Counties with the highest STI rates in Texas
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Counties with the highest STI rates in Texas
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 Texas. 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 Texas compare nationally, and the top counties.
Emma Rubin // Stacker
State-level statistics
– Chlamydia cases: 517.8 per 100K (#16 nationally, 155,483 cases)
– Gonorrhea cases: 206.5 per 100K (#17 nationally, 61,999 cases)
– Primary and secondary syphilis cases: 15.5 per 100K (#26 nationally, 4,655 cases)
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#50. Kimble County
– Chlamydia cases: 504.0 per 100K people (22 cases)
– Gonorrhea cases: 114.5 per 100K people (5 cases)
– Syphilis cases (non-congenital): 0 cases
— Primary and secondary syphilis: 0 cases
— Nonprimary and nonsecondary early syphilis: 0 cases
Roberto Galan // Shutterstock
#49. Angelina County
– Chlamydia cases: 504.0 per 100K people (436 cases)
– Gonorrhea cases: 276.3 per 100K people (239 cases)
– Syphilis cases (non-congenital): 11.6 per 100K people (10 cases)
— Primary and secondary syphilis: 4.6 per 100K people (4 cases)
— Nonprimary and nonsecondary early syphilis: 6.9 per 100K people (6 cases)
SG Arts // Shutterstock
#48. Midland County
– Chlamydia cases: 504.9 per 100K people (848 cases)
– Gonorrhea cases: 176.8 per 100K people (297 cases)
– Syphilis cases (non-congenital): 28.0 per 100K people (47 cases)
— Primary and secondary syphilis: 10.1 per 100K people (17 cases)
— Nonprimary and nonsecondary early syphilis: 17.9 per 100K people (30 cases)
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#47. Titus County
– Chlamydia cases: 506.7 per 100K people (158 cases)
– Gonorrhea cases: 157.1 per 100K people (49 cases)
– Syphilis cases (non-congenital): 35.3 per 100K people (11 case)
— Primary and secondary syphilis: 12.8 per 100K people (4 cases)
— Nonprimary and nonsecondary early syphilis: 22.4 per 100K people (7 cases)
Barna Tanko // Shutterstock
#46. Jim Wells County
– Chlamydia cases: 514.8 per 100K people (200 cases)
– Gonorrhea cases: 56.6 per 100K people (22 cases)
– Syphilis cases (non-congenital): 56.6 per 100K people (22 cases)
— Primary and secondary syphilis: 28.3 per 100K people (11 case)
— Nonprimary and nonsecondary early syphilis: 28.3 per 100K people (11 case)
SevenMaps // Shutterstock
#45. Hockley County
– Chlamydia cases: 514.9 per 100K people (110 cases)
– Gonorrhea cases: 177.9 per 100K people (38 cases)
– Syphilis cases (non-congenital): 182.6 per 100K people (39 cases)
— Primary and secondary syphilis: 65.5 per 100K people (14 cases)
— Nonprimary and nonsecondary early syphilis: 117.0 per 100K people (25 cases)
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#44. Shelby County
– Chlamydia cases: 518.0 per 100K people (124 cases)
– Gonorrhea cases: 200.5 per 100K people (48 cases)
– Syphilis cases (non-congenital): 4.2 per 100K people (1 case)
— Primary and secondary syphilis: 0 cases
— Nonprimary and nonsecondary early syphilis: 4.2 per 100K people (1 case)
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#43. San Patricio County
– Chlamydia cases: 520.8 per 100K people (363 cases)
– Gonorrhea cases: 219.5 per 100K people (153 cases)
– Syphilis cases (non-congenital): 34.4 per 100K people (24 cases)
— Primary and secondary syphilis: 18.7 per 100K people (13 cases)
— Nonprimary and nonsecondary early syphilis: 15.8 per 100K people (11 case)
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#42. Moore County
– Chlamydia cases: 520.9 per 100K people (110 cases)
– Gonorrhea cases: 151.5 per 100K people (32 cases)
– Syphilis cases (non-congenital): 9.5 per 100K people (2 cases)
— Primary and secondary syphilis: 9.5 per 100K people (2 cases)
— Nonprimary and nonsecondary early syphilis: 0 cases
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#41. Morris County
– Chlamydia cases: 523.7 per 100K people (63 cases)
– Gonorrhea cases: 365.8 per 100K people (44 cases)
– Syphilis cases (non-congenital): 33.3 per 100K people (4 cases)
— Primary and secondary syphilis: 24.9 per 100K people (3 cases)
— Nonprimary and nonsecondary early syphilis: 8.3 per 100K people (1 case)
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#40. Hale County
– Chlamydia cases: 527.6 per 100K people (170 cases)
– Gonorrhea cases: 335.2 per 100K people (108 cases)
– Syphilis cases (non-congenital): 55.9 per 100K people (18 cases)
— Primary and secondary syphilis: 27.9 per 100K people (9 cases)
— Nonprimary and nonsecondary early syphilis: 27.9 per 100K people (9 cases)
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#39. Victoria County
– Chlamydia cases: 527.7 per 100K people (480 cases)
– Gonorrhea cases: 213.3 per 100K people (194 cases)
– Syphilis cases (non-congenital): 22.0 per 100K people (20 cases)
— Primary and secondary syphilis: 6.6 per 100K people (6 cases)
— Nonprimary and nonsecondary early syphilis: 15.4 per 100K people (14 cases)
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#38. Lamar County
– Chlamydia cases: 531.0 per 100K people (266 cases)
– Gonorrhea cases: 283.4 per 100K people (142 cases)
– Syphilis cases (non-congenital): 6.0 per 100K people (3 cases)
— Primary and secondary syphilis: 0 cases
— Nonprimary and nonsecondary early syphilis: 6.0 per 100K people (3 cases)
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#37. Gonzales County
– Chlamydia cases: 539.7 per 100K people (106 cases)
– Gonorrhea cases: 157.8 per 100K people (31 case)
– Syphilis cases (non-congenital): 30.5 per 100K people (6 cases)
— Primary and secondary syphilis: 0 cases
— Nonprimary and nonsecondary early syphilis: 30.5 per 100K people (6 cases)
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#36. Smith County
– Chlamydia cases: 540.9 per 100K people (1,283 cases)
– Gonorrhea cases: 277.0 per 100K people (657 cases)
– Syphilis cases (non-congenital): 18.1 per 100K people (43 cases)
— Primary and secondary syphilis: 10.1 per 100K people (24 cases)
— Nonprimary and nonsecondary early syphilis: 8.0 per 100K people (19 cases)
Roberto Galan // Shutterstock
#35. Camp County
– Chlamydia cases: 546.9 per 100K people (69 cases)
– Gonorrhea cases: 253.6 per 100K people (32 cases)
– Syphilis cases (non-congenital): 47.6 per 100K people (6 cases)
— Primary and secondary syphilis: 23.8 per 100K people (3 cases)
— Nonprimary and nonsecondary early syphilis: 23.8 per 100K people (3 cases)
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#34. Cameron County
– Chlamydia cases: 549.4 per 100K people (2,324 cases)
– Gonorrhea cases: 109.9 per 100K people (465 cases)
– Syphilis cases (non-congenital): 12.5 per 100K people (53 cases)
— Primary and secondary syphilis: 3.3 per 100K people (14 cases)
— Nonprimary and nonsecondary early syphilis: 9.2 per 100K people (39 cases)
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#33. Willacy County
– Chlamydia cases: 551.3 per 100K people (112 cases)
– Gonorrhea cases: 93.5 per 100K people (19 cases)
– Syphilis cases (non-congenital): 9.8 per 100K people (2 cases)
— Primary and secondary syphilis: 4.9 per 100K people (1 case)
— Nonprimary and nonsecondary early syphilis: 4.9 per 100K people (1 case)
xradiophotog // Shutterstock
#32. Erath County
– Chlamydia cases: 555.6 per 100K people (241 case)
– Gonorrhea cases: 103.7 per 100K people (45 cases)
– Syphilis cases (non-congenital): 9.2 per 100K people (4 cases)
— Primary and secondary syphilis: 4.6 per 100K people (2 cases)
— Nonprimary and nonsecondary early syphilis: 4.6 per 100K people (2 cases)
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#31. Pecos County
– Chlamydia cases: 555.6 per 100K people (84 cases)
– Gonorrhea cases: 211.7 per 100K people (32 cases)
– Syphilis cases (non-congenital): 13.2 per 100K people (2 cases)
— Primary and secondary syphilis: 6.6 per 100K people (1 case)
— Nonprimary and nonsecondary early syphilis: 6.6 per 100K people (1 case)
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#30. Tom Green County
– Chlamydia cases: 556.1 per 100K people (664 cases)
– Gonorrhea cases: 307.3 per 100K people (367 cases)
– Syphilis cases (non-congenital): 152.4 per 100K people (182 cases)
— Primary and secondary syphilis: 39.4 per 100K people (47 cases)
— Nonprimary and nonsecondary early syphilis: 113.1 per 100K people (135 cases)
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#29. Bee County
– Chlamydia cases: 569.1 per 100K people (176 cases)
– Gonorrhea cases: 207.0 per 100K people (64 cases)
– Syphilis cases (non-congenital): 64.7 per 100K people (20 cases)
— Primary and secondary syphilis: 19.4 per 100K people (6 cases)
— Nonprimary and nonsecondary early syphilis: 45.3 per 100K people (14 cases)
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#28. Robertson County
– Chlamydia cases: 583.8 per 100K people (99 cases)
– Gonorrhea cases: 206.4 per 100K people (35 cases)
– Syphilis cases (non-congenital): 5.9 per 100K people (1 case)
— Primary and secondary syphilis: 5.9 per 100K people (1 case)
— Nonprimary and nonsecondary early syphilis: 0 cases
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#27. Brooks County
– Chlamydia cases: 586.2 per 100K people (41 case)
– Gonorrhea cases: 71.5 per 100K people (5 cases)
– Syphilis cases (non-congenital): 42.9 per 100K people (3 cases)
— Primary and secondary syphilis: 28.6 per 100K people (2 cases)
— Nonprimary and nonsecondary early syphilis: 14.3 per 100K people (1 case)
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#26. Uvalde County
– Chlamydia cases: 586.4 per 100K people (145 cases)
– Gonorrhea cases: 157.7 per 100K people (39 cases)
– Syphilis cases (non-congenital): 32.4 per 100K people (8 cases)
— Primary and secondary syphilis: 0 cases
— Nonprimary and nonsecondary early syphilis: 32.4 per 100K people (8 cases)
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#25. Kenedy County
– Chlamydia cases: 588.2 per 100K people (2 cases)
– Gonorrhea cases: 0 cases
– Syphilis cases (non-congenital): 0 cases
— Primary and secondary syphilis: 0 cases
— Nonprimary and nonsecondary early syphilis: 0 cases
Jacob Boomsma // Shutterstock
#24. Jefferson County
– Chlamydia cases: 591.2 per 100K people (1,500 cases)
– Gonorrhea cases: 298.8 per 100K people (758 cases)
– Syphilis cases (non-congenital): 38.6 per 100K people (98 cases)
— Primary and secondary syphilis: 18.9 per 100K people (48 cases)
— Nonprimary and nonsecondary early syphilis: 19.7 per 100K people (50 cases)
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#23. Walker County
– Chlamydia cases: 593.8 per 100K people (463 cases)
– Gonorrhea cases: 229.6 per 100K people (179 cases)
– Syphilis cases (non-congenital): 28.2 per 100K people (22 cases)
— Primary and secondary syphilis: 5.1 per 100K people (4 cases)
— Nonprimary and nonsecondary early syphilis: 23.1 per 100K people (18 cases)
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#22. Nolan County
– Chlamydia cases: 596.0 per 100K people (87 cases)
– Gonorrhea cases: 328.8 per 100K people (48 cases)
– Syphilis cases (non-congenital): 48.0 per 100K people (7 cases)
— Primary and secondary syphilis: 13.7 per 100K people (2 cases)
— Nonprimary and nonsecondary early syphilis: 34.3 per 100K people (5 cases)
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#21. Ector County
– Chlamydia cases: 596.6 per 100K people (961 case)
– Gonorrhea cases: 227.8 per 100K people (367 cases)
– Syphilis cases (non-congenital): 50.3 per 100K people (81 case)
— Primary and secondary syphilis: 16.1 per 100K people (26 cases)
— Nonprimary and nonsecondary early syphilis: 34.1 per 100K people (55 cases)
Roberto Galan // Shutterstock
#20. Bowie County
– Chlamydia cases: 615.7 per 100K people (570 cases)
– Gonorrhea cases: 350.0 per 100K people (324 cases)
– Syphilis cases (non-congenital): 55.1 per 100K people (51 case)
— Primary and secondary syphilis: 22.7 per 100K people (21 case)
— Nonprimary and nonsecondary early syphilis: 32.4 per 100K people (30 cases)
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#19. Harris County
– Chlamydia cases: 620.2 per 100K people (29,321 case)
– Gonorrhea cases: 274.4 per 100K people (12,976 cases)
– Syphilis cases (non-congenital): 58.5 per 100K people (2,765 cases)
— Primary and secondary syphilis: 17.8 per 100K people (841 case)
— Nonprimary and nonsecondary early syphilis: 40.7 per 100K people (1,924 cases)
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#18. Mclennan County
– Chlamydia cases: 633.2 per 100K people (1,666 cases)
– Gonorrhea cases: 333.7 per 100K people (878 cases)
– Syphilis cases (non-congenital): 39.1 per 100K people (103 cases)
— Primary and secondary syphilis: 12.9 per 100K people (34 cases)
— Nonprimary and nonsecondary early syphilis: 26.2 per 100K people (69 cases)
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#17. Duval County
– Chlamydia cases: 656.0 per 100K people (64 cases)
– Gonorrhea cases: 102.5 per 100K people (10 cases)
– Syphilis cases (non-congenital): 20.5 per 100K people (2 cases)
— Primary and secondary syphilis: 20.5 per 100K people (2 cases)
— Nonprimary and nonsecondary early syphilis: 0 cases
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#16. Brazos County
– Chlamydia cases: 656.5 per 100K people (1,556 cases)
– Gonorrhea cases: 222.8 per 100K people (528 cases)
– Syphilis cases (non-congenital): 19.0 per 100K people (45 cases)
— Primary and secondary syphilis: 9.3 per 100K people (22 cases)
— Nonprimary and nonsecondary early syphilis: 9.7 per 100K people (23 cases)
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#15. Travis County
– Chlamydia cases: 662.5 per 100K people (8,646 cases)
– Gonorrhea cases: 332.0 per 100K people (4,333 cases)
– Syphilis cases (non-congenital): 63.8 per 100K people (833 cases)
— Primary and secondary syphilis: 32.0 per 100K people (417 cases)
— Nonprimary and nonsecondary early syphilis: 31.9 per 100K people (416 cases)
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#14. Nacogdoches County
– Chlamydia cases: 668.0 per 100K people (432 cases)
– Gonorrhea cases: 278.3 per 100K people (180 cases)
– Syphilis cases (non-congenital): 15.5 per 100K people (10 cases)
— Primary and secondary syphilis: 6.2 per 100K people (4 cases)
— Nonprimary and nonsecondary early syphilis: 9.3 per 100K people (6 cases)
Gestalt Imagery // Shutterstock
#13. Terrell County
– Chlamydia cases: 690.6 per 100K people (5 cases)
– Gonorrhea cases: 138.1 per 100K people (1 case)
– Syphilis cases (non-congenital): 138.1 per 100K people (1 case)
— Primary and secondary syphilis: 138.1 per 100K people (1 case)
— Nonprimary and nonsecondary early syphilis: 0 cases
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#12. Bexar County
– Chlamydia cases: 692.2 per 100K people (14,039 cases)
– Gonorrhea cases: 332.5 per 100K people (6,743 cases)
– Syphilis cases (non-congenital): 58.3 per 100K people (1,182 cases)
— Primary and secondary syphilis: 23.1 per 100K people (469 cases)
— Nonprimary and nonsecondary early syphilis: 35.2 per 100K people (713 cases)
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#11. Reagan County
– Chlamydia cases: 707.0 per 100K people (23 cases)
– Gonorrhea cases: 276.7 per 100K people (9 cases)
– Syphilis cases (non-congenital): 61.5 per 100K people (2 cases)
— Primary and secondary syphilis: 61.5 per 100K people (2 cases)
— Nonprimary and nonsecondary early syphilis: 0 cases
Roberto Galan // Shutterstock
#10. Gregg County
– Chlamydia cases: 726.2 per 100K people (902 cases)
– Gonorrhea cases: 274.6 per 100K people (341 case)
– Syphilis cases (non-congenital): 36.2 per 100K people (45 cases)
— Primary and secondary syphilis: 20.1 per 100K people (25 cases)
— Nonprimary and nonsecondary early syphilis: 16.1 per 100K people (20 cases)
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#9. Nueces County
– Chlamydia cases: 745.2 per 100K people (2,631 case)
– Gonorrhea cases: 286.3 per 100K people (1,011 case)
– Syphilis cases (non-congenital): 55.8 per 100K people (197 cases)
— Primary and secondary syphilis: 25.8 per 100K people (91 case)
— Nonprimary and nonsecondary early syphilis: 30.0 per 100K people (106 cases)
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#8. Lubbock County
– Chlamydia cases: 780.1 per 100K people (2,453 cases)
– Gonorrhea cases: 375.3 per 100K people (1,180 cases)
– Syphilis cases (non-congenital): 135.8 per 100K people (427 cases)
— Primary and secondary syphilis: 79.5 per 100K people (250 cases)
— Nonprimary and nonsecondary early syphilis: 56.3 per 100K people (177 cases)
Tricia Daniel // Shutterstock
#7. Bell County
– Chlamydia cases: 810.6 per 100K people (3,077 cases)
– Gonorrhea cases: 374.9 per 100K people (1,423 cases)
– Syphilis cases (non-congenital): 15.3 per 100K people (58 cases)
— Primary and secondary syphilis: 6.1 per 100K people (23 cases)
— Nonprimary and nonsecondary early syphilis: 9.2 per 100K people (35 cases)
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#6. Dallas County
– Chlamydia cases: 838.5 per 100K people (21,684 cases)
– Gonorrhea cases: 419.8 per 100K people (10,855 cases)
– Syphilis cases (non-congenital): 63.9 per 100K people (1,652 cases)
— Primary and secondary syphilis: 9.6 per 100K people (247 cases)
— Nonprimary and nonsecondary early syphilis: 54.3 per 100K people (1,405 cases)
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#5. Kleberg County
– Chlamydia cases: 881.3 per 100K people (270 cases)
– Gonorrhea cases: 169.7 per 100K people (52 cases)
– Syphilis cases (non-congenital): 29.4 per 100K people (9 cases)
— Primary and secondary syphilis: 3.3 per 100K people (1 case)
— Nonprimary and nonsecondary early syphilis: 26.1 per 100K people (8 cases)
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#4. Frio County
– Chlamydia cases: 916.7 per 100K people (169 cases)
– Gonorrhea cases: 282.1 per 100K people (52 cases)
– Syphilis cases (non-congenital): 54.2 per 100K people (10 cases)
— Primary and secondary syphilis: 10.8 per 100K people (2 cases)
— Nonprimary and nonsecondary early syphilis: 43.4 per 100K people (8 cases)
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#3. Reeves County
– Chlamydia cases: 1,028.5 per 100K people (149 cases)
– Gonorrhea cases: 89.7 per 100K people (13 cases)
– Syphilis cases (non-congenital): 6.9 per 100K people (1 case)
— Primary and secondary syphilis: 6.9 per 100K people (1 case)
— Nonprimary and nonsecondary early syphilis: 0 cases
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#2. Potter County
– Chlamydia cases: 1,227.0 per 100K people (1,430 cases)
– Gonorrhea cases: 550.0 per 100K people (641 case)
– Syphilis cases (non-congenital): 121.8 per 100K people (142 cases)
— Primary and secondary syphilis: 26.6 per 100K people (31 case)
— Nonprimary and nonsecondary early syphilis: 95.2 per 100K people (111 case)
Edward H. Campbell // Shutterstock
#1. Dimmit County
– Chlamydia cases: 2,041.8 per 100K people (173 cases)
– Gonorrhea cases: 177.0 per 100K people (15 cases)
– Syphilis cases (non-congenital): 23.6 per 100K people (2 cases)
— Primary and secondary syphilis: 11.8 per 100K people (1 case)
— Nonprimary and nonsecondary early syphilis: 11.8 per 100K people (1 case)
This story features data reporting and writing by Emma Rubin and is part of a series utilizing data automation across 49 states.
