City
- Chlamydia cases: 631.9 per 100K people (2,892 cases)
- Gonorrhea cases: 199.3 per 100K people (912 cases)
- Syphilis cases (non-congenital): 22.9 per 100K people (105 cases)
--- Primary and secondary syphilis: 13.8 per 100K people (63 cases)
--- Nonprimary and nonsecondary early syphilis: 9.2 per 100K people (42 cases)
#17. Martinsville City
- Chlamydia cases: 651.0 per 100K people (88 cases)
- Gonorrhea cases: 244.1 per 100K people (33 cases)
- Syphilis cases (non-congenital): 7.4 per 100K people (1 case)
--- Primary and secondary syphilis: 7.4 per 100K people (1 case)
--- Nonprimary and nonsecondary early syphilis: 0 cases
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Ken Schulze // Shutterstock
36 / 51#16. Chesapeake City
- Chlamydia cases: 654.7 per 100K people (1,645 cases)
- Gonorrhea cases: 247.5 per 100K people (622 cases)
- Syphilis cases (non-congenital): 19.1 per 100K people (48 cases)
--- Primary and secondary syphilis: 10.3 per 100K people (26 cases)
--- Nonprimary and nonsecondary early syphilis: 8.8 per 100K people (22 cases)
Don Williamson // Shutterstock
37 / 51#15. Nottoway County
- Chlamydia cases: 711.8 per 100K people (111 case)
- Gonorrhea cases: 128.3 per 100K people (20 cases)
- Syphilis cases (non-congenital): 6.4 per 100K people (1 case)
--- Primary and secondary syphilis: 6.4 per 100K people (1 case)
--- Nonprimary and nonsecondary early syphilis: 0 cases
Wileydoc // Shutterstock
38 / 51#14. Emporia City
- Chlamydia cases: 723.5 per 100K people (41 case)
- Gonorrhea cases: 458.8 per 100K people (26 cases)
- Syphilis cases (non-congenital): 105.9 per 100K people (6 cases)
--- Primary and secondary syphilis: 52.9 per 100K people (3 cases)
--- Nonprimary and nonsecondary early syphilis: 52.9 per 100K people (3 cases)
O.C Ritz // Shutterstock
39 / 51#13. Suffolk City
- Chlamydia cases: 725.6 per 100K people (698 cases)
- Gonorrhea cases: 315.0 per 100K people (303 cases)
- Syphilis cases (non-congenital): 17.7 per 100K people (17 cases)
--- Primary and secondary syphilis: 9.4 per 100K people (9 cases)
--- Nonprimary and nonsecondary early syphilis: 8.3 per 100K people (8 cases)
Bryan Pollard // Shutterstock
40 / 51#12. Danville City
- Chlamydia cases: 750.9 per 100K people (317 cases)
- Gonorrhea cases: 267.7 per 100K people (113 cases)
- Syphilis cases (non-congenital): 14.2 per 100K people (6 cases)
--- Primary and secondary syphilis: 7.1 per 100K people (3 cases)
--- Nonprimary and nonsecondary early syphilis: 7.1 per 100K people (3 cases)
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#11. Roanoke City
- Chlamydia cases: 766.7 per 100K people (758 cases)
- Gonorrhea cases: 609.9 per 100K people (603 cases)
- Syphilis cases (non-congenital): 27.3 per 100K people (27 cases)
--- Primary and secondary syphilis: 24.3 per 100K people (24 cases)
--- Nonprimary and nonsecondary early syphilis: 3.0 per 100K people (3 cases)
#10. Franklin City
- Chlamydia cases: 888.4 per 100K people (73 cases)
- Gonorrhea cases: 231.2 per 100K people (19 cases)
- Syphilis cases (non-congenital): 0 cases
--- Primary and secondary syphilis: 0 cases
--- Nonprimary and nonsecondary early syphilis: 0 cases
OJUP // Shutterstock
43 / 51#9. Hopewell City
- Chlamydia cases: 911.8 per 100K people (211 case)
- Gonorrhea cases: 440.8 per 100K people (102 cases)
- Syphilis cases (non-congenital): 17.3 per 100K people (4 cases)
--- Primary and secondary syphilis: 4.3 per 100K people (1 case)
--- Nonprimary and nonsecondary early syphilis: 13.0 per 100K people (3 cases)
Bryan Pollard // Shutterstock
44 / 51#8. Radford City
- Chlamydia cases: 981.9 per 100K people (162 cases)
- Gonorrhea cases: 151.5 per 100K people (25 cases)
- Syphilis cases (non-congenital): 0 cases
--- Primary and secondary syphilis: 0 cases
--- Nonprimary and nonsecondary early syphilis: 0 cases
Chankhamp // Shutterstock
45 / 51#7. Harrisonburg City
- Chlamydia cases: 991.6 per 100K people (510 cases)
- Gonorrhea cases: 161.4 per 100K people (83 cases)
- Syphilis cases (non-congenital): 27.2 per 100K people (14 cases)
--- Primary and secondary syphilis: 17.5 per 100K people (9 cases)
--- Nonprimary and nonsecondary early syphilis: 9.7 per 100K people (5 cases)
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#6. Newport News City
- Chlamydia cases: 1,041.8 per 100K people (1,923 cases)
- Gonorrhea cases: 462.7 per 100K people (854 cases)
- Syphilis cases (non-congenital): 36.3 per 100K people (67 cases)
--- Primary and secondary syphilis: 19.0 per 100K people (35 cases)
--- Nonprimary and nonsecondary early syphilis: 17.3 per 100K people (32 cases)
Kyle J Little // Shutterstock
47 / 51#5. Hampton City
- Chlamydia cases: 1,074.4 per 100K people (1,480 cases)
- Gonorrhea cases: 477.7 per 100K people (658 cases)
- Syphilis cases (non-congenital): 37.8 per 100K people (52 cases)
--- Primary and secondary syphilis: 19.6 per 100K people (27 cases)
--- Nonprimary and nonsecondary early syphilis: 18.1 per 100K people (25 cases)
Erin Cadigan // Shutterstock
48 / 51#4. Richmond City
- Chlamydia cases: 1,104.6 per 100K people (2,503 cases)
- Gonorrhea cases: 543.7 per 100K people (1,232 cases)
- Syphilis cases (non-congenital): 51.2 per 100K people (116 cases)
--- Primary and secondary syphilis: 23.8 per 100K people (54 cases)
--- Nonprimary and nonsecondary early syphilis: 27.4 per 100K people (62 cases)
#3. Norfolk City
- Chlamydia cases: 1,288.9 per 100K people (3,030 cases)
- Gonorrhea cases: 529.6 per 100K people (1,245 cases)
- Syphilis cases (non-congenital): 43.8 per 100K people (103 cases)
--- Primary and secondary syphilis: 23.8 per 100K people (56 cases)
--- Nonprimary and nonsecondary early syphilis: 20.0 per 100K people (47 cases)
OJUP // Shutterstock
50 / 51#2. Petersburg City
- Chlamydia cases: 1,295.3 per 100K people (433 cases)
- Gonorrhea cases: 511.5 per 100K people (171 case)
- Syphilis cases (non-congenital): 50.9 per 100K people (17 cases)
--- Primary and secondary syphilis: 26.9 per 100K people (9 cases)
--- Nonprimary and nonsecondary early syphilis: 23.9 per 100K people (8 cases)
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#1. Portsmouth City
- Chlamydia cases: 1,335.9 per 100K people (1,307 cases)
- Gonorrhea cases: 656.2 per 100K people (642 cases)
- Syphilis cases (non-congenital): 84.8 per 100K people (83 cases)
--- Primary and secondary syphilis: 52.1 per 100K people (51 case)
--- Nonprimary and nonsecondary early syphilis: 32.7 per 100K people (32 cases)
This story features data reporting and writing by Emma Rubin and is part of a series utilizing data automation across 49 states.
