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.
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Stacker used CDC data to look at which counties reported the highest rate of sexually transmitted infections in Michigan. 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 Michigan compare nationally, and the top counties.
State-level statistics
- Chlamydia cases: 428.3 per 100K (#33 nationally, 42,977 cases) - Gonorrhea cases: 163.2 per 100K (#26 nationally, 16,378 cases) - Primary and secondary syphilis cases: 9.7 per 100K (#42 nationally, 972 cases)
#50. Gladwin County
- Chlamydia cases: 200.1 per 100K people (51 case) - Gonorrhea cases: 35.3 per 100K people (9 cases) - Syphilis cases (non-congenital): 3.9 per 100K people (1 case) --- Primary and secondary syphilis: 3.9 per 100K people (1 case) --- Nonprimary and nonsecondary early syphilis: 0 cases
#49. St. Clair County
- Chlamydia cases: 211.2 per 100K people (338 cases) - Gonorrhea cases: 98.1 per 100K people (157 cases) - Syphilis cases (non-congenital): 8.1 per 100K people (13 cases) --- Primary and secondary syphilis: 5.6 per 100K people (9 cases) --- Nonprimary and nonsecondary early syphilis: 2.5 per 100K people (4 cases)
#48. Chippewa County
- Chlamydia cases: 211.9 per 100K people (78 cases) - Gonorrhea cases: 32.6 per 100K people (12 cases) - Syphilis cases (non-congenital): 2.7 per 100K people (1 case) --- Primary and secondary syphilis: 2.7 per 100K people (1 case) --- Nonprimary and nonsecondary early syphilis: 0 cases
#47. Gratiot County
- Chlamydia cases: 214.2 per 100K people (89 cases) - Gonorrhea cases: 62.6 per 100K people (26 cases) - Syphilis cases (non-congenital): 9.6 per 100K people (4 cases) --- Primary and secondary syphilis: 2.4 per 100K people (1 case) --- Nonprimary and nonsecondary early syphilis: 7.2 per 100K people (3 cases)
#46. Antrim County
- Chlamydia cases: 218.4 per 100K people (52 cases) - Gonorrhea cases: 29.4 per 100K people (7 cases) - Syphilis cases (non-congenital): 8.4 per 100K people (2 cases) --- Primary and secondary syphilis: 4.2 per 100K people (1 case) --- Nonprimary and nonsecondary early syphilis: 4.2 per 100K people (1 case)
#45. Monroe County
- Chlamydia cases: 220.3 per 100K people (342 cases) - Gonorrhea cases: 48.3 per 100K people (75 cases) - Syphilis cases (non-congenital): 5.2 per 100K people (8 cases) --- Primary and secondary syphilis: 1.9 per 100K people (3 cases) --- Nonprimary and nonsecondary early syphilis: 3.2 per 100K people (5 cases)
#44. Iron County
- Chlamydia cases: 223.5 per 100K people (26 cases) - Gonorrhea cases: 17.2 per 100K people (2 cases) - Syphilis cases (non-congenital): 8.6 per 100K people (1 case) --- Primary and secondary syphilis: 0 cases --- Nonprimary and nonsecondary early syphilis: 8.6 per 100K people (1 case)
#43. Shiawassee County
- Chlamydia cases: 231.3 per 100K people (157 cases) - Gonorrhea cases: 101.7 per 100K people (69 cases) - Syphilis cases (non-congenital): 5.9 per 100K people (4 cases) --- Primary and secondary syphilis: 1.5 per 100K people (1 case) --- Nonprimary and nonsecondary early syphilis: 4.4 per 100K people (3 cases)
#42. Newaygo County
- Chlamydia cases: 234.6 per 100K people (118 cases) - Gonorrhea cases: 79.5 per 100K people (40 cases) - Syphilis cases (non-congenital): 4.0 per 100K people (2 cases) --- Primary and secondary syphilis: 2.0 per 100K people (1 case) --- Nonprimary and nonsecondary early syphilis: 2.0 per 100K people (1 case)
#41. Hillsdale County
- Chlamydia cases: 234.9 per 100K people (107 cases) - Gonorrhea cases: 131.7 per 100K people (60 cases) - Syphilis cases (non-congenital): 2.2 per 100K people (1 case) --- Primary and secondary syphilis: 2.2 per 100K people (1 case) --- Nonprimary and nonsecondary early syphilis: 0 cases
#40. Alpena County
- Chlamydia cases: 235.4 per 100K people (68 cases) - Gonorrhea cases: 13.8 per 100K people (4 cases) - Syphilis cases (non-congenital): 0 cases --- Primary and secondary syphilis: 0 cases --- Nonprimary and nonsecondary early syphilis: 0 cases
#39. Dickinson County
- Chlamydia cases: 236.6 per 100K people (61 case) - Gonorrhea cases: 15.5 per 100K people (4 cases) - Syphilis cases (non-congenital): 7.8 per 100K people (2 cases) --- Primary and secondary syphilis: 3.9 per 100K people (1 case) --- Nonprimary and nonsecondary early syphilis: 3.9 per 100K people (1 case)
#38. Gogebic County
- Chlamydia cases: 236.8 per 100K people (34 cases) - Gonorrhea cases: 20.9 per 100K people (3 cases) - Syphilis cases (non-congenital): 0 cases --- Primary and secondary syphilis: 0 cases --- Nonprimary and nonsecondary early syphilis: 0 cases
#37. Otsego County
- Chlamydia cases: 237.3 per 100K people (60 cases) - Gonorrhea cases: 35.6 per 100K people (9 cases) - Syphilis cases (non-congenital): 4.0 per 100K people (1 case) --- Primary and secondary syphilis: 0 cases --- Nonprimary and nonsecondary early syphilis: 4.0 per 100K people (1 case)
#36. Arenac County
- Chlamydia cases: 240.4 per 100K people (36 cases) - Gonorrhea cases: 46.7 per 100K people (7 cases) - Syphilis cases (non-congenital): 0 cases --- Primary and secondary syphilis: 0 cases --- Nonprimary and nonsecondary early syphilis: 0 cases
#35. Grand Traverse County
- Chlamydia cases: 242.0 per 100K people (232 cases) - Gonorrhea cases: 50.1 per 100K people (48 cases) - Syphilis cases (non-congenital): 4.2 per 100K people (4 cases) --- Primary and secondary syphilis: 1.0 per 100K people (1 case) --- Nonprimary and nonsecondary early syphilis: 3.1 per 100K people (3 cases)
#34. Lenawee County
- Chlamydia cases: 242.5 per 100K people (240 cases) - Gonorrhea cases: 73.8 per 100K people (73 cases) - Syphilis cases (non-congenital): 3.0 per 100K people (3 cases) --- Primary and secondary syphilis: 2.0 per 100K people (2 cases) --- Nonprimary and nonsecondary early syphilis: 1.0 per 100K people (1 case)
#33. Mackinac County
- Chlamydia cases: 247.6 per 100K people (27 cases) - Gonorrhea cases: 27.5 per 100K people (3 cases) - Syphilis cases (non-congenital): 0 cases --- Primary and secondary syphilis: 0 cases --- Nonprimary and nonsecondary early syphilis: 0 cases
#32. Barry County
- Chlamydia cases: 250.8 per 100K people (158 cases) - Gonorrhea cases: 60.3 per 100K people (38 cases) - Syphilis cases (non-congenital): 9.5 per 100K people (6 cases) --- Primary and secondary syphilis: 4.8 per 100K people (3 cases) --- Nonprimary and nonsecondary early syphilis: 4.8 per 100K people (3 cases)
#31. Oakland County
- Chlamydia cases: 253.9 per 100K people (3,224 cases) - Gonorrhea cases: 101.4 per 100K people (1,288 cases) - Syphilis cases (non-congenital): 18.3 per 100K people (232 cases) --- Primary and secondary syphilis: 9.5 per 100K people (121 case) --- Nonprimary and nonsecondary early syphilis: 8.7 per 100K people (111 case)
#30. Osceola County
- Chlamydia cases: 255.4 per 100K people (59 cases) - Gonorrhea cases: 34.6 per 100K people (8 cases) - Syphilis cases (non-congenital): 8.7 per 100K people (2 cases) --- Primary and secondary syphilis: 8.7 per 100K people (2 cases) --- Nonprimary and nonsecondary early syphilis: 0 cases
#29. Allegan County
- Chlamydia cases: 262.9 per 100K people (318 cases) - Gonorrhea cases: 87.6 per 100K people (106 cases) - Syphilis cases (non-congenital): 8.3 per 100K people (10 cases) --- Primary and secondary syphilis: 5.0 per 100K people (6 cases) --- Nonprimary and nonsecondary early syphilis: 3.3 per 100K people (4 cases)
#28. Baraga County
- Chlamydia cases: 267.8 per 100K people (22 cases) - Gonorrhea cases: 0 cases - Syphilis cases (non-congenital): 0 cases --- Primary and secondary syphilis: 0 cases --- Nonprimary and nonsecondary early syphilis: 0 cases
#27. Clinton County
- Chlamydia cases: 280.8 per 100K people (223 cases) - Gonorrhea cases: 96.9 per 100K people (77 cases) - Syphilis cases (non-congenital): 2.5 per 100K people (2 cases) --- Primary and secondary syphilis: 1.3 per 100K people (1 case) --- Nonprimary and nonsecondary early syphilis: 1.3 per 100K people (1 case)
#26. Branch County
- Chlamydia cases: 282.3 per 100K people (127 cases) - Gonorrhea cases: 104.5 per 100K people (47 cases) - Syphilis cases (non-congenital): 6.7 per 100K people (3 cases) --- Primary and secondary syphilis: 6.7 per 100K people (3 cases) --- Nonprimary and nonsecondary early syphilis: 0 cases
#25. Oceana County
- Chlamydia cases: 283.4 per 100K people (76 cases) - Gonorrhea cases: 52.2 per 100K people (14 cases) - Syphilis cases (non-congenital): 0 cases --- Primary and secondary syphilis: 0 cases --- Nonprimary and nonsecondary early syphilis: 0 cases
#24. Marquette County
- Chlamydia cases: 290.5 per 100K people (192 cases) - Gonorrhea cases: 25.7 per 100K people (17 cases) - Syphilis cases (non-congenital): 1.5 per 100K people (1 case) --- Primary and secondary syphilis: 0 cases --- Nonprimary and nonsecondary early syphilis: 1.5 per 100K people (1 case)
#23. Ionia County
- Chlamydia cases: 302.1 per 100K people (203 cases) - Gonorrhea cases: 135.4 per 100K people (91 case) - Syphilis cases (non-congenital): 7.4 per 100K people (5 cases) --- Primary and secondary syphilis: 4.5 per 100K people (3 cases) --- Nonprimary and nonsecondary early syphilis: 3.0 per 100K people (2 cases)
#22. Kalkaska County
- Chlamydia cases: 305.9 per 100K people (55 cases) - Gonorrhea cases: 22.2 per 100K people (4 cases) - Syphilis cases (non-congenital): 0 cases --- Primary and secondary syphilis: 0 cases --- Nonprimary and nonsecondary early syphilis: 0 cases
#21. Van Buren County
- Chlamydia cases: 310.6 per 100K people (235 cases) - Gonorrhea cases: 95.2 per 100K people (72 cases) - Syphilis cases (non-congenital): 6.6 per 100K people (5 cases) --- Primary and secondary syphilis: 4.0 per 100K people (3 cases) --- Nonprimary and nonsecondary early syphilis: 2.6 per 100K people (2 cases)
#20. Montcalm County
- Chlamydia cases: 316.9 per 100K people (213 cases) - Gonorrhea cases: 87.8 per 100K people (59 cases) - Syphilis cases (non-congenital): 4.5 per 100K people (3 cases) --- Primary and secondary syphilis: 1.5 per 100K people (1 case) --- Nonprimary and nonsecondary early syphilis: 3.0 per 100K people (2 cases)
#19. Eaton County
- Chlamydia cases: 322.2 per 100K people (351 case) - Gonorrhea cases: 145.9 per 100K people (159 cases) - Syphilis cases (non-congenital): 6.4 per 100K people (7 cases) --- Primary and secondary syphilis: 4.6 per 100K people (5 cases) --- Nonprimary and nonsecondary early syphilis: 1.8 per 100K people (2 cases)
#18. Cass County
- Chlamydia cases: 322.4 per 100K people (166 cases) - Gonorrhea cases: 134.0 per 100K people (69 cases) - Syphilis cases (non-congenital): 0 cases --- Primary and secondary syphilis: 0 cases --- Nonprimary and nonsecondary early syphilis: 0 cases
#17. St. Joseph County
- Chlamydia cases: 325.9 per 100K people (198 cases) - Gonorrhea cases: 227.1 per 100K people (138 cases) - Syphilis cases (non-congenital): 3.3 per 100K people (2 cases) --- Primary and secondary syphilis: 1.6 per 100K people (1 case) --- Nonprimary and nonsecondary early syphilis: 1.6 per 100K people (1 case)
#16. Ottawa County
- Chlamydia cases: 336.3 per 100K people (1,006 cases) - Gonorrhea cases: 85.6 per 100K people (256 cases) - Syphilis cases (non-congenital): 4.7 per 100K people (14 cases) --- Primary and secondary syphilis: 2.7 per 100K people (8 cases) --- Nonprimary and nonsecondary early syphilis: 2.0 per 100K people (6 cases)
#15. Mecosta County
- Chlamydia cases: 359.7 per 100K people (144 cases) - Gonorrhea cases: 102.4 per 100K people (41 case) - Syphilis cases (non-congenital): 15.0 per 100K people (6 cases) --- Primary and secondary syphilis: 10.0 per 100K people (4 cases) --- Nonprimary and nonsecondary early syphilis: 5.0 per 100K people (2 cases)
#14. Macomb County
- Chlamydia cases: 378.0 per 100K people (3,314 cases) - Gonorrhea cases: 159.7 per 100K people (1,400 cases) - Syphilis cases (non-congenital): 18.0 per 100K people (158 cases) --- Primary and secondary syphilis: 10.3 per 100K people (90 cases) --- Nonprimary and nonsecondary early syphilis: 7.8 per 100K people (68 cases)
#13. Bay County
- Chlamydia cases: 383.6 per 100K people (395 cases) - Gonorrhea cases: 133.0 per 100K people (137 cases) - Syphilis cases (non-congenital): 6.8 per 100K people (7 cases) --- Primary and secondary syphilis: 2.9 per 100K people (3 cases) --- Nonprimary and nonsecondary early syphilis: 3.9 per 100K people (4 cases)
#12. Washtenaw County
- Chlamydia cases: 393.1 per 100K people (1,452 cases) - Gonorrhea cases: 145.4 per 100K people (537 cases) - Syphilis cases (non-congenital): 13.0 per 100K people (48 cases) --- Primary and secondary syphilis: 9.2 per 100K people (34 cases) --- Nonprimary and nonsecondary early syphilis: 3.8 per 100K people (14 cases)
#11. Isabella County
- Chlamydia cases: 424.3 per 100K people (275 cases) - Gonorrhea cases: 104.9 per 100K people (68 cases) - Syphilis cases (non-congenital): 1.5 per 100K people (1 case) --- Primary and secondary syphilis: 1.5 per 100K people (1 case) --- Nonprimary and nonsecondary early syphilis: 0 cases
#10. Jackson County
- Chlamydia cases: 515.5 per 100K people (825 cases) - Gonorrhea cases: 268.7 per 100K people (430 cases) - Syphilis cases (non-congenital): 6.2 per 100K people (10 cases) --- Primary and secondary syphilis: 2.5 per 100K people (4 cases) --- Nonprimary and nonsecondary early syphilis: 3.7 per 100K people (6 cases)
#9. Kent County
- Chlamydia cases: 586.7 per 100K people (3,861 case) - Gonorrhea cases: 279.2 per 100K people (1,837 cases) - Syphilis cases (non-congenital): 14.6 per 100K people (96 cases) --- Primary and secondary syphilis: 9.6 per 100K people (63 cases) --- Nonprimary and nonsecondary early syphilis: 5.0 per 100K people (33 cases)
#8. Berrien County
- Chlamydia cases: 595.0 per 100K people (911 case) - Gonorrhea cases: 345.5 per 100K people (529 cases) - Syphilis cases (non-congenital): 3.9 per 100K people (6 cases) --- Primary and secondary syphilis: 2.6 per 100K people (4 cases) --- Nonprimary and nonsecondary early syphilis: 1.3 per 100K people (2 cases)
#7. Ingham County
- Chlamydia cases: 629.5 per 100K people (1,788 cases) - Gonorrhea cases: 343.6 per 100K people (976 cases) - Syphilis cases (non-congenital): 15.8 per 100K people (45 cases) --- Primary and secondary syphilis: 7.4 per 100K people (21 case) --- Nonprimary and nonsecondary early syphilis: 8.4 per 100K people (24 cases)
#6. Saginaw County
- Chlamydia cases: 658.3 per 100K people (1,248 cases) - Gonorrhea cases: 345.5 per 100K people (655 cases) - Syphilis cases (non-congenital): 5.8 per 100K people (11 case) --- Primary and secondary syphilis: 4.2 per 100K people (8 cases) --- Nonprimary and nonsecondary early syphilis: 1.6 per 100K people (3 cases)
#5. Calhoun County
- Chlamydia cases: 665.8 per 100K people (891 case) - Gonorrhea cases: 397.6 per 100K people (532 cases) - Syphilis cases (non-congenital): 12.7 per 100K people (17 cases) --- Primary and secondary syphilis: 9.0 per 100K people (12 cases) --- Nonprimary and nonsecondary early syphilis: 3.7 per 100K people (5 cases)
#4. Genesee County
- Chlamydia cases: 667.5 per 100K people (2,698 cases) - Gonorrhea cases: 428.5 per 100K people (1,732 cases) - Syphilis cases (non-congenital): 7.2 per 100K people (29 cases) --- Primary and secondary syphilis: 4.5 per 100K people (18 cases) --- Nonprimary and nonsecondary early syphilis: 2.7 per 100K people (11 case)
#3. Kalamazoo County
- Chlamydia cases: 728.4 per 100K people (1,902 cases) - Gonorrhea cases: 418.6 per 100K people (1,093 cases) - Syphilis cases (non-congenital): 36.8 per 100K people (96 cases) --- Primary and secondary syphilis: 25.7 per 100K people (67 cases) --- Nonprimary and nonsecondary early syphilis: 11.1 per 100K people (29 cases)
#2. Muskegon County
- Chlamydia cases: 773.9 per 100K people (1,366 cases) - Gonorrhea cases: 438.5 per 100K people (774 cases) - Syphilis cases (non-congenital): 4.5 per 100K people (8 cases) --- Primary and secondary syphilis: 2.8 per 100K people (5 cases) --- Nonprimary and nonsecondary early syphilis: 1.7 per 100K people (3 cases)
#1. Wayne County
- Chlamydia cases: 777.5 per 100K people (13,799 cases) - Gonorrhea cases: 441.6 per 100K people (7,838 cases) - Syphilis cases (non-congenital): 45.6 per 100K people (809 cases) --- Primary and secondary syphilis: 25.4 per 100K people (451 case) --- Nonprimary and nonsecondary early syphilis: 20.2 per 100K people (358 cases)
This story features data reporting and writing by Emma Rubin and is part of a series utilizing data automation across 49 states.