STD Rates in South Dakota
CDC surveillance data for South Dakota covering chlamydia, gonorrhea, syphilis, and HIV — with 15-year trends, state comparisons, and national rankings.
South Dakota ranks 8th in the country for combined STD rates — a position that might surprise people who picture rural, sparsely populated states as largely insulated from this kind of disease burden. The combined rate of 858.3 cases per 100,000 people sits well above the national median, and the state has held near the top of that ranking even as some individual disease rates began declining in 2023. The numbers went down last year. The rank didn't move much.
Chlamydia is the most common diagnosis in South Dakota, as it is everywhere, but the state's rate of 531.6 per 100,000 sits about 13% above the national median of 471.3. What's notable isn't the 2023 snapshot — it's the trajectory. The rate has climbed 44% since 2008, rising steadily through the 2010s before peaking around 567 in 2022 and pulling back slightly last year. That pullback is real, but the rate hasn't returned anywhere close to where it was a decade ago. The plateau is at a higher baseline than before.
Gonorrhea tells the sharper story. South Dakota's rate of 253.3 per 100,000 is still more than 66% above the national median of 152.2 — even after a 24.9% drop from 2022 to 2023. That drop sounds significant until you see where it fell from: 363.9 in 2021, a rate that represented a 442% increase from 2008 levels. Syphilis follows a similar arc. The rate was essentially zero in South Dakota for most of the 2000s — then it climbed to 84.3 in 2022 before falling to 73.4 in 2023. That's still nearly five times the national median of 14.8. One year of decline doesn't erase a decade of acceleration.
HIV diagnoses in South Dakota have remained relatively low, hovering between 28 and 42 new cases per year from 2017 to 2022, with a rate that has stayed near 5 per 100,000. The 2020 figure likely reflects pandemic-related drops in testing rather than a genuine reduction in transmission. If you live in Sioux Falls, Rapid City, or Aberdeen — the state's largest population centers and likely its highest-transmission areas — knowing your status matters more than the statewide average suggests.
STD Trends in South Dakota
South Dakota's chlamydia rate has been above the national median for years, but what stands out is how durable that gap has become. The rate rose 44% between 2008 and 2023, climbing steadily before plateauing near its all-time high around 2021-2022. The modest 6.3% decline in 2023 brings the rate to 531.6 — still 13% above the US median of 471.3, and far above where the state started this climb.
Gonorrhea is where South Dakota's numbers become hard to contextualize without stepping back. The rate rose 442% between 2008 and its 2021 peak, reaching 363.9 per 100,000 — more than double the national median at the time. The 2023 rate of 253.3 reflects a sharp two-year decline, but it still sits 66% above the US median of 152.2, meaning the disease remains significantly more prevalent here than in most of the country.
Syphilis in South Dakota was effectively absent for most of the 2000s — the rate was at or near zero from 2000 through 2010. Then it began climbing, slowly at first, and then sharply: by 2022 it hit 84.3 per 100,000, nearly six times the national median of 14.8. The 2023 rate of 73.4 represents a 12.9% decline, but it remains the highest sustained syphilis burden the state has recorded in modern data.
HIV data for South Dakota covers 2017 through 2022, the most recent years available. New diagnoses have ranged from 28 to 42 cases annually, with rates staying close to 5 per 100,000 — a relatively low figure compared to most states. The slight dip to 31 cases in 2021 likely reflects reduced testing access during the pandemic rather than a true decline in transmission, and the 2022 count of 42 cases was the highest in the observed period.
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South Dakota vs National Average
Comparing 2023 rates against the U.S. median across all 50 states.
| Infection | South Dakota | US Median | Difference |
|---|---|---|---|
| Chlamydia | 531.6 | 471.3 | 12.8% above |
| Gonorrhea | 253.3 | 152.2 | 66.4% above |
| Syphilis (P&S) | 73.4 | 14.8 | 395.9% above |
What the numbers mean — and what to do about them
Nearly 8,000 South Dakota residents were diagnosed with chlamydia, gonorrhea, or syphilis in 2023. That's roughly one in every 115 people in the state — in a single year. The combined rate of 858.3 per 100,000 puts South Dakota 8th in the country, ahead of most states people might expect to rank higher. These aren't numbers concentrated in a few urban zip codes. They reflect a disease burden spread across a state with fewer than a million people.
The trend that warrants the most attention is gonorrhea. Even after two years of decline, the rate is still more than 66% above the national median — and because gonorrhea often produces no symptoms, particularly in women, most transmission happens without either person knowing. The same applies to chlamydia, which has held above the national median for years. When rates are this elevated and a large share of cases go undetected, the diagnosed numbers represent only part of what's actually circulating.
If you live in Sioux Falls, Rapid City, or Aberdeen, routine testing isn't a precaution reserved for high-risk situations — it's how you stay ahead of infections that rarely announce themselves. South Dakota's STD rate has been climbing for the better part of fifteen years, and the recent one-year dip doesn't change that trajectory. STDTest.com can show you exactly where to get tested in your city today.
WHO SHOULD GET TESTED
Sexually active adults in South Dakota, particularly those in Sioux Falls, Rapid City, and Aberdeen where transmission pressure is highest. South Dakota's gonorrhea rate is 66% above the national median and its syphilis rate is nearly five times the median — both diseases that often show no symptoms. Anyone with a new or multiple partners should test routinely, not just when something feels wrong.
HOW OFTEN
Once a year is a reasonable minimum for sexually active adults given South Dakota's above-median rates across all three major STDs. If you have multiple partners or a new partner, every 3 to 6 months is more appropriate. South Dakota's chlamydia and gonorrhea rates have both run above the national median for years — annual testing assumes a lower baseline risk than the data supports.
WHAT TO EXPECT
STD testing is fast and mostly 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, both chlamydia and gonorrhea are curable with antibiotics, and syphilis is treatable when caught early. The hardest part is usually just scheduling the appointment.
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