The Centers for Disease Control and Prevention (C.D.C.) released its latest Sexually Transmitted Disease Surveillance Report along with new data on the number of reported sexually transmitted disease (STD) cases across the United States.

Their research team analyzed the latest statistics on a state-by-state basis and developed the 2023 list of the top states with the highest STD rates along with key trends. But before we get to the rankings, here are some findings and trends that we observed:

Between 2021 and 2022, the rate of chlamydia cases held largely steady, and the rate of gonorrhea infections fell 9.2%. A drop in total gonorrhea cases was the first in at least a decade, according to a statement from Dr. Laura Bachmann, acting director of the CDC’s Division of STD Prevention. But Bachmann said officials would examine whether it marked “a true decline in infections” or was tied to changes in diagnoses and reporting.

The continued growth in Syphilis cases is of particular concern, especially in light of potential funding cuts that could hamper efforts to curb sexually transmitted diseases: The country’s 207,255 cases marked its highest total since 1950, according to the CDC, while the rate of primary and secondary syphilis cases – when the disease is particularly contagious – rose by 9% from 2021 to 2022.

Meanwhile, cases of congenital syphilis – which occurs when a mother passes a syphilis infection to her baby while pregnant and can result in the infant’s death – surged by more than 30% year over year to 3,755, and the rate of 102.5 cases per 100,000 live births is the highest reported since 1991. There were 282 stillbirths and infant deaths related to congenital syphilis in 2022, and five states – Texas, California, Arizona, Florida and Louisiana – accounted for nearly 60% of congenital syphilis cases that year.

Now, let’s get on with the list. It may surprise you…

10. Arizona

Total STD Rate: 880.4 per 100,000
Chlamydia Rate: 554.4 per 100,000
Gonorrhea Rate: 224.1 per 100,000
Syphilis Rate (cumulative): 101.9 per 100,000

9. Arkansas

Total STD Rate: 903.8 per 100,000
Chlamydia Rate: 588.3 per 100,000
Gonorrhea Rate: 223 per 100,000
Syphilis Rate (cumulative): 92.5 per 100,000

8. North Carolina

Total STD Rate: 914.4 per 100,000
Chlamydia Rate: 603.1 per 100,000
Gonorrhea Rate: 249.7 per 100,000
Syphilis Rate (cumulative): 61.6 per 100,000

7. Alabama

Total STD Rate: 934.7 per 100,000
Chlamydia Rate: 612.1 per 100,000
Gonorrhea Rate: 261.7 per 100,000
Syphilis Rate (cumulative): 60.9 per 100,000

6. South Carolina

Total STD Rate: 991 per 100,000
Chlamydia Rate: 672.5 per 100,000
Gonorrhea Rate: 271.7 per 100,000
Syphilis Rate (cumulative): 46.8 per 100,000