STD Rates in Tennessee
CDC surveillance data for Tennessee covering chlamydia, gonorrhea, syphilis, and HIV — with 15-year trends, city-level context, and national comparisons.
Tennessee ranks 19th in the country for STD burden — solidly in the top third nationally, with a combined rate of 718.6 cases per 100,000 people across chlamydia, gonorrhea, and syphilis. That puts the state 13% above the US combined median. But the more interesting story isn't where Tennessee sits today. It's the direction things have been moving — and what happened in 2023 that broke from nearly a decade of upward pressure.
Chlamydia is Tennessee's highest-volume disease, and the state's rate of 517.4 per 100,000 sits about 10% above the US median of 471.3. The long-run trajectory is a steady climb — up roughly 15% since 2008. What's notable in 2023 is a modest pullback: rates dropped 3.8% from 2022. That decline is real, but it follows years of growth, and the rate remains well above where it stood a decade ago. The trend line hasn't reversed — it's paused.
Gonorrhea tells a sharper story. Tennessee's rate has risen 32.5% since 2008, and for several years it ran well above the national median. At its 2021 peak, the rate hit 269.1 per 100,000 — nearly double what it was in 2014. The 2023 number, 186.4, reflects an 18.2% single-year drop, one of the larger one-year declines in the state's recent record. Still, the current rate is 22% above the national median of 152.2. Syphilis, meanwhile, has more than doubled since 2008 — a 124% increase — though its 2023 rate of 14.8 per 100,000 lands exactly at the US median, down 7.5% from 2022's recent high of 16.0.
HIV diagnoses in Tennessee rose steadily from 721 cases in 2017 to 863 in 2022 — a rate of 14.5 per 100,000 by the end of that period. The 2020 dip to 649 cases likely reflects pandemic-era disruptions to testing access rather than an actual decline in transmission. HIV data lags by a few years, so the 2022 figures are the most current available. If you're in Nashville, Memphis, or Knoxville — the state's three most populous cities, and the areas where STD rates tend to concentrate — STDTest.com can help you locate a testing site near you.
STD Trends in Tennessee
Tennessee's chlamydia rate has been climbing since at least 2000, and even after a modest 3.8% dip in 2023, it still sits roughly 10% above the national median of 471.3 per 100,000. The long-run rise of about 15% since 2008 is less a spike than a slow, sustained drift upward. The 2023 decline is worth watching, but one year doesn't define a trend — the state has seen brief pullbacks before.
Gonorrhea is where Tennessee's numbers carry the most weight over time. The rate has risen 32.5% since 2008 and peaked at 269.1 per 100,000 in 2021 before falling sharply. The 2023 rate of 186.4 is down 18.2% in a single year — but it still runs 22% above the national median of 152.2, meaning even after a significant decline, Tennessee remains an above-average state for gonorrhea.
Syphilis in Tennessee has more than doubled since 2008 — a 124% increase that tracks a national resurgence seen across most states. After reaching a recent high of 16.0 per 100,000 in 2022, the rate fell to 14.8 in 2023, landing exactly at the national median. That's a meaningful shift from 2019, when Tennessee's syphilis rate was 9.9 — well below median — suggesting the state has moved from low-burden to average in just a few years.
Tennessee's HIV diagnosis rate climbed from 12.8 per 100,000 in 2017 to 14.5 in 2022 — the most recent year with complete data. The 2020 drop to 649 cases almost certainly reflects reduced testing access during the pandemic rather than a real decline in new infections. The broader trend is a slow but consistent rise, with 863 diagnoses recorded in 2022, the highest count in this six-year window.
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Tennessee vs National Average
Comparing 2023 rates against the U.S. median across all 50 states.
| Infection | Tennessee | US Median | Difference |
|---|---|---|---|
| Chlamydia | 517.4 | 471.3 | 9.8% above |
| Gonorrhea | 186.4 | 152.2 | 22.5% above |
| Syphilis (P&S) | 14.8 | 14.8 | 0% 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 |
|---|---|---|---|---|---|
| Shelby County | #1 of 95 | 1513.8 | 1053.8 | 429.0 | 31.0 |
| Lake County | #2 of 95 | 1260.5 | 819.3 | 425.4 | 15.8 |
| Davidson County | #3 of 95 | 1237.8 | 824.8 | 395.5 | 17.5 |
| Madison County | #4 of 95 | 1195.7 | 912.4 | 270.2 | 13.1 |
| Hardeman County | #5 of 95 | 1181.2 | 954.4 | 215.1 | 11.7 |
| Lauderdale County | #6 of 95 | 1166.3 | 902.1 | 247.9 | 16.3 |
| Haywood County | #7 of 95 | 1096.5 | 825.3 | 259.7 | 11.5 |
| Montgomery County | #8 of 95 | 1056.4 | 796.7 | 245.5 | 14.2 |
| Dyer County | #9 of 95 | 887.7 | 676.7 | 189.1 | 21.9 |
| Hamilton County | #10 of 95 | 805.0 | 572.6 | 192.4 | 40.0 |
| Weakley County | #11 of 95 | 719.4 | 559.2 | 151.1 | 9.1 |
| Gibson County | #12 of 95 | 709.2 | 552.5 | 150.8 | 5.9 |
| Bledsoe County | #13 of 95 | 703.8 | 617.5 | 39.8 | 46.5 |
| Rutherford County | #14 of 95 | 687.8 | 510.2 | 168.9 | 8.7 |
| Knox County | #15 of 95 | 657.6 | 456.6 | 183.2 | 17.8 |
| Carroll County | #16 of 95 | 620.3 | 467.8 | 142.1 | 10.4 |
| Obion County | #17 of 95 | 611.6 | 417.6 | 194.0 | 0.0 |
| Henderson County | #18 of 95 | 577.1 | 463.1 | 103.3 | 10.7 |
| Fayette County | #19 of 95 | 568.2 | 450.5 | 115.4 | 2.3 |
| Maury County | #20 of 95 | 563.3 | 426.1 | 126.4 | 10.8 |
| Crockett County | #21 of 95 | 550.7 | 457.7 | 85.8 | 7.2 |
| Tipton County | #22 of 95 | 549.9 | 422.5 | 120.9 | 6.5 |
| Lincoln County | #23 of 95 | 528.1 | 406.4 | 110.6 | 11.1 |
| Bedford County | #24 of 95 | 488.2 | 403.4 | 81.0 | 3.8 |
| Dekalb County | #25 of 95 | 475.9 | 320.4 | 122.5 | 33.0 |
| Coffee County | #26 of 95 | 466.7 | 346.3 | 117.1 | 3.3 |
| Giles County | #27 of 95 | 459.0 | 384.1 | 65.1 | 9.8 |
| Washington County | #28 of 95 | 442.2 | 302.0 | 131.5 | 8.7 |
| Rhea County | #28 of 95 | 442.2 | 359.6 | 53.1 | 29.5 |
| Henry County | #30 of 95 | 430.0 | 334.8 | 95.2 | 0.0 |
| Marshall County | #31 of 95 | 427.5 | 349.0 | 78.5 | 0.0 |
| Sevier County | #32 of 95 | 426.6 | 352.1 | 63.4 | 11.1 |
| Chester County | #33 of 95 | 420.3 | 357.8 | 56.8 | 5.7 |
| Hamblen County | #34 of 95 | 416.8 | 356.4 | 54.4 | 6.0 |
| Hardin County | #35 of 95 | 415.0 | 323.2 | 84.5 | 7.3 |
| Bradley County | #36 of 95 | 405.0 | 280.5 | 112.0 | 12.5 |
| Sumner County | #37 of 95 | 401.5 | 304.8 | 93.8 | 2.9 |
| Robertson County | #38 of 95 | 397.2 | 315.2 | 76.8 | 5.2 |
| Cocke County | #39 of 95 | 395.6 | 299.4 | 69.5 | 26.7 |
| Wilson County | #40 of 95 | 386.1 | 290.2 | 90.4 | 5.5 |
| Carter County | #41 of 95 | 382.4 | 270.1 | 107.0 | 5.3 |
| Lawrence County | #42 of 95 | 381.7 | 281.9 | 97.6 | 2.2 |
| Anderson County | #43 of 95 | 371.4 | 284.2 | 69.8 | 17.4 |
| Marion County | #44 of 95 | 371.0 | 279.1 | 78.3 | 13.6 |
| Warren County | #45 of 95 | 368.2 | 255.6 | 103.2 | 9.4 |
| Mcnairy County | #46 of 95 | 363.2 | 286.7 | 65.0 | 11.5 |
| Franklin County | #47 of 95 | 358.3 | 284.4 | 73.9 | 0.0 |
| Dickson County | #48 of 95 | 356.0 | 264.4 | 88.1 | 3.5 |
| Mcminn County | #49 of 95 | 353.8 | 278.4 | 75.4 | 0.0 |
| Hancock County | #50 of 95 | 345.0 | 273.1 | 71.9 | 0.0 |
| Meigs County | #51 of 95 | 343.3 | 168.0 | 168.0 | 7.3 |
| Decatur County | #52 of 95 | 343.2 | 326.0 | 17.2 | 0.0 |
| Smith County | #53 of 95 | 336.0 | 282.4 | 48.7 | 4.9 |
| Trousdale County | #54 of 95 | 334.1 | 301.5 | 32.6 | 0.0 |
| Cheatham County | #55 of 95 | 333.8 | 250.9 | 73.4 | 9.5 |
| Jefferson County | #56 of 95 | 333.7 | 273.2 | 58.8 | 1.7 |
| Macon County | #57 of 95 | 328.4 | 253.8 | 70.9 | 3.7 |
| Sullivan County | #58 of 95 | 315.8 | 231.9 | 76.5 | 7.4 |
| Greene County | #59 of 95 | 312.8 | 235.6 | 68.9 | 8.3 |
| Grundy County | #60 of 95 | 293.7 | 222.1 | 57.3 | 14.3 |
| Hickman County | #61 of 95 | 286.6 | 213.0 | 58.1 | 15.5 |
| Putnam County | #62 of 95 | 283.8 | 227.8 | 46.5 | 9.5 |
| Grainger County | #63 of 95 | 283.6 | 198.5 | 68.9 | 16.2 |
| Unicoi County | #64 of 95 | 275.9 | 197.1 | 78.8 | 0.0 |
| Monroe County | #65 of 95 | 275.8 | 209.9 | 49.4 | 16.5 |
| Blount County | #66 of 95 | 275.7 | 213.5 | 58.0 | 4.2 |
| Campbell County | #67 of 95 | 273.4 | 216.3 | 47.2 | 9.9 |
| Moore County | #68 of 95 | 266.7 | 192.6 | 59.3 | 14.8 |
| Polk County | #69 of 95 | 266.1 | 194.1 | 66.5 | 5.5 |
| Benton County | #70 of 95 | 260.9 | 223.6 | 37.3 | 0.0 |
| Wayne County | #71 of 95 | 255.2 | 217.9 | 37.3 | 0.0 |
| White County | #72 of 95 | 254.4 | 160.3 | 55.8 | 38.3 |
| Roane County | #73 of 95 | 251.4 | 192.5 | 55.3 | 3.6 |
| Jackson County | #74 of 95 | 250.8 | 169.9 | 64.7 | 16.2 |
| Hawkins County | #75 of 95 | 249.1 | 192.8 | 54.6 | 1.7 |
| Loudon County | #76 of 95 | 247.6 | 193.1 | 42.9 | 11.6 |
| Van Buren County | #77 of 95 | 246.4 | 154.0 | 77.0 | 15.4 |
| Clay County | #78 of 95 | 246.3 | 181.5 | 25.9 | 38.9 |
| Humphreys County | #79 of 95 | 229.0 | 187.4 | 41.6 | 0.0 |
| Morgan County | #80 of 95 | 227.1 | 185.4 | 32.4 | 9.3 |
| Stewart County | #81 of 95 | 225.0 | 196.9 | 28.1 | 0.0 |
| Cannon County | #82 of 95 | 219.1 | 146.1 | 66.4 | 6.6 |
| Lewis County | #83 of 95 | 214.4 | 168.4 | 38.3 | 7.7 |
| Williamson County | #84 of 95 | 213.6 | 168.6 | 41.2 | 3.8 |
| Sequatchie County | #85 of 95 | 198.1 | 151.5 | 29.1 | 17.5 |
| Scott County | #86 of 95 | 193.9 | 175.9 | 13.5 | 4.5 |
| Union County | #87 of 95 | 192.8 | 159.1 | 33.7 | 0.0 |
| Houston County | #88 of 95 | 190.6 | 178.7 | 11.9 | 0.0 |
| Overton County | #89 of 95 | 188.6 | 145.8 | 25.7 | 17.1 |
| Claiborne County | #90 of 95 | 177.6 | 128.6 | 27.6 | 21.4 |
| Pickett County | #91 of 95 | 175.5 | 156.0 | 19.5 | 0.0 |
| Fentress County | #92 of 95 | 172.6 | 147.2 | 20.3 | 5.1 |
| Johnson County | #93 of 95 | 152.4 | 125.2 | 21.8 | 5.4 |
| Cumberland County | #94 of 95 | 148.2 | 115.8 | 18.5 | 13.9 |
| Perry County | #95 of 95 | 146.2 | 123.7 | 22.5 | 0.0 |
What the numbers mean — and what to do about them
Tennessee recorded just under 51,000 combined chlamydia, gonorrhea, and syphilis diagnoses in 2023. At a combined rate of 718.6 per 100,000, the state sits 13% above the national median — not at the extreme end of the national spectrum, but firmly above average. For a state of 7.1 million people, those numbers represent a steady, ongoing disease burden, not an isolated spike.
The trend that carries the most clinical weight is gonorrhea's long-run rise — up 32.5% since 2008, even after last year's 18.2% single-year decline. Gonorrhea is largely asymptomatic, particularly in women, which means a significant portion of those 13,000+ annual cases go unnoticed and untreated. Untreated gonorrhea can lead to pelvic inflammatory disease, infertility, and increased HIV susceptibility. The 2023 decline may reflect improved treatment or screening uptake, but the underlying rate remains well above the national median — meaning the transmission pool hasn't shrunk as much as the headline drop suggests. Syphilis, meanwhile, has more than doubled since 2008. Tennessee's rate now sits exactly at the national median, but the trajectory over the past 15 years is a reminder that slow-moving trends still compound. Tennessee's gonorrhea rate has run above the national median for years without most residents knowing it. STDTest.com can show you where to get tested today.
WHO SHOULD GET TESTED
Anyone sexually active in Tennessee is a reasonable candidate, but the data points to higher risk for people under 25 (who account for a disproportionate share of chlamydia diagnoses), people with multiple or new partners, and residents of Nashville, Memphis, and Knoxville, where STD rates tend to be higher than state averages. Tennessee's gonorrhea rate is 22% above the national median — that's a population-level signal, not just a statistic.
HOW OFTEN
Given Tennessee's above-median rates for chlamydia and gonorrhea, once a year is a reasonable floor for sexually active adults. If you have more than one partner, or live in a high-density urban area like Memphis or Nashville, every three to six months is more appropriate. Syphilis diagnoses have more than doubled in the state since 2008 — annual syphilis screening is worth adding if you're already testing for other STDs.
WHAT TO EXPECT
STD testing is straightforward — typically a urine sample, blood draw, or swab, depending on what's being screened. Most results come back within a few days. Many clinics in Tennessee offer confidential or anonymous testing, and treatment for chlamydia, gonorrhea, and syphilis is available and effective when caught early. The hardest part is usually just making the appointment.
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