Counties with the highest STI rates in Alabama
Published 10:26 pm Monday, March 18, 2024
Counties with the highest STI rates in Alabama
Sexually transmitted infections are on the rise, putting more people at risk as they spread. Chlamydia rates have nearly doubled since 2000, while the rate of gonorrhea went up by 50% over the same period. The Centers for Disease Control and Prevention reports that syphilis rates are reaching levels last seen in the 1950s.
But some regions of the U.S. are seeing higher rates than others.
Stacker used CDC data to look at which counties reported the highest rate of sexually transmitted infections in Alabama. Counties are ranked by the rate of chlamydia infections, the most prominent STI at the national level, with gonorrhea and then syphilis rates serving as tiebreakers. This story focuses on bacterial infections, which can be cured, rather than viral infections such as HIV and herpes. At the county level, 2021 cases are the most recent available from the CDC, but state and national-level data for 2022 are also included. This story focuses on sexual transmissions and does not include congenital syphilis cases that were inherited from the mother.
Condoms are the most effective way to prevent the spread of STIs for people with multiple sexual partners, but research has found a decreasing rate of condom use among straight, bisexual, and gay male populations.
During the HIV/AIDS epidemic throughout the 1980s and 1990s, public health efforts advocating for condom use helped curb the spread of the virus. Today, however, condoms are no longer the only tool. Pills such as PrEP lower the risk of contracting HIV from sex by as much as 99%.
While more recent data is not available, the latest CDC survey from 2011-2015 showed less than half of unmarried men used condoms during the last time they had sex.
Among high school students having sex, the share using condoms has fallen from 60% in 2011 to 52% in 2021. While one-third of sexually active students used hormonal birth control, only 10% used both condoms and birth control. Methods like the pill and IUDs are effective at preventing pregnancy but do not stop the spread of STIs.
Chlamydia, gonorrhea, and syphilis are technically bacterial infections—meaning they can be cured with antibiotics—but they can still have lasting health impacts, including pelvic inflammatory disease and infertility. These risks are heightened when left untreated, which many STIs are as they don’t obviously present themselves.
The CDC recommends annual testing for cisgender women, transgender men, and gender-nonconforming people with cervixes. It also recommends annual testing for males with male sexual partners. People in these groups who frequently have sex with anonymous partners should be tested every three to six months. Anyone with symptoms should always get tested according to the guidelines.
The CDC says there is little evidence that screening among straight men lowers the spread, and the agency’s limited budget is put towards programs benefiting the most at-risk groups. However, some public health groups advocate for testing among all people regardless of sex and sexual orientation.
Data from the National Survey of Family Growth shows men on average have more opposite-sex sexual partners than women, and some argue that catching STIs throughout a sexual network rather than just for the most at-risk groups could curb their spread.
Soon, a pill may also help counter the spread of STIs. DoxyPEP can be taken 24 to 72 hours after unprotected sex and stops an STI before it becomes spreadable and symptomatic. The CDC has shared proposed guidelines recommending it for men who have sex with men and transgender women. The drug was originally approved for treating inhalation of anthrax, and doctors can prescribe it for off-label use.
Read on to see how STI infection rates in Alabama compare nationally, and the top counties.
Emma Rubin // Stacker
State-level statistics
– Chlamydia cases: 612.1 per 100K (#6 nationally, 31,060 cases)
– Gonorrhea cases: 261.7 per 100K (#7 nationally, 13,279 cases)
– Primary and secondary syphilis cases: 23.5 per 100K (#12 nationally, 1,190 cases)
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#50. Walker County
– Chlamydia cases: 359.5 per 100K people (233 cases)
– Gonorrhea cases: 158.9 per 100K people (103 cases)
– Syphilis cases (non-congenital): 12.3 per 100K people (8 cases)
— Primary and secondary syphilis: 10.8 per 100K people (7 cases)
— Nonprimary and nonsecondary early syphilis: 1.5 per 100K people (1 case)
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#49. Choctaw County
– Chlamydia cases: 367.0 per 100K people (46 cases)
– Gonorrhea cases: 183.5 per 100K people (23 cases)
– Syphilis cases (non-congenital): 16.0 per 100K people (2 cases)
— Primary and secondary syphilis: 0 cases
— Nonprimary and nonsecondary early syphilis: 16.0 per 100K people (2 cases)
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#48. Lamar County
– Chlamydia cases: 409.1 per 100K people (56 cases)
– Gonorrhea cases: 189.9 per 100K people (26 cases)
– Syphilis cases (non-congenital): 51.1 per 100K people (7 cases)
— Primary and secondary syphilis: 43.8 per 100K people (6 cases)
— Nonprimary and nonsecondary early syphilis: 7.3 per 100K people (1 case)
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#47. Clay County
– Chlamydia cases: 422.8 per 100K people (60 cases)
– Gonorrhea cases: 133.9 per 100K people (19 cases)
– Syphilis cases (non-congenital): 7.0 per 100K people (1 case)
— Primary and secondary syphilis: 0 cases
— Nonprimary and nonsecondary early syphilis: 7.0 per 100K people (1 case)
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#46. Washington County
– Chlamydia cases: 448.9 per 100K people (68 cases)
– Gonorrhea cases: 250.9 per 100K people (38 cases)
– Syphilis cases (non-congenital): 6.6 per 100K people (1 case)
— Primary and secondary syphilis: 0 cases
— Nonprimary and nonsecondary early syphilis: 6.6 per 100K people (1 case)
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#45. Lauderdale County
– Chlamydia cases: 462.6 per 100K people (435 cases)
– Gonorrhea cases: 196.7 per 100K people (185 cases)
– Syphilis cases (non-congenital): 40.4 per 100K people (38 cases)
— Primary and secondary syphilis: 21.3 per 100K people (20 cases)
— Nonprimary and nonsecondary early syphilis: 19.1 per 100K people (18 cases)
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#44. Geneva County
– Chlamydia cases: 468.1 per 100K people (125 cases)
– Gonorrhea cases: 333.3 per 100K people (89 cases)
– Syphilis cases (non-congenital): 15.0 per 100K people (4 cases)
— Primary and secondary syphilis: 7.5 per 100K people (2 cases)
— Nonprimary and nonsecondary early syphilis: 7.5 per 100K people (2 cases)
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#43. Etowah County
– Chlamydia cases: 469.2 per 100K people (484 cases)
– Gonorrhea cases: 214.2 per 100K people (221 case)
– Syphilis cases (non-congenital): 10.7 per 100K people (11 case)
— Primary and secondary syphilis: 3.9 per 100K people (4 cases)
— Nonprimary and nonsecondary early syphilis: 6.8 per 100K people (7 cases)
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#42. Covington County
– Chlamydia cases: 474.4 per 100K people (178 cases)
– Gonorrhea cases: 197.2 per 100K people (74 cases)
– Syphilis cases (non-congenital): 8.0 per 100K people (3 cases)
— Primary and secondary syphilis: 2.7 per 100K people (1 case)
— Nonprimary and nonsecondary early syphilis: 5.3 per 100K people (2 cases)
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#41. Morgan County
– Chlamydia cases: 475.5 per 100K people (588 cases)
– Gonorrhea cases: 270.9 per 100K people (335 cases)
– Syphilis cases (non-congenital): 17.8 per 100K people (22 cases)
— Primary and secondary syphilis: 11.3 per 100K people (14 cases)
— Nonprimary and nonsecondary early syphilis: 6.5 per 100K people (8 cases)
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#40. Lee County
– Chlamydia cases: 493.7 per 100K people (875 cases)
– Gonorrhea cases: 228.0 per 100K people (404 cases)
– Syphilis cases (non-congenital): 20.9 per 100K people (37 cases)
— Primary and secondary syphilis: 10.2 per 100K people (18 cases)
— Nonprimary and nonsecondary early syphilis: 10.7 per 100K people (19 cases)
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#39. Tallapoosa County
– Chlamydia cases: 516.8 per 100K people (212 cases)
– Gonorrhea cases: 251.1 per 100K people (103 cases)
– Syphilis cases (non-congenital): 14.6 per 100K people (6 cases)
— Primary and secondary syphilis: 2.4 per 100K people (1 case)
— Nonprimary and nonsecondary early syphilis: 12.2 per 100K people (5 cases)
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#38. Colbert County
– Chlamydia cases: 516.8 per 100K people (297 cases)
– Gonorrhea cases: 297.5 per 100K people (171 case)
– Syphilis cases (non-congenital): 27.8 per 100K people (16 cases)
— Primary and secondary syphilis: 12.2 per 100K people (7 cases)
— Nonprimary and nonsecondary early syphilis: 15.7 per 100K people (9 cases)
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#37. Pickens County
– Chlamydia cases: 521.2 per 100K people (98 cases)
– Gonorrhea cases: 276.6 per 100K people (52 cases)
– Syphilis cases (non-congenital): 31.9 per 100K people (6 cases)
— Primary and secondary syphilis: 21.3 per 100K people (4 cases)
— Nonprimary and nonsecondary early syphilis: 10.6 per 100K people (2 cases)
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#36. Randolph County
– Chlamydia cases: 541.2 per 100K people (119 cases)
– Gonorrhea cases: 300.2 per 100K people (66 cases)
– Syphilis cases (non-congenital): 81.9 per 100K people (18 cases)
— Primary and secondary syphilis: 13.6 per 100K people (3 cases)
— Nonprimary and nonsecondary early syphilis: 68.2 per 100K people (15 cases)
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#35. Calhoun County
– Chlamydia cases: 545.0 per 100K people (632 cases)
– Gonorrhea cases: 233.7 per 100K people (271 case)
– Syphilis cases (non-congenital): 18.1 per 100K people (21 case)
— Primary and secondary syphilis: 6.0 per 100K people (7 cases)
— Nonprimary and nonsecondary early syphilis: 12.1 per 100K people (14 cases)
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#34. Conecuh County
– Chlamydia cases: 556.1 per 100K people (63 cases)
– Gonorrhea cases: 123.6 per 100K people (14 cases)
– Syphilis cases (non-congenital): 8.8 per 100K people (1 case)
— Primary and secondary syphilis: 8.8 per 100K people (1 case)
— Nonprimary and nonsecondary early syphilis: 0 cases
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#33. Elmore County
– Chlamydia cases: 556.5 per 100K people (497 cases)
– Gonorrhea cases: 213.9 per 100K people (191 case)
– Syphilis cases (non-congenital): 16.8 per 100K people (15 cases)
— Primary and secondary syphilis: 1.1 per 100K people (1 case)
— Nonprimary and nonsecondary early syphilis: 15.7 per 100K people (14 cases)
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#32. Autauga County
– Chlamydia cases: 577.0 per 100K people (341 case)
– Gonorrhea cases: 225.1 per 100K people (133 cases)
– Syphilis cases (non-congenital): 32.2 per 100K people (19 cases)
— Primary and secondary syphilis: 18.6 per 100K people (11 case)
— Nonprimary and nonsecondary early syphilis: 13.5 per 100K people (8 cases)
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#31. Coffee County
– Chlamydia cases: 577.8 per 100K people (313 cases)
– Gonorrhea cases: 324.9 per 100K people (176 cases)
– Syphilis cases (non-congenital): 20.3 per 100K people (11 case)
— Primary and secondary syphilis: 16.6 per 100K people (9 cases)
— Nonprimary and nonsecondary early syphilis: 3.7 per 100K people (2 cases)
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#30. Madison County
– Chlamydia cases: 602.2 per 100K people (2,380 cases)
– Gonorrhea cases: 330.0 per 100K people (1,304 cases)
– Syphilis cases (non-congenital): 20.7 per 100K people (82 cases)
— Primary and secondary syphilis: 9.1 per 100K people (36 cases)
— Nonprimary and nonsecondary early syphilis: 11.6 per 100K people (46 cases)
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#29. Escambia County
– Chlamydia cases: 607.6 per 100K people (223 cases)
– Gonorrhea cases: 264.3 per 100K people (97 cases)
– Syphilis cases (non-congenital): 5.4 per 100K people (2 cases)
— Primary and secondary syphilis: 2.7 per 100K people (1 case)
— Nonprimary and nonsecondary early syphilis: 2.7 per 100K people (1 case)
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#28. Talladega County
– Chlamydia cases: 619.4 per 100K people (505 cases)
– Gonorrhea cases: 327.5 per 100K people (267 cases)
– Syphilis cases (non-congenital): 27.0 per 100K people (22 cases)
— Primary and secondary syphilis: 8.6 per 100K people (7 cases)
— Nonprimary and nonsecondary early syphilis: 18.4 per 100K people (15 cases)
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#27. Dale County
– Chlamydia cases: 620.2 per 100K people (306 cases)
– Gonorrhea cases: 379.0 per 100K people (187 cases)
– Syphilis cases (non-congenital): 30.4 per 100K people (15 cases)
— Primary and secondary syphilis: 22.3 per 100K people (11 case)
— Nonprimary and nonsecondary early syphilis: 8.1 per 100K people (4 cases)
JNix // Shutterstock
#26. Chambers County
– Chlamydia cases: 645.6 per 100K people (223 cases)
– Gonorrhea cases: 361.9 per 100K people (125 cases)
– Syphilis cases (non-congenital): 23.2 per 100K people (8 cases)
— Primary and secondary syphilis: 8.7 per 100K people (3 cases)
— Nonprimary and nonsecondary early syphilis: 14.5 per 100K people (5 cases)
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#25. Marengo County
– Chlamydia cases: 658.0 per 100K people (125 cases)
– Gonorrhea cases: 279.0 per 100K people (53 cases)
– Syphilis cases (non-congenital): 21.1 per 100K people (4 cases)
— Primary and secondary syphilis: 15.8 per 100K people (3 cases)
— Nonprimary and nonsecondary early syphilis: 5.3 per 100K people (1 case)
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#24. Monroe County
– Chlamydia cases: 661.6 per 100K people (130 cases)
– Gonorrhea cases: 244.3 per 100K people (48 cases)
– Syphilis cases (non-congenital): 5.1 per 100K people (1 case)
— Primary and secondary syphilis: 0 cases
— Nonprimary and nonsecondary early syphilis: 5.1 per 100K people (1 case)
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#23. Bibb County
– Chlamydia cases: 662.9 per 100K people (149 cases)
– Gonorrhea cases: 293.6 per 100K people (66 cases)
– Syphilis cases (non-congenital): 4.4 per 100K people (1 case)
— Primary and secondary syphilis: 4.4 per 100K people (1 case)
— Nonprimary and nonsecondary early syphilis: 0 cases
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#22. Sumter County
– Chlamydia cases: 665.9 per 100K people (81 case)
– Gonorrhea cases: 378.2 per 100K people (46 cases)
– Syphilis cases (non-congenital): 41.1 per 100K people (5 cases)
— Primary and secondary syphilis: 16.4 per 100K people (2 cases)
— Nonprimary and nonsecondary early syphilis: 24.7 per 100K people (3 cases)
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#21. Houston County
– Chlamydia cases: 681.2 per 100K people (732 cases)
– Gonorrhea cases: 474.6 per 100K people (510 cases)
– Syphilis cases (non-congenital): 37.2 per 100K people (40 cases)
— Primary and secondary syphilis: 19.5 per 100K people (21 case)
— Nonprimary and nonsecondary early syphilis: 17.7 per 100K people (19 cases)
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#20. Russell County
– Chlamydia cases: 688.0 per 100K people (404 cases)
– Gonorrhea cases: 323.6 per 100K people (190 cases)
– Syphilis cases (non-congenital): 64.7 per 100K people (38 cases)
— Primary and secondary syphilis: 32.4 per 100K people (19 cases)
— Nonprimary and nonsecondary early syphilis: 32.4 per 100K people (19 cases)
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#19. Clarke County
– Chlamydia cases: 725.0 per 100K people (165 cases)
– Gonorrhea cases: 364.7 per 100K people (83 cases)
– Syphilis cases (non-congenital): 8.8 per 100K people (2 cases)
— Primary and secondary syphilis: 8.8 per 100K people (2 cases)
— Nonprimary and nonsecondary early syphilis: 0 cases
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#18. Barbour County
– Chlamydia cases: 729.0 per 100K people (182 cases)
– Gonorrhea cases: 532.8 per 100K people (133 cases)
– Syphilis cases (non-congenital): 8.0 per 100K people (2 cases)
— Primary and secondary syphilis: 0 cases
— Nonprimary and nonsecondary early syphilis: 8.0 per 100K people (2 cases)
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#17. Mobile County
– Chlamydia cases: 734.7 per 100K people (3,035 cases)
– Gonorrhea cases: 401.1 per 100K people (1,657 cases)
– Syphilis cases (non-congenital): 46.2 per 100K people (191 case)
— Primary and secondary syphilis: 34.4 per 100K people (142 cases)
— Nonprimary and nonsecondary early syphilis: 11.9 per 100K people (49 cases)
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#16. Henry County
– Chlamydia cases: 756.1 per 100K people (132 cases)
– Gonorrhea cases: 486.9 per 100K people (85 cases)
– Syphilis cases (non-congenital): 5.7 per 100K people (1 case)
— Primary and secondary syphilis: 5.7 per 100K people (1 case)
— Nonprimary and nonsecondary early syphilis: 0 cases
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#15. Tuscaloosa County
– Chlamydia cases: 778.8 per 100K people (1,768 cases)
– Gonorrhea cases: 356.4 per 100K people (809 cases)
– Syphilis cases (non-congenital): 47.1 per 100K people (107 cases)
— Primary and secondary syphilis: 26.9 per 100K people (61 case)
— Nonprimary and nonsecondary early syphilis: 20.3 per 100K people (46 cases)
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#14. Perry County
– Chlamydia cases: 789.9 per 100K people (66 cases)
– Gonorrhea cases: 586.5 per 100K people (49 cases)
– Syphilis cases (non-congenital): 23.9 per 100K people (2 cases)
— Primary and secondary syphilis: 23.9 per 100K people (2 cases)
— Nonprimary and nonsecondary early syphilis: 0 cases
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#13. Wilcox County
– Chlamydia cases: 794.6 per 100K people (83 cases)
– Gonorrhea cases: 277.6 per 100K people (29 cases)
– Syphilis cases (non-congenital): 0 cases
— Primary and secondary syphilis: 0 cases
— Nonprimary and nonsecondary early syphilis: 0 cases
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#12. Bullock County
– Chlamydia cases: 823.6 per 100K people (85 cases)
– Gonorrhea cases: 591.1 per 100K people (61 case)
– Syphilis cases (non-congenital): 38.8 per 100K people (4 cases)
— Primary and secondary syphilis: 29.1 per 100K people (3 cases)
— Nonprimary and nonsecondary early syphilis: 9.7 per 100K people (1 case)
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#11. Crenshaw County
– Chlamydia cases: 825.5 per 100K people (108 cases)
– Gonorrhea cases: 397.5 per 100K people (52 cases)
– Syphilis cases (non-congenital): 30.6 per 100K people (4 cases)
— Primary and secondary syphilis: 22.9 per 100K people (3 cases)
— Nonprimary and nonsecondary early syphilis: 7.6 per 100K people (1 case)
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#10. Coosa County
– Chlamydia cases: 851.7 per 100K people (89 cases)
– Gonorrhea cases: 507.2 per 100K people (53 cases)
– Syphilis cases (non-congenital): 19.1 per 100K people (2 cases)
— Primary and secondary syphilis: 9.6 per 100K people (1 case)
— Nonprimary and nonsecondary early syphilis: 9.6 per 100K people (1 case)
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#9. Dallas County
– Chlamydia cases: 866.6 per 100K people (326 cases)
– Gonorrhea cases: 398.7 per 100K people (150 cases)
– Syphilis cases (non-congenital): 18.6 per 100K people (7 cases)
— Primary and secondary syphilis: 10.6 per 100K people (4 cases)
— Nonprimary and nonsecondary early syphilis: 8.0 per 100K people (3 cases)
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#8. Jefferson County
– Chlamydia cases: 873.0 per 100K people (5,830 cases)
– Gonorrhea cases: 514.4 per 100K people (3,435 cases)
– Syphilis cases (non-congenital): 38.3 per 100K people (256 cases)
— Primary and secondary syphilis: 18.3 per 100K people (122 cases)
— Nonprimary and nonsecondary early syphilis: 20.1 per 100K people (134 cases)
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#7. Pike County
– Chlamydia cases: 900.2 per 100K people (297 cases)
– Gonorrhea cases: 412.2 per 100K people (136 cases)
– Syphilis cases (non-congenital): 42.4 per 100K people (14 cases)
— Primary and secondary syphilis: 27.3 per 100K people (9 cases)
— Nonprimary and nonsecondary early syphilis: 15.2 per 100K people (5 cases)
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#6. Macon County
– Chlamydia cases: 920.9 per 100K people (174 cases)
– Gonorrhea cases: 349.3 per 100K people (66 cases)
– Syphilis cases (non-congenital): 37.0 per 100K people (7 cases)
— Primary and secondary syphilis: 10.6 per 100K people (2 cases)
— Nonprimary and nonsecondary early syphilis: 26.5 per 100K people (5 cases)
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#5. Lowndes County
– Chlamydia cases: 963.4 per 100K people (96 cases)
– Gonorrhea cases: 562.0 per 100K people (56 cases)
– Syphilis cases (non-congenital): 10.0 per 100K people (1 case)
— Primary and secondary syphilis: 10.0 per 100K people (1 case)
— Nonprimary and nonsecondary early syphilis: 0 cases
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#4. Montgomery County
– Chlamydia cases: 1,061.4 per 100K people (2,414 cases)
– Gonorrhea cases: 548.3 per 100K people (1,247 cases)
– Syphilis cases (non-congenital): 69.5 per 100K people (158 cases)
— Primary and secondary syphilis: 29.9 per 100K people (68 cases)
— Nonprimary and nonsecondary early syphilis: 39.6 per 100K people (90 cases)
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#3. Greene County
– Chlamydia cases: 1,074.8 per 100K people (82 cases)
– Gonorrhea cases: 458.8 per 100K people (35 cases)
– Syphilis cases (non-congenital): 118.0 per 100K people (9 cases)
— Primary and secondary syphilis: 39.3 per 100K people (3 cases)
— Nonprimary and nonsecondary early syphilis: 78.6 per 100K people (6 cases)
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#2. Butler County
– Chlamydia cases: 1,090.9 per 100K people (206 cases)
– Gonorrhea cases: 317.7 per 100K people (60 cases)
– Syphilis cases (non-congenital): 26.5 per 100K people (5 cases)
— Primary and secondary syphilis: 21.2 per 100K people (4 cases)
— Nonprimary and nonsecondary early syphilis: 5.3 per 100K people (1 case)
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#1. Hale County
– Chlamydia cases: 1,294.6 per 100K people (191 case)
– Gonorrhea cases: 745.6 per 100K people (110 cases)
– Syphilis cases (non-congenital): 40.7 per 100K people (6 cases)
— Primary and secondary syphilis: 0 cases
— Nonprimary and nonsecondary early syphilis: 40.7 per 100K people (6 cases)
This story features data reporting and writing by Emma Rubin and is part of a series utilizing data automation across 49 states.
