Like most of the rest of the United States, the prevalence of sexually transmitted diseases and sexually transmitted infections in the San Diego metro area has been on a steady rise over the past several years, and newly released federal data from 2018 shows that STD rates don’t seem to be slowing down anytime soon.

According to the Centers for Disease Control and Prevention, the population-adjusted rates of chlamydia and gonorrhea in San Diego metro rose for the fourth consecutive year, while the rate of syphilis saw a minor decline between 2017 and 2018.

Let’s take a closer look at these common STDs and how prevalent they are in the San Diego metro area, including how San Diego compares with the rest of California and other cities across the country.

NOTE: For the purposes of this analysis, we’ll explore CDC data for the San Diego metropolitan statistical area, which covers all of San Diego County, including the cities of San Diego and Carlsbad.

In This Section

Chlamydia in San Diego

Nationally, chlamydia is the most common of the three STDs that are considered federally reportable, meaning local and state health officials are legally obligated to collect and report data for chlamydia, gonorrhea and syphilis. In 2018, chlamydia occurred at a population-adjusted rate of 539.9 in the U.S. overall and 585.3 in the state of California. The rate in San Diego was higher than both.

Between 2014 and 2018, the rate of chlamydia in San Diego climbed by more than one-third, rising from 482.7 per 100,000 people to 656.5 per 100,000.

San Diego chlamydia rate per 100,000 people by year

2014 482.7
2015 526.7
2016 570.8
2017 624.1
2018 656.5

Among the six California cities and metro areas for which the CDC has published data for 2018, San Diego’s rate of chlamydia is the highest by a considerable margin. The lowest among all California cities and metro areas is San Jose, and San Diego’s rate is more than 50% higher than that of San Jose.

San Diego chlamydia rate per 100,000 people compared to other cities and California

San Diego 656.5
San Francisco 619.5
Los Angeles 615.1
Sacramento 606.8
California 585.3
Riverside 541.1
San Jose 428

In addition to setting the chlamydia pace within the state of California, San Diego’s chlamydia rate is also among the highest of the 50 largest U.S. cities and metro areas for which the CDC has published data. San Diego ranks No. 9 for chlamydia and is the highest-ranking Western city in the top 10.

Chlamydia rate per 100,000 people, highest and lowest

Highest
Memphis, TN 931.2
New Orleans, LA 827.6
Virginia Beach, VA 819.4
Milwaukee, WI 789.3
Richmond, VA 683.4
Indianapolis, IN 675.8
Charlotte, NC 672.5
Cleveland, OH 668.9
San Diego, CA 656.5
Philadelphia, PA 637.8
Lowest
Pittsburgh, PA 369.6
San Jose, CA 428
Boston, MA-NH 436.5
Salt Lake City, UT 454.8
Minneapolis-St. Paul, MN 461.5
Providence, RI 464.9
Hartford, CT 473.9
Portland, OR 482.2
Seattle-Tacoma, WA 484.7
Louisville, KY 487.7

In addition to high current rates of chlamydia, San Diego recorded one of the highest increases in the rate of the STD between 2014 and 2018, placing seventh nationally with a 36% increase in chlamydia over the past half-decade. Still, San Diego’s increase in chlamydia was lower than those recorded by Sacramento and San Francisco. In all, four California cities had among the 10 highest increases in the chlamydia rate.

Percentage increase in chlamydia rate, 2014-2018, highest and lowest

Highest
Washington, DC 81.0%
Boston, MA 44.8%
Sacramento, CA 40.8%
Raleigh, NC 40.0%
San Francisco, CA 39.7%
Charlotte, NC 36.1%
San Diego, CA 36.0%
Las Vegas, NV 35.6%
San Jose, CA 33.1%
Providence, RI 31.4%
Lowest
Louisville, KY -8.3%
San Antonio, TX -0.8%
Birmingham, AL 0.8%
Cincinnati, OH 5.3%
Pittsburgh, PA 8.0%
Austin, TX 8.0%
Richmond, VA 10.2%
Buffalo, NY 10.3%
Houston, TX 10.8%
Indianapolis, IN 11.5%

Gonorrhea in San Diego

Gonorrhea, once known as the clap, is the second most common of the three federally reported STDs with a national rate in 2018 of 179.1 per 100,000 people. California’s rate of 200.3 per 100,000 is a bit higher than the national rate, and San Diego’s 185.3 per 100,000 is smack in the middle of the two.

Still, despite a rate lower than the overall rate for the state, the San Diego county area has seen gonorrhea become considerably more prevalent over the past five years, with the rate rising by more than 75% since 2014.

San Diego gonorrhea rate per 100,000 people by year

2014 104.8
2015 111.9
2016 150.4
2017 179
2018 185.3

Taking other California cities and metro areas into consideration, gonorrhea is generally less prevalent in San Diego than in other major cities in the Golden State. While San Diego’s chlamydia rate was the highest among all metro areas studied by the CDC, the city’s gonorrhea rate is one of the lowest.

San Diego gonorrhea rate per 100,000 people compared to other cities and California

San Francisco 267.4
Los Angeles 233.7
California 200.3
Sacramento 189.3
San Diego 185.3
Riverside 174.1
San Jose 111.6

Among the 50 major metro areas observed by the CDC, San Diego’s gonorrhea rate puts the city at No. 30. San Diego has a slightly higher gonorrhea rate than similarly sized cities like San Antonio (174 per 100,000) and Dallas (179 per 100,000). Still, the Memphis metro area has by far the highest gonorrhea rate.

Gonorrhea rate per 100,000 people, highest and lowest

Highest
Memphis, TN 404.8
Milwaukee, WI 301.2
Birmingham, AL 292.2
New Orleans LA 280.9
Columbus, OH 272.1
Jacksonville, FL 269.4
San Francisco, CA 267.4
Kansas City, MO 265.7
Cleveland, OH 262.3
Virginia Beach, VA 261.1
San Diego, CA (30) 185.3
Lowest
Boston, MA 110.9
San Jose, CA 111.6
Pittsburgh, PA 112.7
Providence, RI 120.7
Tampa, FL 140.8
Washington, DC 149.8
Miami, FL 156.2
Houston, TX 157.1
Salt Lake City, UT 160.7
Minneapolis-St. Paul, MN 162

All 50 metro areas for which the CDC has published data saw their gonorrhea rates rise between 2014 and 2018, with an average increase of more than 60%. San Diego’s nearly 77% increase puts the city on the list of the communities with the 20 highest increases in gonorrhea rates. A total of four California cities are among the top 20 with only Los Angeles posting a higher increase than San Diego.

Percentage increase in gonorrhea rate, 2014-2018, top 20

Washington, DC 203.9%
Portland, OR 170.8%
Denver, CO 149.3%
Hartford, CT 122.6%
Providence, RI 112.9%
Kansas City, MO 108.2%
Memphis, TN 107.2%
Boston, MA 93.2%
Buffalo, NY 90.2%
Las Vegas, NV 87.4%
Milwaukee, WI 0.832
Los Angeles, CA 80.9%
Salt Lake City, UT 80.6%
Riverside, CA 80.2%
San Diego, CA 76.8%
Seattle-Tacoma, WA 73.6%
San Francisco, CA 72.7%
Baltimore, MD 72.0%
New York, NY 71.4%
Birmingham, AL 70.8%

Syphilis in San Diego

The least common but most dangerous of the three major STDs, syphilis, is the only STD for which San Diego posted a rate decline between 2017 and 2018. Nationally, the rate of primary and secondary syphilis, which are the stages of the disease in which it’s at its most contagious, is 10.8 per 100,000, and the rate has risen in the U.S. for the past seven straight years. California’s rate of primary and secondary syphilis, 19.2 per 100,000, is the second-highest in the country, behind only Nevada’s 22.7 per 100,000.

Despite a one-year decline, the prevalence of syphilis in the San Diego metro area has climbed by more than 45% over the past half-decade.

San Diego primary and secondary syphilis rate per 100,000 people by year

2014 11.4
2015 14.9
2016 15.8
2017 17.5
2018 16.6

Two California cities, Los Angeles and Sacramento, have syphilis rates higher than the overall state rate and San Diego’s rate of 16.6 per 100,000. This puts San Diego in the middle among the six California cities for which the CDC has published STD data.

San Diego primary and secondary syphilis rate per 100,000 people compared to other cities and California

San Francisco 21.9
Los Angeles 21
Sacramento 20.4
California 19.2
San Diego 16.6
San Jose 14.8
Riverside 13.6

San Diego comes in at No. 12 among the 50 largest metro areas, just behind Louisville and Kansas City. The city has a higher rate than the two cities closest in size, Dallas (10 per 100,000) and San Antonio (11.5 per 100,000).

Primary and secondary syphilis rate per 100,000 people, highest and lowest

Highest
Las Vegas, NV 25.1
San Francisco, CA 21.9
Los Angeles, CA 21
Sacramento, CA 20.4
Atlanta, GA 18.6
New Orleans, LA 18.5
Oklahoma City, OK 18.2
Miami, FL 17.5
Phoenix, AZ 17.3
Louisville, KY 16.9
Kansas City, MO 16.7
San Diego, CA 16.6
Lowest
Hartford, CT 2.5
Pittsburgh, PA 3.9
Milwaukee, WI 4.1
Buffalo, NY 4.7
Cleveland, OH 5.6
Minneapolis-St. Paul, MN 6.6
Cincinnati, OH 7.3
Providence, RI 7.8
Boston, MA 8.1
Denver, CO 8.3
Indianapolis, IN 8.5
Houston, TX 9.4

All but two of the 50 major metro areas we studied had increases in their rates of primary and secondary syphilis over the past five years, with an average increase of more than 75%. While San Diego did post a troubling 45.6% increase, the jump puts the city at No. 28 nationally.

Percentage increase in primary and secondary syphilis rate, 2014-2018, highest and lowest

Highest
Washington, DC 213.5%
Richmond, VA 200.0%
Jacksonville, FL 198.0%
Salt Lake City, UT 191.2%
Nashville, TN 190.2%
Sacramento, CA 183.3%
Oklahoma City, OK 167.6%
Louisville, KY 160.0%
San Jose, CA 142.6%
Virginia Beach, VA 142.0%
San Diego, CA (28) 45.6%
Lowest
Columbus, OH -7.2%
Minneapolis-St. Paul, MN -5.7%
Cincinnati, OH 2.8%
New Orleans, LA 4.5%
Atlanta, GA 5.1%
San Antonio, TX 8.5%
Buffalo, NY 9.3%
Pittsburgh, PA 18.2%
Austin, TX 18.8%
Hartford, CT 19.0%

San Diego County Cities

  • Carlsbad
  • Chula Vista
  • Coronado
  • Del Mar
  • El Cajon
  • Encinitas
  • Escondido
  • Imperial Beach
  • La Mesa
  • Lemon Grove
  • National City
  • Oceanside
  • Poway
  • San Diego
  • San Marcos
  • Santee
  • Solana Beach
  • Vista

Conclusion

Sexually transmitted diseases are becoming more common in San Diego County, across California and throughout the United States. The San Diego County area, which also covers Carlsbad, has seen rates of chlamydia, gonorrhea and syphilis rise over the past half-decade, with some rates and increases putting the city at the top of some pretty problematic lists.

Additional Resources

  • Centers for Disease Control and Prevention, Sexually Transmitted Disease Surveillance 2018, Table 1. Sexually Transmitted Diseases — Reported Cases and Rates of Reported Cases, United States, 1941–2018. (2019.) Retrieved from https://www.cdc.gov/std/stats18/tables/1.htm
  • Centers for Disease Control and Prevention, Sexually Transmitted Disease Surveillance 2018, Table 6. Chlamydia — Reported Cases and Rates of Reported Cases in Selected Metropolitan Statistical Areas (MSAs)* in Alphabetical Order, United States, 2014–2018. (2019.) Retrieved from https://www.cdc.gov/std/stats18/tables/6.htm
  • Centers for Disease Control and Prevention, Sexually Transmitted Disease Surveillance 2018, Table 17. Gonorrhea — Reported Cases and Rates of Reported Cases in Selected Metropolitan Statistical Areas (MSAs)* in Alphabetical Order, United States, 2014–2018. (2019.) Retrieved from https://www.cdc.gov/std/stats18/tables/17.htm
  • Centers for Disease Control and Prevention, Sexually Transmitted Disease Surveillance 2018, Table 30. Primary and Secondary Syphilis — Reported Cases and Rates of Reported Cases in Selected Metropolitan Statistical Areas (MSAs)* in Alphabetical Order, United States, 2014–2018. (2019.) Retrieved from https://www.cdc.gov/std/stats18/tables/30.htm

Published on December 9th, 2019

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by AtHomeSTDKit

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