Counties with the highest STI rates in Virginia
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.
State-level statistics
- Gonorrhea cases: 154.7 per 100K (#27 nationally, 13,437 cases)
- Primary and secondary syphilis cases: 10.8 per 100K (#38 nationally, 936 cases)
#50. Caroline County
- 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
- 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)
#48. Buckingham County
- 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
#47. Williamsburg City
- Gonorrhea cases: 102.6 per 100K people (16 cases)
- Syphilis cases (non-congenital): 19.2 per 100K people (3 cases)
--- Primary and secondary syphilis: 6.4 per 100K people (1 case)
--- Nonprimary and nonsecondary early syphilis: 12.8 per 100K people (2 cases)
#46. Prince William County
- 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)
#45. Surry County
- 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
- 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
- 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)
#42. Chesterfield County
- 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)
#41. Northumberland County
- 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
- 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)
#39. Charlottesville City
- 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)
#38. Waynesboro City
- 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)
#37. Greensville County
- 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
#36. Prince George County
- 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)
#35. Alexandria City
- 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)
#34. Westmoreland County
- 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
- 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
#32. Colonial Heights City
- 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)
#31. Winchester City
- 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
- 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)
#29. Manassas City
- 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
- 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
- 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)
#26. Henrico County
- 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
- 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
- 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
#23. Northampton County
- 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
#22. Sussex County
- Gonorrhea cases: 241.6 per 100K people (26 cases)
- Syphilis cases (non-congenital): 0 cases
--- Primary and secondary syphilis: 0 cases
--- Nonprimary and nonsecondary early syphilis: 0 cases
#21. Prince Edward County
- 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
- 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
- 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)
#18. Virginia Beach City
- 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
- 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
#16. Chesapeake City
- 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)
#15. Nottoway County
- 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
#14. Emporia City
- 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)
#13. Suffolk City
- 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)
#12. Danville City
- 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)
#11. Roanoke City
- 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
- 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
#9. Hopewell City
- 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)
#8. Radford City
- 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
#7. Harrisonburg City
- 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)
#6. Newport News City
- 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)
#5. Hampton City
- 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)
#4. Richmond City
- 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
- 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)
#2. Petersburg City
- 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)
#1. Portsmouth City
- 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.