STD Rates in Massachusetts
CDC surveillance data for Massachusetts covering chlamydia, gonorrhea, syphilis, and HIV — with 15-year trends, city-level context, and national comparisons.
Massachusetts sits in the lower third of states for STD burden, ranking 34th out of 50 with a combined rate of 563.1 cases per 100,000 people in 2023. But that relative standing obscures a longer story — one where gonorrhea has increased more than 330% since 2008 and syphilis has more than tripled, making Massachusetts a state that looks better than average on a spreadsheet while carrying disease trends that have moved steadily in one direction for 15 years.
Chlamydia is the quietest of the three major STDs here, which is not the same as saying it's small. Nearly 29,000 Massachusetts residents were diagnosed in 2023, at a rate of 412.7 per 100,000 — about 12% below the national median of 471.3. The long-run climb has also slowed considerably: after rising more than 54% between 2008 and 2023, the rate grew just 1.6% from 2022 to 2023. Whether that's a plateau or a pause is the open question.
Gonorrhea is where Massachusetts's numbers get harder to dismiss. The rate stood at 30 per 100,000 in 2009. By 2023, it had reached 139.8 — a 330% increase over 15 years, and still below the national median of 152.2, but closing in. The 2023 figure was up 6% from 2022, continuing a climb that has barely flattened since 2016. Syphilis, by contrast, offered one of the few reversals in the data: after hitting 11.8 per 100,000 in 2022, the rate dropped to 10.6 in 2023 — a 10% decline, and still meaningfully below the national median of 14.8.
HIV data through 2022 shows a state that saw new diagnoses fall sharply between 2018 and 2020, from 640 cases to 427 — a drop almost certainly shaped more by pandemic-related testing disruptions than any real epidemiological shift. Since then, new diagnoses have held steady near 443 cases per year, at a rate of 7.3 per 100,000. If you're in Boston, Worcester, or Springfield — the state's three largest cities, and the centers of its STD burden — STDTest.com can show you exactly where to get tested near you.
STD Trends in Massachusetts
Massachusetts's chlamydia rate has been rising for more than two decades, but the pace has slowed sharply. After growing 54% between 2008 and 2023, the rate edged up just 1.6% in the most recent year — from 406.4 to 412.7 per 100,000. That's still nearly 29,000 diagnoses in a single year, and the rate remains well above where it was even a decade ago, but the trajectory looks more like a plateau than a continued climb.
Gonorrhea has been Massachusetts's most dramatic long-run story. The rate was 30 per 100,000 in 2009; it's now 139.8 — a 330% increase over 15 years. That puts Massachusetts just below the national median of 152.2, a threshold it's approaching steadily after years of double-digit percentage growth. The 6% year-over-year increase in 2023 suggests the trend hasn't stalled.
Syphilis in Massachusetts is below the national median — 10.6 per 100,000 versus a US median of 14.8 — but it took a long road to get there, tripling from 3.3 in 2008. The 2023 figure is actually an improvement: the rate dropped 10.2% from 11.8 in 2022, one of the clearer year-over-year reversals in the state's recent STD data. Whether that decline holds is worth watching.
Massachusetts HIV data runs through 2022 only. New diagnoses peaked at 640 in 2018, then fell to 427 in 2020 — a drop that aligns closely with pandemic-era disruptions to routine testing rather than a genuine reduction in transmission. Since then, the number has stabilized near 443 cases per year, with a rate of 7.3 per 100,000, essentially unchanged from 2021.
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Massachusetts vs National Average
Comparing 2023 rates against the U.S. median across all 50 states.
| Infection | Massachusetts | US Median | Difference |
|---|---|---|---|
| Chlamydia | 412.7 | 471.3 | 12.4% below |
| Gonorrhea | 139.8 | 152.2 | 8.1% below |
| Syphilis (P&S) | 10.6 | 14.8 | 28.4% below |
STD Rates by County
County-level data from CDC surveillance. Ranked by combined rate per 100,000.
| County | State Rank | Combined | Chlamydia | Gonorrhea | Syphilis |
|---|---|---|---|---|---|
| Suffolk County | #1 of 14 | 1321.4 | 891.3 | 403.7 | 26.4 |
| Hampden County | #2 of 14 | 773.2 | 572.5 | 177.5 | 23.2 |
| Plymouth County | #3 of 14 | 546.3 | 418.6 | 119.7 | 8.0 |
| Essex County | #4 of 14 | 538.4 | 419.0 | 109.5 | 9.9 |
| Nantucket County | #5 of 14 | 512.3 | 484.6 | 27.7 | 0.0 |
| Bristol County | #6 of 14 | 469.7 | 348.5 | 113.6 | 7.6 |
| Middlesex County | #7 of 14 | 440.2 | 317.6 | 114.0 | 8.6 |
| Worcester County | #8 of 14 | 416.4 | 329.1 | 81.4 | 5.9 |
| Dukes County | #9 of 14 | 408.2 | 326.6 | 62.4 | 19.2 |
| Norfolk County | #10 of 14 | 369.8 | 274.9 | 90.0 | 4.9 |
| Barnstable County | #11 of 14 | 354.2 | 256.3 | 91.9 | 6.0 |
| Hampshire County | #12 of 14 | 292.9 | 216.6 | 71.4 | 4.9 |
| Berkshire County | #13 of 14 | 253.9 | 209.0 | 39.4 | 5.5 |
| Franklin County | #14 of 14 | 187.7 | 142.6 | 40.9 | 4.2 |
What the numbers mean — and what to do about them
Massachusetts diagnosed roughly 39,000 people with chlamydia, gonorrhea, or syphilis in 2023 — about 107 people every day. The combined rate of 563.1 per 100,000 puts the state in the lower third nationally, which sounds reassuring until you look at the direction of travel. Every major STD tracked here has risen substantially over the past 15 years, and 2023 was not an exception for gonorrhea or chlamydia.
Gonorrhea is the trend worth paying closest attention to. A 330% increase since 2008 is not a statistical artifact — it reflects real, sustained transmission happening across the state. And because gonorrhea, like chlamydia, is often asymptomatic, most of those nearly 10,000 annual cases in Massachusetts are being caught through testing rather than symptoms. People who aren't testing aren't being counted, which means the true number of infections is almost certainly higher than what the data shows. The syphilis decline in 2023 is a counterpoint worth noting — but a single year of improvement doesn't undo a decade-long rise.
If you live in Massachusetts — especially in or near Boston, Worcester, or Springfield — and you're sexually active, the state's numbers make a straightforward case for regular testing. Gonorrhea has tripled here in less than a decade and most people who have it don't know it. STDTest.com can show you where to get tested today, with clinics in all three cities offering fast, confidential results.
WHO SHOULD GET TESTED
Sexually active adults in Massachusetts — particularly those in Boston, Worcester, and Springfield, where STD rates are concentrated. Given the state's gonorrhea rate of 139.8 per 100,000 and continuing upward trend, anyone with new or multiple partners is at meaningful risk. Men who have sex with men face elevated gonorrhea and syphilis exposure statewide.
HOW OFTEN
At least once a year if you're sexually active. Given that Massachusetts gonorrhea rates have risen in nearly every year since 2009 and chlamydia diagnoses remain close to 29,000 annually, every-six-months testing makes sense if you have multiple partners or don't consistently use condoms. Don't wait for symptoms — most infections in Massachusetts are caught through testing, not because of how they feel.
WHAT TO EXPECT
STD testing in Massachusetts is quick, private, and routine. Most clinics offer urine tests or swabs for chlamydia and gonorrhea, a blood draw for syphilis and HIV, and results within a few days. Many locations in Boston, Worcester, and Springfield offer same-day appointments. A positive result means treatment is available — chlamydia and gonorrhea are curable with antibiotics, and syphilis is as well when caught early.
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