Rates of several common sexually transmitted diseases have risen steadily across the United States for the past several years, and Washington D.C. is one of the epicenters of this unfortunate upward trend.
The federal Centers for Disease Control reported that while the District generally did not lead cities in 2018 when it comes to overall rates, few cities have seen increases in the rates of chlamydia, gonorrhea and syphilis that rival the jump recorded in D.C.
How common are these sexually transmitted diseases in the nation’s capital and surrounding metro areas, which includes the city of Washington and counties in Virginia, Maryland and West Virginia as well as the cities of Arlington and Alexandria, both in the commonwealth of Virginia? To understand the prevalence of sexually transmitted infections in the D.C. metro area, we’ll examine CDC data for the five-year period between 2014 and 2018 for three STIs, chlamydia, gonorrhea, and primary and secondary syphilis, for which federal law mandates local and state health officials gather and report data.
In This Section
- Chlamydia in D.C
- Gonorrhea in D.C
- Syphilis in D.C
Chlamydia in D.C.
Of the three STDs, chlamydia is by far the most common. More than 1.7 million new chlamydia infections occurred in the United States in 2018, and the overall U.S. population-adjusted rate was 539.9 per 100,000 people. This represents a nearly 20% increase over the past five years, and the national chlamydia rate is at its highest point on record.
Washington’s chlamydia rate has climbed much more dramatically than the national rate, rising by more than 80% over the past half-decade.
Washington, D.C. chlamydia rate per 100,000 people by year
| 2014 | 304 |
| 2015 | 309.8 |
| 2016 | 346.9 |
| 2017 | 533 |
| 2018 | 550.3 |
The District’s chlamydia rate is near the middle of other areas in the region, including the three states in the metro area as well as several nearby major cities, though Washington’s rate is the lowest among nearby cities.
Washington, D.C. chlamydia rate per 100,000 people compared to area cities and states
| Virginia Beach | 819.4 |
| Philadelphia | 637.8 |
| Baltimore | 622 |
| Maryland | 586.3 |
| Washington, D.C. | 550.3 |
| Virginia | 507.3 |
| West Virginia | 198.2 |
Among the 50 largest U.S. metro areas, Washington’s chlamydia rate is in the bottom half with the District ranking No. 32 among the 50.
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 |
| Washington, DC (32) | 550.3 |
A relatively low rate is where the good news ends, though. That’s because if trends continue the way they are headed in Washington, the city won’t be in the bottom half nationally for long. In fact, Washington’s increase in the chlamydia rate between 2014 and 2018 is by far the largest such increase among the 50 largest cities in the country.
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 D.C.
More than 1.1 million new cases of gonorrhea, also known as the clap, were reported in the U.S. in 2018 for a population-adjusted rate of 179.1 per 100,000 people. The District of Columbia did manage to record a one-year drop in this rate between 2017 and 2018, but overall, the rate has exploded.
Between 2014 and 2018, the gonorrhea rate in Washington climbed by more than 200%, by far the biggest increase among all major cities and metro areas.
Washington, D.C. gonorrhea rate per 100,000 people by year
| 2014 | 49.3 |
| 2015 | 49.3 |
| 2016 | 70.7 |
| 2017 | 155.7 |
| 2018 | 149.8 |
Washington ranks in the bottom half among states and major cities in the region with the lowest rate of the four cities on the list.
Washington, D.C. gonorrhea rate per 100,000 people compared to area cities and states
| Virginia Beach | 261.1 |
| Baltimore | 213.6 |
| Philadelphia | 198.9 |
| Maryland | 170.3 |
| Washington, D.C. | 149.8 |
| Virginia | 139 |
| West Virginia | 62.9 |
Washington’s population-adjusted gonorrhea rate is one of the lowest among the 50 biggest American cities and metro areas, ranking the city just behind Tampa and ahead of Miami.
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 |
| 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 |
But, as we’ve already discussed, the relatively low gonorrhea rate in Washington is mitigated by the fact that the city has seen the largest increase in gonorrhea over the past five years among all major American cities.
Percentage increase in gonorrhea rate, 2014-2018, top 10
| 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% |
Syphilis in D.C.
Nearly 35,000 new cases of primary and secondary syphilis, the two earliest and most contagious stages of the dangerous bacterial infection, were reported in 2018. This makes syphilis by far the least common of the three major STDs, but syphilis is also the most dangerous, as untreated syphilis can lead to serious health problems, including organ and nerve damage.
Nationally, primary and secondary syphilis have roared to prominence in recent years, nearly doubling since 2014 and standing at the highest rate recorded since the early 1990s. In Washington, D.C., similar increases have been noted.
Primary and secondary syphilis have risen every year for the past five in Washington, rising by nearly 215% over the past five years.
Washington, D.C. primary and secondary syphilis rate per 100,000 people by year
| 2014 | 3.7 |
| 2015 | 3.8 |
| 2016 | 4.5 |
| 2017 | 10.3 |
| 2018 | 11.6 |
Washington’s population-adjusted rate of primary and secondary syphilis places the metro D.C. area smack in the middle of its regional neighbors, and the metro area has a lower rate than two other major cities nearby but a higher rate than Philadelphia.
Washington, D.C. primary and secondary syphilis rate per 100,000 people compared to area cities and states
| Baltimore | 15.9 |
| Maryland | 12.2 |
| Virginia Beach | 12.1 |
| Washington, D.C. | 11.6 |
| Philadelphia | 9.7 |
| Virginia | 8.3 |
| West Virginia | 3.6 |
Washington ranks No. 32 among the 50 biggest American cities and metro areas with a primary and secondary syphilis rate that’s less than half that of the national leader, Las Vegas.
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 |
| Atlantal, 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 |
| 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 |
| Washington, DC (32) | 11.6 |
As with both chlamydia and gonorrhea, Washington has seen the highest percentage increase in the primary and secondary syphilis rate among the 50 biggest American cities over the past five years.
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% |
| 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% |
Only a few cities have seen rates of any of the three STDs fall over the past five years, and the average increase is about 53%. But the nation’s capital posted nation-leading increases for all three STIs, with an average increase in the triple digits.
Average percentage increase, chlamydia, gonorrhea, and primary and secondary syphilis, 2014-2018, top 10
| Washington, DC | 166.1% |
| Salt Lake City, UT | 96.8% |
| Sacramento, CA | 95.5% |
| Nashville, TN | 87.5% |
| Jacksonville, FL | 87.0% |
| Richmond, VA | 81.2% |
| Memphis, TN | 79.5% |
| Portland, OR | 77.2% |
| Oklahoma City, OK | 75.5% |
| Denver, CO | 72.8% |
Conclusion
The Washington, D.C. metro area has seen disturbingly large increases in the prevalence of three common but treatable sexually transmitted infections over the past five years. While the metro area does not generally have rates of these STDs that are among the national leaders, the very rapid increase of STDs in the nation’s capital is distressing, to say the least, particularly considering that all three STDs are easily treated and cured in most people.
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
by AtHomeSTDKit
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