STD Infections Reach All-Time High in the U.S. in 2018

Drug use, poverty, stigma, unstable housing, decreased condom use and cuts to STD programs at the state and local levels cited as causes for the infection increase.

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(Graphic courtesy Center for Disease Control and Prevention)

Combined cases of syphilis, gonorrhea, and chlamydia reached an all-time high in the United States in 2018, according to the annual Sexually Transmitted Disease Surveillance Report released by the Centers for Disease Control and Prevention (CDC).

Sexually transmitted diseases (STDs) can have severe health consequences. Among the most tragic are newborn deaths related to congenital syphilis, which increased 22 percent from 2017 to 2018 (from 77 to 94 deaths).

The new report shows that from 2017 to 2018, there were increases in the three most commonly reported STDs:

  • There were more than 115,000 syphilis cases.
    • The number of primary and secondary syphilis cases – the most infectious stages of syphilis – increased 14 percent to more than 35,000 cases, the highest number reported since 1991.
    • Among newborns, syphilis cases increased 40 percent to more than 1,300 cases.
  • Gonorrhea increased 5 percent to more than 580,000 cases – also the highest number reported since 1991.
  • Chlamydia increased 3 percent to more than 1.7 million cases – the most ever reported to CDC.

“STDs can come at a high cost for babies and other vulnerable populations,” said Jonathan Mermin, M.D., M.P.H., director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. “Curbing STDs will improve the overall health of the nation and prevent infertility, HIV, and infant deaths.”

Antibiotics can cure syphilis, gonorrhea, and chlamydia. However, left untreated, STDs can be transmitted to others and produce adverse health outcomes such as infertility, ectopic pregnancy, and increased HIV risk. Congenital syphilis – syphilis passed from a mother to her baby during pregnancy – can lead to miscarriage, stillbirth, newborn death, and severe lifelong physical and neurological problems.

Syphilis in newborns is a tragic consequence of the growing STD epidemic

The 40 percent increase in congenital syphilis cases continues a dangerous trend seen in recent years. Although most states reported at least one case of congenital syphilis, five states – Texas, California, Florida, Arizona, and Louisiana – accounted for 70 percent of cases in the U.S.

Early prenatal care and STD testing are essential with each pregnancy to safeguard mothers and their babies from the dangers of syphilis. CDC recommends syphilis testing for all pregnant women the first time they see a healthcare provider about their pregnancy. Women who are vulnerable for acquiring or who live in high-prevalence areas should be tested again early in the third trimester and at delivery.

“There are tools available to prevent every case of congenital syphilis,” said Gail Bolan, M.D., director of CDC’s Division of STD Prevention. “Testing is simple and can help women to protect their babies from syphilis – a preventable disease that can have irreversible consequences.”

The national rise in congenital syphilis parallels increases in syphilis among women of reproductive age. From 2017 to 2018, syphilis cases increased 36 percent among women of childbearing age. Addressing rising syphilis incidence is critical to prevent congenital syphilis. Women can protect themselves by practicing safer sex, being tested for syphilis by a health care provider, and if infected, seeking treatment immediately and asking her partner to get tested and treated to avoid reinfection.

Multiple factors drive the continued increase in STDs

Data suggest that multiple factors are contributing to the overall increase in STDs, including:

  • Drug use, poverty, stigma, and unstable housing, which can reduce access to STD prevention and care
  • Decreased condom use among vulnerable groups, including young people and gay and bisexual men
  • Cuts to STD programs at the state and local level – in recent years, more than half of local programs have experienced budget cuts, resulting in clinic closures, reduced screening, staff loss, and reduced patient follow-up and linkage to care services

Urgent action needed to break the cycle of STD increases

CDC continues to work on multiple fronts to address the nation’s STD epidemic. For example, CDC provides resources to state and local health departments for STD prevention and surveillance. CDC’s current funding program for health departments, Strengthening STD Prevention and Control for Health Departments, supports several high-priority strategies and activities, including eliminating congenital syphilis. As part this program, CDC supports health departments in conducting disease investigations, responding to public health outbreaks, providing training for health care providers, community engagement and partnerships, and other efforts.

The U.S. Department of Health and Human Services, which includes CDC, is developing a Sexually Transmitted Infections (STI) Federal Action Plan (STI Plan) to address and reverse the nation’s STD epidemic. The STI Plan is being developed by partners across the federal government, with input from a wide array of stakeholders, and will be released in 2020. Click HERE for more information.

However, urgent action from all types of stakeholders is needed to help control the increases in STDs. Health care providers should make STD screening and timely treatment a standard part of medical care; this work can start with taking a complete sexual history. In addition, state and local health departments should strengthen the local public health infrastructure needed to prevent and control STDs, and ensure resources are directed to the most vulnerable populations.


In Hampton Roads, there are several organizations offering free STD testing, prevention services, housing and wraparound care. For more information about where you can find information about where you can get tested, prevent the spread of STDs and receive care in your area, visit GetTested, National HIV, STD, and Hepatitis Testing

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