Ranking America’s Colleges by STI Outbreak Surge Risk

We analyzed the STI risk of 1,259 colleges and found that six U.S. colleges face critical STI surge risk, while 73% show declining infection trends from 2021–2023. 

A new report by LabCafe provides the first systematic identification of colleges at highest risk for STI outbreaks. 

Key Takeaway

• Great Basin College (Nevada) shows highest risk with 331% chlamydia growth rate.
• Tribal colleges face 3.6× higher STI rates than national average.
• Vermont institutions show concerning growth despite lower baseline rates.
• 915 colleges (73%) show declining STI trends.

Risk Assessment

College campuses have long struggled with high STI rates among 18–24 year olds, but systematic risk assessment has been lacking. This analysis fills a critical gap by identifying specific institutions requiring immediate public health attention.

Our approach:

• Analyzed CDC surveillance data for all 3,142 U.S. counties (2021–2023)  
• Mapped 2,575 colleges to county-level STI data using FIPS codes  
• Applied data quality controls excluding counties with fewer than 5 baseline cases  
• Created Risk-Surge Index combining growth rates and current STI burden  
• Classified colleges into five risk categories from declining to critical

High-Risk Institutions

Critical Risk (>50 Risk-Surge Index):

• Great Basin College (Elko, NV) — Index: 66.6
• Little Priest Tribal College (Winnebago, NE) — Index: 60.1

High Risk (25–50 Risk-Surge Index):

• West Texas A&M University (Canyon, TX) — Index: 47.5
• Chadron State College (Chadron, NE) — Index: 29.7
• Chief Dull Knife College (Lame Deer, MT) — Index: 27.7
• Vermont Law School (South Royalton, VT) — Index: 27.6

Surge Risk by College

Statistical Summary

• Mean Risk-Surge Index: -1.2 (indicating overall decline)
• Tribal colleges average STI rate: 4,337 per 100,000
• National average STI rate: 3,306 per 100,000

Top 10 States by Average STI Risk (Colleges)

• Nevada — Average Risk: 66.6, Colleges: 1, Critical Risk Colleges: 1.
• Vermont — Average Risk: 8.8, Colleges: 16, High Risk Colleges: 1.
• Nebraska — Average Risk: 5.2, Colleges: 18, Critical Risk Colleges: 1, High Risk Colleges: 1.
• Louisiana — Average Risk: 3.9, Colleges: 15.
• Delaware — Average Risk: 2.4, Colleges: 2.
• Massachusetts — Average Risk: 1.1, Colleges: 29.
• Oregon — Average Risk: 0.7, Colleges: 16.
• Texas — Average Risk: 0.6, Colleges: 43, High Risk Colleges: 1.
• New York — Average Risk: 0.4, Colleges: 79.
• Rhode Island — Average Risk: 0.4, Colleges: 5.

THE BOTTOM LINE

With most colleges showing declining STI trends, the path forward is clear: maintain momentum through smart, targeted prevention and testing. For the small number of high-risk campuses, timely testing and early detection can make the difference between isolated cases and campus-wide outbreaks. 

Methodology

Data Sources

• Utilized CDC Atlas Plus STI Surveillance System (2021–2023)
• Matched 2,575 U.S. colleges to county-level case data using FIPS codes
• Specification and validation protocols ensured accurate geographic mapping

Data Quality Controls

• Excluded counties with fewer than 5 baseline cases to avoid statistical noise
• Applied rigorous statistical validation, retaining 93.1% of initial dataset for analysis

Risk-Surge Index Construction

• Developed an index combining recent chlamydia growth rates and current STI burden
• Index formula: (Growth Rate × Current Rate) divided by 10,000
• Provided guidelines for interpreting index and identified thresholds for risk categories

Geographic & Institutional Analysis

• Aggregated results at the state and institutional levels
• Classified colleges by risk level; analyzed temporal trends and seasonal patterns

Limitations & Assumptions

• County-level data may not capture campus-specific risks
• Methodological decisions and any data constraints are clearly stated for transparency