STD Rates in Texas
CDC surveillance data for Texas covering chlamydia, gonorrhea, syphilis, and HIV — with 15-year trends, city-level context, and national comparisons.
Texas ranks 21st out of 50 states for combined STD burden — squarely in the upper half, with a combined rate of 683.3 per 100,000 people. That number sits about 7% above the national median. But the more telling story isn't where Texas stands today — it's how it got here, and which diseases are still climbing.
Chlamydia is Texas's highest-volume disease by far, with more than 150,000 cases reported in 2023. The rate — 491.9 per 100,000 — is above the national median of 471.3, and it's been hovering in that range since the early 2010s. The good news, such as it is: chlamydia dropped 5% from 2022 to 2023, the first meaningful pullback after years of creeping growth. The long-run picture is still up, though — the rate has risen about 18% since 2008, suggesting that plateau isn't the same as progress.
Gonorrhea is where the trend line gets harder to explain away. Texas's rate of 176.4 is 16% above the national median of 152.2 — and that's actually after a 14.6% drop from 2022 to 2023, the sharpest single-year decline of the three major STDs. The rate had surged from 118 in 2009 to nearly 219 in 2021, a 33% long-run increase. Syphilis tells a different story: the rate has risen 158% since 2008, from 5.8 to 15.0 per 100,000 — and while it ticked down slightly in 2023, it remains just above the national median of 14.8. Two diseases declining year-over-year, neither one actually low.
HIV data through 2022 shows Texas recording 4,890 new diagnoses that year — a rate of 19.8 per 100,000, the highest in the six-year window. New cases dipped sharply in 2020, likely reflecting testing disruptions during the pandemic rather than any real reduction in transmission, before rebounding strongly in 2021 and 2022. If you're in Houston, San Antonio, or Dallas — three of the largest metros in the country and among the highest-volume testing markets in the state — the data makes a straightforward case for knowing your status. STDTest.com can help you find a testing location near you.
STD Trends in Texas
Texas's chlamydia rate has been elevated for over a decade, and 2023's reading of 491.9 per 100,000 sits above the national median of 471.3 — but what's notable is how little it has moved in either direction since 2011. The rate has essentially plateaued in the 485–535 range for twelve years, suggesting a persistent baseline rather than an ongoing surge. The 5% year-over-year decline in 2023 is the first notable dip in that stretch, though a single year rarely signals a turning point.
Gonorrhea in Texas has had one of the more volatile trajectories in the state's STD data — rising 33% from 2008 to a peak of 218.9 per 100,000 in 2021, then falling back to 176.4 in 2023 after a 14.6% single-year drop. Even at its current level, the rate is 16% above the national median of 152.2, meaning Texas hasn't returned to a middling position even after two consecutive years of decline. The spike-and-partial-retreat pattern bears watching: similar patterns in other states have reversed quickly.
Syphilis has risen more sharply in Texas than either chlamydia or gonorrhea over the long run — up 158% since 2008, from a rate of 5.8 to 15.0 per 100,000 in 2023. It now sits just barely above the national median of 14.8, a threshold Texas was well below for most of the 2000s. The slight 3.2% dip from 2022 to 2023 interrupts what had been a nearly unbroken 15-year climb, but one year of modest decline doesn't rewrite a trend that long.
Texas's HIV data covers 2017 through 2022, and over that window new diagnoses have generally held in the 4,300–4,900 range per year. The 2020 figure — 3,626 cases at a rate of 15.2 — stands out as an outlier, almost certainly reflecting reduced testing access during the early pandemic rather than a genuine decline in transmission. By 2022, diagnoses had rebounded to 4,890, the highest annual count in the six-year dataset, with a rate of 19.8 per 100,000.
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Texas vs National Average
Comparing 2023 rates against the U.S. median across all 50 states.
| Infection | Texas | US Median | Difference |
|---|---|---|---|
| Chlamydia | 491.9 | 471.3 | 4.4% above |
| Gonorrhea | 176.4 | 152.2 | 15.9% above |
| Syphilis (P&S) | 15 | 14.8 | 1.4% above |
What the numbers mean — and what to do about them
In raw terms, Texas recorded more than 208,000 combined chlamydia, gonorrhea, and syphilis cases in 2023 across a population of roughly 30.5 million. That works out to a combined rate of 683.3 per 100,000 — about 7% above the national median. For a state this large, those numbers add up fast, and the case counts in major metros like Houston, Dallas, and San Antonio represent a substantial share of the total.
The trend that warrants the most attention is syphilis. A 158% increase over fifteen years isn't noise — it reflects a disease that spreads efficiently when screening gaps exist, because most people with syphilis have no symptoms and don't know they're infected. Gonorrhea has followed a similar pattern: rates surged through the 2010s, peaked in 2021, and remain above the national median even after two years of decline. When diseases are this common and this often asymptomatic, the gap between actual infection and reported cases is always wider than the data shows.
If you live in Texas — particularly in Houston, San Antonio, or Dallas, where case volumes are highest — routine testing is the practical response to what the data shows. Texas's syphilis rate has more than doubled since 2008 while most residents had no idea it was happening. STDTest.com can show you exactly where to get tested today, so you're not part of that gap.
WHO SHOULD GET TESTED
Anyone sexually active in Texas should consider routine STD screening, but the data points most clearly to adults under 25 — who account for a disproportionate share of chlamydia cases — and to anyone in Houston, Dallas, or San Antonio, where combined case volumes are highest. Given Texas's gonorrhea rate sits 16% above the national median and syphilis has risen 158% since 2008, testing isn't just for people who have symptoms. Most infections in these categories produce none.
HOW OFTEN
Once a year is a reasonable baseline for sexually active adults given Texas's above-median rates for chlamydia and gonorrhea. If you have multiple partners or have had unprotected sex, testing every three to six months is more appropriate — especially for gonorrhea and syphilis, both of which have shown sustained elevation in Texas over the past decade. HIV testing is also worth including annually given the state's 2022 rate of 19.8 per 100,000.
WHAT TO EXPECT
STD testing is fast and low-friction at most sites. Chlamydia and gonorrhea are typically detected with a urine sample or swab; syphilis and HIV require a blood draw. Results usually come back within a few days, and many clinics offer confidential or anonymous options. If something comes back positive, effective treatment exists for all three bacterial STDs — and early detection makes treatment simpler.
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