The Alabama Department of Public Health is urging people to make safer and more informed decisions about sex as the rate of sexually transmitted diseases continues to climb.

Alabama ranks sixth in the nation for the highest rate of STDs, according to U.S. News & World Report.

The site compiled the ranking using data from 2023 provided by the Centers for Disease Control and Prevention (CDC), the most recent year available.

According to the ranking, Alabama’s total STD rate is 952.3 per 100,000 residents. Its chlamydia rate is 651.1 per 100,000, while the rate of gonorrhea is 226.9 per 100,000. The cumulative syphilis rate is 74.3 per 100,000.

The state’s total STD and chlamydia rates have remained close to the same between the 2023 and 2024 report, but gonorrhea rates have dropped significantly (226.9 over 321.3) and syphilis rates have nearly doubled (74.3 over 43.1).

Changes in gonorrhea and syphilis rates

According to the CDC, because gonococcal infections can be asymptomatic, trends in case reports are influenced by both changes in incidence and screening coverage. So recent national declines in rates of reported gonorrhea may reflect declines in new infections, as well as reduced screening.

The CDC recommends annual testing for all sexually active women under the age of 25 or those older with multiple sex partners, and that sexually active gay and bisexual men get tested every year.

While gonorrheal rates have been falling nationwide, syphilis rates have been steadily climbing over the past four years and saw the highest number of reported cases (over 209,000) since the 1950s in 2022.

The CDC’s Division of STD Prevention points to increases in substance abuse tied to risky sexual behavior, decrease in condom use, ongoing social and economic conditions and reduction in sexually transmitted disease services at the state and local level.

They recommend getting tested regularly for syphilis if you are sexually active and are a gay or bisexual man, have HIV, are taking pre-exposure prophylaxis (PrEP) for HIV prevention, have partner(s) who have tested positive for syphilis, have certain risk factors for syphilis, like living in a community with high rates of syphilis.

Their website site adds that all pregnant people should receive syphilis testing at their first prenatal visit.

Why does Alabama rank so high and what can people do to stay safe?

According to the ADPH, a lack of information and resources may be to blame for Alabama’s high ranking.

“STIs [sexually transmitted infections, can be used interchangeably with STD] can occur anywhere there is bodily fluid exchange,” their website reads.

“Stigma and poor sexual education are the primary reasons for high transmission post infection. Areas with high STI rates are near urban centers and within populations experiencing limited access to clinical treatments.”

Condom use, communication with partners about possible exposures, and regular testing for anyone engaging in sexual activity are highly recommended by the ADPH to prevent the spread of STDs.

National numbers

For the first time in several years, rates of major sexually transmitted diseases in the U.S. have been falling.

Nationally, the rate of STDs is 734 cases per 100,000 people, a 2.3% decrease over the previous year, according to CDC data gathered by U.S. News & World Report.

While more than 2.4 million total cases of syphilis, gonorrhea and chlamydia were diagnosed and reported in the U.S. last year, this marks a 2% decrease from the case count in 2022 and a 4% drop from 2019.

The rate of chlamydia cases decreased by less than 1%, and the rate of gonorrhea infections decreased nearly 8% over the same period after falling by 9% from 2021 to 2022, the report says.