Sexually transmitted diseases, or STDs, are on the rise in the state of Oklahoma and across the United States. In fact, according to the federal Centers for Disease Control and Prevention, the U.S. has recorded four straight years of increases in the national rates of chlamydia, gonorrhea, and primary and secondary syphilis. Not only are the rates of most STDs rising in Oklahoma, the state already has some of the highest rates of STDs in the country.

Which sexually transmitted diseases and infections are Oklahomans most at risk of contracting, how has prevalence of STDs changed in our state over time, and what geographic differences can be noted when digging down into city- and county-level data? To answer all these questions, we’ll examine CDC data as well as information from the Oklahoma State Department of Health.

Chlamydia Rates in Oklahoma

More than 21,000 people were diagnosed with chlamydia in Oklahoma in 2017, placing the state 26th among all states when counting sheer numbers. But after adjusting for population differences, Oklahoma rises to 16th, and the state’s chlamydia rate is about 5% higher than the overall U.S. rate.

Chlamydia infections per 100,000 people

Highest
Alaska 799.8
Louisiana 742.4
Mississippi 707.6
New Mexico 651.6
South Carolina 649.8
Georgia 623.7
Alabama 615.5
North Carolina 612.2
New York 591.6
Illinois 589.9
Oklahoma 554.4
Total 528.8
Lowest
North Dakota 432.5
Massachusetts 425.7
New Jersey 392
Idaho 368.4
Wyoming 365.8
Maine 342.1
Utah 332.2
New Hampshire 330.5
Vermont 297.5
West Virginia 226.1

Chlamydia has been rising in prevalence in Oklahoma, with the population-adjusted rate of the disease climbing more than 25% between 2012 and 2017.

Oklahoma chlamydia rate by year (cases per 100,000 people)

2012 307
2013 317.8
2014 334.9
2015 350.2
2016 385
2017 392

Six of the 10 states with the highest chlamydia rates are in the South, and Oklahoma ranks in the bottom half of the region. Oklahoma’s rate is about 25% lower than regional leader Louisiana.

Chlamydia infection rate, Southern states (cases per 100,000 people)

Louisiana 742.4
Mississippi 707.6
South Carolina 649.8
Georgia 623.7
Alabama 615.5
North Carolina 612.2
Maryland 586.3
Arkansas 579.6
Delaware 566.3
Oklahoma 554.4
Texas 543.9
Tennessee 522.5
Virginia 488.3
Florida 485.2
Kentucky 435.4
West Virginia 226.1

 Gonorrhea Rates in Oklahoma

Oklahoma’s gonorrhea rate is sixth-highest in the nation after adjusting for differences in population. The state’s rate is nearly 35% higher than the overall national rate.

Gonorrhea infections per 100,000 people

Highest
Mississippi 309.8
Alaska 295.1
Louisiana 256.7
South Carolina 254.4
Alabama 245.7
Oklahoma 231.4
Arkansas 224.5
North Carolina 220.9
Georgia 217.5
Ohio 216.3
Total 171.9
Lowest
Rhode Island 102.9
Hawaii 95.1
Utah 83.3
Montana 75
West Virginia 70.8
Wyoming 70.4
Idaho 58.6
Maine 46.6
New Hampshire 38.4
Vermont 32.5

Gonorrhea frequency in Oklahoma has gone up every year since 2012, nearly doubling in that time.

Oklahoma gonorrhea rate by year (cases per 100,000 people)

2012 116.4
2013 137.7
2014 158.2
2015 167.3
2016 193.6
2017 231.4

Eight Southern states are among the top 10 nationally, and Oklahoma is in the top half of the region.

Gonorrhea infection rate, Southern states (cases per 100,000 people)

Mississippi 309.8
Louisiana 256.7
South Carolina 254.4
Alabama 245.7
Oklahoma 231.4
Arkansas 224.5
North Carolina 220.9
Georgia 217.5
Delaware 187.4
Tennessee 185
Maryland 170.3
Texas 170.2
Kentucky 167.2
Florida 153.7
Virginia 143.3
West Virginia 70.8

Syphilis Rates in Oklahoma

Oklahoma ranks No. 12 among the 50 states for the rate of primary and secondary syphilis, though the state’s rate is equal to the overall national rate.

Primary and secondary syphilis infections per 100,000 people

Highest
Nevada 20
California 17.1
Georgia 14.5
Louisiana 14.5
Arizona 13.1
Maryland 12.2
New York 11.9
Florida 11.6
North Carolina 10.6
Mississippi 10.4
Illinois 9.6
Oklahoma 9.5
Total 9.5
Lowest
South Dakota 3.8
West Virginia 3.4
New Hampshire 3.2
Iowa 3.2
Connecticut 3.1
Wisconsin 3
Nebraska 2.3
Vermont 2.1
Alaska 1.8
Wyoming 0.7

The prevalence of primary and secondary syphilis, the two earliest stages of syphilis, has exploded in Oklahoma over the past half-decade, with the rate climbing more than 330% between 2012 and 2017.

Oklahoma primary and secondary syphilis rate by year (cases per 100,000 people)

2012 2.2
2013 3.1
2014 3.9
2015 5.3
2016 6.7
2017 9.5

Six of the 10 states with the highest syphilis rates are in the South, and Oklahoma ranks near the middle of the region.

Primary and secondary syphilis infection rates, Southern states (cases per 100,000 people)

Georgia 14.5
Louisiana 14.5
Maryland 12.2
Florida 11.6
North Carolina 10.6
Mississippi 10.4
Oklahoma 9.5
Alabama 8.7
Texas 8
Arkansas 7.8
Tennessee 7.3
South Carolina 7.3
Virginia 6
Delaware 6
Kentucky 5.9
West Virginia 3.4

HIV & Other STD Rates in Oklahoma

HIV

More than 300 people were newly diagnosed with HIV in Oklahoma in 2017, and the state’s population-adjusted rate places it among the 25 states with the lowest rates of the virus. But Oklahoma’s HIV rate has gone up, rising 3% between 2016 and 2017. See How to Test for HIV

Hepatitis B & C

Acute infections of both hepatitis B and hepatitis C occur at rates near the overall national rate in Oklahoma. But both viral infections have seen their rates in Oklahoma decline over the past few years. Hep B has dropped by nearly 62%, while hep C rates have fallen by a similar amount. See How to Test for Hepatitis

HPV

Detailing exactly how many people in Oklahoma are infected with human papillomavirus, the most common STD in the world, is difficult because so few people are ever diagnosed. But looking at cancers related to HPV can help focus attention on how common untreated HPV is, since several cancers are caused mainly by HPV, including cervical, penile and anal cancer. HPV-related cancer occurs in Oklahoma at a rate of 13.2 per 100,000, higher than the national median of 11.7 per 100,000. See How to Test for HPV

STDs in Oklahoma Cities & Counties

Oklahoma’s position among the leaders in multiple STDs is driven largely by just a few locales across the state, including Oklahoma City, Tulsa and Lawton.

Chlamydia

Tulsa and Oklahoma City account for nearly two-thirds of all chlamydia cases in Oklahoma, though some counties not in either metro area have higher rates than others.

Oklahoma counties by chlamydia infection rate (cases per 100,000 people), top 10

Comanche 913.7
Custer 860.3
Woods 836.9
Muskogee 777.2
Ottawa 681.6
Oklahoma 673.5
Payne 653.3
Tulsa 642.2
Pottawatomie 618.3
Okmulgee 617.1

Gonorrhea

The Oklahoma City metro area accounted for more than 1 in 3 gonorrhea cases in the state, and the metro has the 14th-highest prevalence of gonorrhea among all major U.S. metro areas.

Oklahoma counties by gonorrhea infection rate (cases per 100,000 people), top 10

Muskogee 361.3
Comanche 330.8
Oklahoma 281.7
Adair 271.5
Choctaw 268.7
Tulsa 268
Okmulgee 244.8
Woodward 225.8
Bryan 221.6
Jackson 215.7

Primary and secondary syphilis

Nearly 2 in 3 of all infections of primary and secondary syphilis in Oklahoma were diagnosed in people residing in the Oklahoma City metro area, and the area ranks 10th out of all major U.S. metro areas for syphilis prevalence.

Oklahoma counties by primary and secondary syphilis infection rate (cases per 100,000 people)

Ellis 24.5
Latimer 19.2
Cotton 16.8
Oklahoma 16.5
Jefferson 16.1
Pottawatomie 12.4
Comanche 11.5
Nowata 9.6
Johnston 9
Atoka 7.2

Conclusion

Oklahoma’s picture of STD-related health is largely negative and seems to be getting worse. The state ranks among the leaders when it comes to the prevalence of several sexually transmitted diseases and infections, and rates are generally climbing for most of the diseases we’ve examined. But progress can be made, and one of the best ways to do that is to get yourself tested so that you are aware of your STD status. Most sexually active people will contract an STD at some point in their lives, and there’s no shame in having one. But ensuring that you do your part to stem the tide of STDs in Oklahoma means finding out your status so that you can get treated, if possible, and avoid passing your infections along to others.

Additional References

 Note: Some states have published more recent data for chlamydia, gonorrhea, and primary and secondary syphilis. For states in which that’s the case, we have substituted the individual state data for 2018 and used that in our rankings, while other states’ rankings are based on 2017 numbers. In some cases, we assume that when the full national dataset is published by the CDC, states’ positions relative to other states will change some, though those changes are unlikely to be dramatic, since the CDC data comes from the states.

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by AtHomeSTDKit

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