STD Rates in Iowa
CDC surveillance data for Iowa covering chlamydia, gonorrhea, syphilis, and HIV — with 15-year trends, state rankings, and national comparisons.
Iowa sits in the lower third nationally for STD burden, ranking 35th out of 50 states with a combined rate of 553.9 per 100,000 people. That's a reasonably comfortable position — but the decade-long trajectory underneath that ranking tells a more complicated story. Gonorrhea has more than doubled since 2008. Syphilis has risen nearly twentyfold. Iowa may look middling on a national snapshot, but the direction of travel has been consistently upward for a long time.
Chlamydia remains the most common STD in Iowa by a wide margin, with 13,687 cases reported in 2023 at a rate of 426.8 per 100,000 — about 10% below the national median of 471.3. That gap is real, but it's narrower than it used to be. The rate has climbed 36% since 2008, and while 2023 saw a 6.6% year-over-year decline, it's too early to call that a reversal. Chlamydia peaked in Iowa in 2019 at 508.5 before dipping during the pandemic and drifting down since — a pattern worth watching, not yet one worth celebrating.
Gonorrhea is where Iowa's numbers get harder to dismiss. The rate has more than doubled since 2008, rising from 56.8 to a peak of 216.9 in 2020. It has pulled back since — falling 16.3% in 2023 alone to 116.8 — but it's still more than twice where it stood fifteen years ago, and still only modestly below the national median of 152.2. Syphilis tells a sharper version of the same story. The rate was essentially zero in the early 2000s — 0.4 per 100,000 in 2000 — and now sits at 10.3, below the US median of 14.8 but representing a near-twentyfold increase over the period. The 2023 decline of 1% is more of a plateau than a reversal.
Iowa's HIV data runs through 2022 and shows a relatively stable picture: around 100 to 124 new diagnoses per year, with a rate hovering between 3.8 and 4.7 per 100,000. New diagnoses dipped in 2019 and 2020, a pattern seen nationally that likely reflects pandemic-related disruptions to testing rather than an actual decline in transmission. If you live in Des Moines, Cedar Rapids, or Davenport — Iowa's three largest cities and the centers of its STD burden — STDTest.com can help you find a testing location near you.
STD Trends in Iowa
Iowa's chlamydia rate has climbed 36% since 2008, though at 426.8 per 100,000 it currently sits about 10% below the national median of 471.3. The rate peaked in 2019 at 508.5 — above the median at that point — before falling during the pandemic years and continuing to drift downward. Whether that recent decline reflects improved testing access, behavior change, or simply a post-pandemic correction remains unclear.
Gonorrhea has more than doubled in Iowa since 2008, from a rate of 56.8 to 116.8 in 2023 — a 106% increase over fifteen years. The peak came in 2020 at 216.9, and the rate has been falling since, including a 16.3% drop in 2023. Iowa remains below the national median of 152.2, but the long-run rise makes that comparison less reassuring than it might otherwise seem.
Iowa's syphilis rate has undergone one of the more striking long-run increases in its STD data — rising from 0.5 per 100,000 in 2008 to 10.3 in 2023, a nearly twentyfold increase. The rate is still below the national median of 14.8, and the 2023 figure is essentially flat compared to 2022's 10.4. The trajectory over the past decade, however, shows syphilis going from a near-nonexistent problem to a persistent one.
Iowa's HIV data covers 2017 through 2022 and shows a relatively narrow range: between 99 and 124 new diagnoses annually, with rates between 3.8 and 4.7 per 100,000. New diagnoses fell to their lowest point in 2019 and stayed low through 2020, a dip that aligns with pandemic-related disruptions to testing access rather than a genuine decline in transmission. By 2021 and 2022, case counts had returned to pre-pandemic levels.
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Iowa vs National Average
Comparing 2023 rates against the U.S. median across all 50 states.
| Infection | Iowa | US Median | Difference |
|---|---|---|---|
| Chlamydia | 426.8 | 471.3 | 9.4% below |
| Gonorrhea | 116.8 | 152.2 | 23.3% below |
| Syphilis (P&S) | 10.3 | 14.8 | 30.4% below |
What the numbers mean — and what to do about them
Iowa's 2023 STD data adds up to roughly 17,765 combined diagnoses of chlamydia, gonorrhea, and syphilis across a state of about 3.2 million people. At a combined rate of 553.9 per 100,000, Iowa sits 13% below the national median — a position that sounds comfortable until you look at where the state was fifteen years ago. In 2008, gonorrhea was at 56.8 per 100,000. Today it's at 116.8. Syphilis was nearly nonexistent. Now it's in five figures statewide. The snapshot looks moderate. The trend line is a different conversation.
The clinical reality behind these numbers is that most people with chlamydia or gonorrhea have no symptoms. They don't feel sick. They don't know they're infected. That's not a warning — it's just how these diseases work. And it's why case counts in surveillance data represent only the infections that got tested and reported, not the full picture. Iowa's gonorrhea rate has more than doubled since 2008 largely through asymptomatic transmission — people passing an infection they didn't know they had. The recent year-over-year declines in all three diseases are real, but they follow years of sustained increases, and a single year of lower numbers doesn't reset fifteen years of upward movement.
If you're sexually active and live in Iowa — particularly in Des Moines, Cedar Rapids, or Davenport, where most of the state's case volume is concentrated — routine testing is the only reliable way to know your status. Iowa's gonorrhea rate has more than doubled since 2008 without most people noticing. STDTest.com can show you exactly where to get tested today.
WHO SHOULD GET TESTED
Sexually active adults in Iowa, particularly those under 25 — the age group that accounts for the majority of chlamydia cases nationally. Anyone living in or near Des Moines, Cedar Rapids, or Davenport, where STD rates are highest, should make testing a routine part of their healthcare. Iowa's gonorrhea rate has more than doubled since 2008, meaning the risk is spread more widely than it was a decade ago.
HOW OFTEN
Once a year is a reasonable floor for sexually active adults in Iowa. If you have multiple partners or have had unprotected sex, every three to six months makes more sense — particularly given that Iowa's chlamydia and gonorrhea rates, while below the national median, are significantly higher than they were in the early 2000s and most infections produce no symptoms.
WHAT TO EXPECT
STD testing is quick and largely non-invasive. Chlamydia and gonorrhea are typically detected with a urine sample or swab; syphilis and HIV require a blood draw. Most results come back within a few days. If something comes back positive, treatment for chlamydia and gonorrhea is straightforward — a short course of antibiotics — and syphilis is also treatable, especially when caught early.
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