STD Rates in Hawaii
CDC surveillance data for Hawaii covering chlamydia, gonorrhea, syphilis, and HIV — with 15-year trends, state rankings, and national comparisons.
Hawaii sits in the bottom third nationally for STD burden, ranking 33rd out of 50 states with a combined rate of 575.0 cases per 100,000 people. That puts it below the US median across all three major infections. But the direction of travel matters as much as the rank, and Hawaii's gonorrhea numbers are moving in a way that's hard to overlook.
Chlamydia is Hawaii's most common STD by volume — 6,251 cases in 2023, a rate of 435.6 per 100,000. That sits below the national median of 471.3. The long-run picture adds some context: the rate is actually about 7% lower than it was in 2008, and after hitting a peak near 572 in 2019, it's been declining for several years before ticking back up 13.4% in 2023. Whether that uptick is a one-year blip or the start of a new climb isn't clear yet, but it's worth watching.
Gonorrhea is where Hawaii's story gets more complicated. The rate jumped 23.5% in a single year — from 102.6 in 2022 to 126.7 in 2023. Zoom out and it's starker: gonorrhea has risen more than 165% since 2008. The rate is still below the national median of 152.2, but it's closing that gap. Syphilis moves in the opposite direction. After peaking at 18.0 per 100,000 in 2021, it dropped to 12.7 in 2023 — a 20.6% decline year over year, and now below the national median of 14.8. That's a real shift, though syphilis rates have risen more than 450% from their 2008 baseline, so the longer arc still tells a different story.
Hawaii's HIV data runs through 2022 and shows 78 new diagnoses that year — a rate of 6.4 per 100,000, the highest in the recent dataset. The numbers dipped sharply in 2020, likely reflecting testing disruptions during the pandemic rather than an actual decline in transmission. If you live in Honolulu, Pearl City, or Hilo, STDTest.com can help you find a testing location near you.
STD Trends in Hawaii
Hawaii's chlamydia rate has been remarkably stable over the long run — it was 467.3 in 2008 and sits at 435.6 today, a modest decline over 15 years. The rate peaked near 572 in 2019, fell steadily through 2022, then bounced back 13.4% in 2023. Whether that rebound signals a trend reversal or just a post-pandemic correction is the open question.
Gonorrhea has been Hawaii's fastest-moving STD for years, and 2023 added to that story — a 23.5% single-year increase pushed the rate to 126.7 per 100,000, up from essentially flat numbers between 2019 and 2022. Since 2008, the rate has risen more than 165%. Hawaii still sits below the national median of 152.2, but the gap is narrowing.
Syphilis dropped 20.6% in 2023, falling to 12.7 per 100,000 — just below the national median of 14.8. That's a real and notable decline after the rate hit 18.0 in 2021. The longer arc, though, is a 452% rise since 2008, when syphilis was nearly absent from Hawaii's STD picture at just 2.3 per 100,000.
Hawaii's HIV data covers 2017 through 2022, with 78 new diagnoses in 2022 — a rate of 6.4 per 100,000, the highest point in the recent window. New cases dipped to 53 in 2020, a drop that likely reflects pandemic-related disruptions to testing access rather than a genuine decrease in transmission. By 2021 and 2022, counts had returned to and exceeded pre-pandemic levels.
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Hawaii vs National Average
Comparing 2023 rates against the U.S. median across all 50 states.
| Infection | Hawaii | US Median | Difference |
|---|---|---|---|
| Chlamydia | 435.6 | 471.3 | 7.6% below |
| Gonorrhea | 126.7 | 152.2 | 16.8% below |
| Syphilis (P&S) | 12.7 | 14.8 | 14.2% below |
What the numbers mean — and what to do about them
Hawaii's combined STD rate of 575.0 per 100,000 translates to roughly 8,251 diagnosed cases of chlamydia, gonorrhea, and syphilis in 2023 across a state of 1.4 million people. That's a below-median disease burden by national standards — but medians can obscure movement, and at least one of those three diseases is moving fast.
Gonorrhea is the number to pay attention to. A 23.5% single-year increase, on top of a 165% rise since 2008, points to a disease that spreads quietly. Gonorrhea frequently produces no symptoms, particularly in women, which means transmission continues well before anyone seeks care. The same is true of chlamydia, which rebounded 13.4% in 2023 after several years of decline. When rates shift this quickly in one year, the gap between actual infections and diagnosed cases almost certainly widens.
If you live in Honolulu, Pearl City, or Hilo, the practical takeaway is straightforward: knowing your status requires a test, not a symptom. Hawaii's gonorrhea rate has more than doubled in 15 years largely among people who had no reason to think anything was wrong. STDTest.com can show you exactly where to get tested today — by zip code, near wherever you are in Hawaii.
WHO SHOULD GET TESTED
Any sexually active adult in Hawaii should consider routine STD screening, but the case is strongest for those with multiple partners given the state's rising gonorrhea rate. Hawaii's gonorrhea burden is below the national median but climbing — 126.7 per 100,000 in 2023 and up 23.5% from the prior year. Young adults under 25 account for a disproportionate share of chlamydia diagnoses nationwide, and Hawaii's rate of 435.6 reflects that same pattern.
HOW OFTEN
Once a year is a reasonable floor for sexually active adults in Hawaii. Given that gonorrhea rose sharply in 2023 and chlamydia reversed a multi-year decline, people with new or multiple partners should test every three to six months. Hawaii's syphilis rate fell in 2023 but remains more than four times higher than it was in 2008 — syphilis should be included in any routine panel.
WHAT TO EXPECT
STD testing is fast and straightforward — most panels involve a urine sample, a blood draw, or a swab, and results typically come back within a few days. Many clinics in Honolulu, Pearl City, and Hilo offer same-day or walk-in appointments. If a result comes back positive, treatment for chlamydia, gonorrhea, and syphilis is available and effective.
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