STD Rates in South Carolina
CDC surveillance data for South Carolina covering chlamydia, gonorrhea, syphilis, and HIV — with 15-year trends, state rankings, and national comparisons.
South Carolina ranks 8th in the country for combined STD burden — a position that puts it firmly in the top tier nationally, with a combined rate of 851.8 per 100,000 people, roughly 34% above the US median. That alone would be worth noting. But the more interesting story is what happened in 2023: all three diseases — chlamydia, gonorrhea, and syphilis — fell year over year, in some cases sharply. Whether that's a turning point or a single-year fluctuation is the real question.
Chlamydia is South Carolina's largest STD burden by volume — nearly 33,000 cases in 2023, at a rate of 612.1 per 100,000. That's 30% above the US median of 471.3. The rate has been elevated for over a decade, hovering above 560 since 2009, and it peaked in 2021 at 702.7 before beginning to slide. The 2023 drop of 9% from the prior year is the steepest single-year decline in recent history, but the long-run picture is one of persistent high-baseline transmission, not a crisis that arrived suddenly.
Gonorrhea fell 18% in 2023 — the biggest year-over-year decline of any disease in the state's current data. At 222.4 per 100,000, it's still 46% above the US median of 152.2, and the long-run trend since 2008 is upward: the rate has climbed roughly 6% from its base, with a sharp acceleration between 2017 and 2020 when it surged from 251 to 326. Syphilis tells a different story. Starting from nearly nothing — a rate of 2.2 in 2008 — it climbed almost without interruption to 19.6 in 2022, a rise of roughly 790% over 14 years. The 2023 figure of 17.3 is a pullback, but the rate remains above the national median of 14.8. For a disease that was nearly absent from South Carolina two decades ago, that trajectory is hard to dismiss.
HIV data runs through 2022. New diagnoses dropped during 2020 and 2021 — to 654 cases each year — a pattern consistent with testing disruptions during the pandemic rather than a genuine decline in transmission. By 2022, diagnoses had rebounded to 722, with a rate of 16.1 per 100,000. If you live in Columbia, Charleston, or North Charleston, you're in areas that account for a disproportionate share of the state's STD case volume. STDTest.com can show you testing locations in all three cities.
STD Trends in South Carolina
South Carolina's chlamydia rate has been elevated above 560 per 100,000 for more than a decade — this isn't a recent spike but a sustained high-baseline pattern. The rate peaked at 702.7 in 2021 and has since pulled back to 612.1 in 2023, a 9% decline year over year. Even with that drop, the state sits 30% above the US median of 471.3, and the long-run rise from 2008 has been modest — about 4.6% — which suggests the state never fully brought rates down after earlier surges.
Gonorrhea's 18% year-over-year decline in 2023 is the steepest recent drop in South Carolina's data, but it follows a period of sharp escalation — rates nearly doubled between 2013 and 2020, rising from 151 to 326 per 100,000. At 222.4, the state remains 46% above the US median of 152.2, meaning even with the decline, South Carolina is still well above where most states land. The long-run change since 2008 is a net increase of 6%, masking the far larger swings that happened in between.
Syphilis is where South Carolina's trend stands apart from its other STD data. The rate was 2.2 per 100,000 in 2008; by 2022, it had reached 19.6 — an increase of roughly 790% over 14 years. The 2023 figure of 17.3 represents an 11.7% pullback, but it still sits above the national median of 14.8. A disease that was nearly absent from the state two decades ago now regularly exceeds the US midpoint.
South Carolina's HIV data covers 2017 through 2022. New diagnoses held relatively steady between 2017 and 2019, ranging from 698 to 725 cases annually, then dipped to 654 in both 2020 and 2021 — a decline that coincides closely with pandemic-era testing disruptions and is unlikely to reflect a true reduction in transmission. By 2022, diagnoses had returned to 722, with a rate of 16.1 per 100,000, consistent with pre-pandemic levels.
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South Carolina vs National Average
Comparing 2023 rates against the U.S. median across all 50 states.
| Infection | South Carolina | US Median | Difference |
|---|---|---|---|
| Chlamydia | 612.1 | 471.3 | 29.9% above |
| Gonorrhea | 222.4 | 152.2 | 46.1% above |
| Syphilis (P&S) | 17.3 | 14.8 | 16.9% above |
What the numbers mean — and what to do about them
Nearly 46,000 South Carolina residents were diagnosed with chlamydia, gonorrhea, or syphilis in 2023. At a combined rate of 851.8 per 100,000, the state sits 34% above the US median — meaning that on a per-capita basis, South Carolina carries significantly more STD burden than most of the country. That's not a one-year anomaly. The state has ranked in the top 10 nationally for combined STD rates consistently, and the underlying case counts are large enough that most people in the state know someone affected, whether they realize it or not.
The trend most worth paying attention to is syphilis. It was almost absent from South Carolina in the early 2000s — a rate of 2.2 per 100,000 in 2008 — and has since climbed to levels above the national median. Syphilis is notable because it's often asymptomatic in its early stages, meaning people can transmit it without knowing they have it. The same applies to chlamydia, where South Carolina's rate of 612.1 per 100,000 reflects only diagnosed cases — the actual prevalence is likely higher. Gonorrhea dropped 18% in 2023, which is worth watching, but the rate is still 46% above the US median after nearly a decade of elevated transmission.
If you live in South Carolina — particularly in or around Columbia, Charleston, or North Charleston — the state's sustained position near the top of national STD rankings means routine testing isn't just a precaution, it's practical. Annual testing covers most people's needs; more frequent testing makes sense if you have multiple partners or don't use condoms consistently. South Carolina's gonorrhea rate nearly doubled between 2013 and 2020 without most people noticing. STDTest.com can show you exactly where to get tested in Columbia, Charleston, and North Charleston today.
WHO SHOULD GET TESTED
Anyone sexually active in South Carolina faces above-average risk — the state's chlamydia rate is 30% above the national median and gonorrhea is 46% above it. People under 25, those with multiple partners, and anyone in the Columbia, Charleston, or North Charleston metro areas are in higher-exposure environments given local case volumes. Pregnant women should be screened for all three bacterial STDs given the state's elevated syphilis trajectory.
HOW OFTEN
Once a year is a reasonable floor for sexually active adults given South Carolina's persistently elevated rates. If you have more than one partner or don't use condoms consistently, testing every 3 to 6 months is more appropriate — particularly for gonorrhea and syphilis, both of which have been above the US median in recent years. Don't rely on symptoms; most chlamydia and early syphilis cases produce none.
WHAT TO EXPECT
Most STD tests are quick and straightforward — a urine sample or swab for chlamydia and gonorrhea, a blood draw for syphilis and HIV. Results typically come back within a few days. Many testing sites in Columbia, Charleston, and North Charleston offer confidential or anonymous options. If something comes back positive, treatment for bacterial STDs like chlamydia, gonorrhea, and syphilis is generally a short course of antibiotics.
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