STD Rates in Washington
CDC surveillance data for Washington covering chlamydia, gonorrhea, syphilis, and HIV — with 15-year trends, state rankings, and national comparisons.
Washington ranks 39th out of 50 states for combined STD burden — meaning most of the country has it worse. A combined rate of 505.3 per 100,000 people puts the state well below the national median of 638.3. But that middling ranking obscures something worth looking at: syphilis, which has climbed more than 660% since 2008, now sits well above the US median — and that trajectory doesn't match the relatively clean numbers everywhere else.
Chlamydia is the quietest part of Washington's picture right now. The 2023 rate of 354.4 per 100,000 is well below the national median of 471.3, and it's actually been falling since 2019, when it peaked at 496.3. That peak-and-retreat pattern has played out across many states, and Washington is on the right side of it. The long-run rise from 2008 to 2023 is only about 9% — modest by any comparison. With 27,687 cases diagnosed in 2023, the raw numbers are sizable, but the trend line is pointing in the right direction.
Gonorrhea tells a sharper story. The rate was 34.2 per 100,000 in 2009. By 2019 it had hit 154.1 — above the national median — before leveling off during the pandemic years. In 2023, it fell to 129.6, down 11.5% from the prior year and now below the US median of 152.2. That 172% rise over the long run is real, but recent data suggests the climb has stalled. Syphilis cuts in the other direction. It's declined two years running — down 13.8% in 2023 — but at 21.3 per 100,000, it remains above the national median of 14.8. That combination of recent decline and above-median rate is the tension Washington's public health data is sitting in right now.
HIV data through 2022 shows Washington hovering between 417 and 495 new diagnoses per year. The 2020 drop to 417 cases almost certainly reflects pandemic-related disruptions to testing access rather than a real reduction in transmission — cases bounced back to 485 by 2022. If you're in Seattle, Spokane, or Tacoma and haven't been tested recently, STDTest.com can help you find a location nearby.
STD Trends in Washington
Washington's chlamydia rate has been falling since its 2019 peak of 496.3 per 100,000 — it's now at 354.4, about 25% below the national median of 471.3. That's a meaningful retreat, and the long-run increase since 2008 is only around 9%, one of the flatter trajectories in the country. The trend here isn't a crisis story; it's a plateau that has quietly turned into a decline.
Gonorrhea in Washington rose 172% between 2008 and its peak years around 2018-2019 — going from a rate of 47.6 to 154.1 per 100,000. Since then, it's pulled back, and the 2023 rate of 129.6 now sits below the national median of 152.2 for the first time in several years. The 11.5% single-year drop in 2023 is the steepest decline Washington has seen in the recent trend.
Syphilis is the disease that most complicates Washington's otherwise improving picture. The rate has risen more than 660% since 2008 — from 2.8 to a peak of 24.7 in 2022 — and even after two consecutive years of decline, the 2023 rate of 21.3 per 100,000 remains well above the national median of 14.8. The decline is real, but the state is still operating at a level it didn't see for most of the past two decades.
Washington's HIV diagnosis data runs through 2022 and shows a relatively stable pattern, with new cases ranging from 417 to 495 per year between 2017 and 2022. The 2020 dip to 417 cases — the lowest point in the window — is consistent with pandemic-related drops in testing access seen nationally and likely understates actual transmission that year. By 2022, diagnoses had returned to 485, close to the pre-pandemic range.
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Washington vs National Average
Comparing 2023 rates against the U.S. median across all 50 states.
| Infection | Washington | US Median | Difference |
|---|---|---|---|
| Chlamydia | 354.4 | 471.3 | 24.8% below |
| Gonorrhea | 129.6 | 152.2 | 14.8% below |
| Syphilis (P&S) | 21.3 | 14.8 | 43.9% above |
STD Rates by County
County-level data from CDC surveillance. Ranked by combined rate per 100,000.
| County | State Rank | Combined | Chlamydia | Gonorrhea | Syphilis |
|---|---|---|---|---|---|
| Adams County | #1 of 39 | 999.0 | 927.0 | 57.6 | 14.4 |
| Yakima County | #2 of 39 | 935.6 | 743.1 | 141.1 | 51.4 |
| Franklin County | #3 of 39 | 802.8 | 654.3 | 130.3 | 18.2 |
| Whitman County | #4 of 39 | 729.0 | 685.2 | 39.6 | 4.2 |
| Pierce County | #5 of 39 | 662.3 | 466.8 | 164.7 | 30.8 |
| Benton County | #6 of 39 | 606.8 | 472.5 | 114.3 | 20.0 |
| Grant County | #7 of 39 | 579.5 | 456.8 | 101.3 | 21.4 |
| Spokane County | #8 of 39 | 572.1 | 377.9 | 158.1 | 36.1 |
| King County | #9 of 39 | 547.9 | 324.0 | 198.5 | 25.4 |
| Walla Walla County | #10 of 39 | 534.4 | 449.9 | 73.1 | 11.4 |
| Columbia County | #11 of 39 | 493.4 | 345.4 | 148.0 | 0.0 |
| Kittitas County | #12 of 39 | 481.2 | 432.9 | 46.1 | 2.2 |
| Clark County | #13 of 39 | 462.6 | 346.0 | 98.6 | 18.0 |
| Chelan County | #14 of 39 | 460.1 | 365.0 | 63.8 | 31.3 |
| Okanogan County | #15 of 39 | 446.1 | 347.7 | 61.8 | 36.6 |
| Cowlitz County | #16 of 39 | 425.2 | 334.0 | 79.7 | 11.5 |
| Douglas County | #17 of 39 | 419.6 | 354.9 | 44.6 | 20.1 |
| Thurston County | #18 of 39 | 412.7 | 315.4 | 84.6 | 12.7 |
| Lewis County | #19 of 39 | 406.2 | 327.3 | 62.7 | 16.2 |
| Mason County | #20 of 39 | 400.6 | 315.8 | 65.8 | 19.0 |
| Whatcom County | #21 of 39 | 349.3 | 277.3 | 62.5 | 9.5 |
| Kitsap County | #22 of 39 | 343.3 | 266.2 | 67.0 | 10.1 |
| Snohomish County | #23 of 39 | 335.4 | 252.7 | 74.7 | 8.0 |
| Grays Harbor County | #24 of 39 | 323.5 | 244.5 | 69.9 | 9.1 |
| Skagit County | #25 of 39 | 320.4 | 271.7 | 43.4 | 5.3 |
| Klickitat County | #26 of 39 | 275.6 | 212.0 | 55.1 | 8.5 |
| Lincoln County | #27 of 39 | 255.6 | 178.9 | 68.2 | 8.5 |
| Wahkiakum County | #28 of 39 | 251.9 | 188.9 | 63.0 | 0.0 |
| Island County | #29 of 39 | 220.2 | 178.5 | 33.6 | 8.1 |
| Asotin County | #30 of 39 | 217.3 | 199.6 | 17.7 | 0.0 |
| Ferry County | #31 of 39 | 200.0 | 186.7 | 13.3 | 0.0 |
| Pend Oreille County | #32 of 39 | 194.9 | 125.3 | 69.6 | 0.0 |
| Clallam County | #33 of 39 | 173.9 | 141.7 | 30.9 | 1.3 |
| Pacific County | #34 of 39 | 173.6 | 111.6 | 45.5 | 16.5 |
| Stevens County | #35 of 39 | 170.0 | 110.6 | 59.4 | 0.0 |
| Jefferson County | #36 of 39 | 148.3 | 109.7 | 29.7 | 8.9 |
| San Juan County | #37 of 39 | 145.4 | 113.1 | 26.9 | 5.4 |
| Skamania County | #38 of 39 | 79.1 | 71.2 | 0.0 | 7.9 |
| Garfield County | #39 of 39 | 42.3 | 42.3 | 0.0 | 0.0 |
What the numbers mean — and what to do about them
Washington's combined STD rate of 505.3 per 100,000 translates to roughly 39,500 diagnosed cases of chlamydia, gonorrhea, and syphilis in 2023 alone. The state ranks in the lower-burden half of the country — 39th out of 50 — and several of its trend lines are moving in the right direction. But "lower burden" doesn't mean low risk. Syphilis remains above the national median, and Washington's gonorrhea rate is 172% higher than it was in 2008, even after recent declines.
The disease to watch most closely is syphilis. Even with two consecutive years of decline, Washington's rate of 21.3 per 100,000 is still 44% above the national median. Syphilis is also frequently asymptomatic in early stages — meaning people can transmit it without knowing they're infected. The same is true for chlamydia, which causes no noticeable symptoms in a large share of those who carry it. That's how these numbers persist even in states where awareness is relatively high: the gap between actual infections and diagnosed cases is always wider than the official data shows.
If you live in Seattle, Spokane, or Tacoma — or anywhere in Washington — and haven't been tested in the past year, the state's syphilis trajectory is reason enough to check. Washington's syphilis rate increased more than 660% over fifteen years before recently beginning to ease. That kind of long climb doesn't reverse itself without people actually getting tested and treated. STDTest.com can show you exactly where to get tested in Washington today.
WHO SHOULD GET TESTED
Anyone sexually active in Washington should consider routine testing, particularly given the state's above-median syphilis rate and the long-run rise in gonorrhea. Sexually active adults under 25 face the highest chlamydia burden nationally. Those with multiple partners, or who live in higher-density areas like Seattle or Tacoma where rates tend to concentrate, are at elevated risk across all three diseases.
HOW OFTEN
Once a year is a reasonable floor for sexually active adults in Washington. Given that syphilis remains above the national median and gonorrhea climbed steeply over the past decade before only recently stabilizing, those with multiple partners or inconsistent barrier use should test every three to six months. Washington's chlamydia trend has improved, but annual screening is still standard for anyone under 25.
WHAT TO EXPECT
STD testing in Washington is straightforward — most tests involve a urine sample, a swab, or a blood draw depending on what's being screened. Results typically come back within a few days. Many clinics in Seattle, Spokane, and Tacoma offer confidential testing with no requirement to involve your primary care provider. If something comes back positive, treatment for chlamydia, gonorrhea, and syphilis is available and effective.
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