Where in Florida are STI risks the highest?

Key Takeaways

• Syphilis rates nearly doubled from 13.3 to 24.0 cases per 100,000 between 2017 and 2022 in Florida.
• Gonorrhea increased by about 30%, from 176.4 to 230.4 cases per 100,000 over the same period.
• Florida’s STI Risk Score is 41.4 (12th highest in the U.S.).
• Gadsden County’s risk score (23.7) is over four times higher than St. Johns County (5.9).

Sexually transmitted infections (STIs) remain a significant public health challenge in Florida. A new report by LabCafe examines trends in reportable bacterial STIs, assessing Florida’s statewide risk profile.

Trends in Reportable Bacterial STIs (2017–2022).

• Gonorrhea rates have risen sharply, increasing by about 30% from 176 to 230 cases per 100,000.
• Primary and Secondary Syphilis rates nearly doubled, from 13 to 24 cases per 100,000, marking the steepest growth among the three major reportable STIs; these early stages are highly contagious and marked by sores and rash.
• Chlamydia rates have remained steady, at about 555 cases per 100,000 in both 2017 and 2022, with only a temporary dip during the pandemic in 2020

Current Statewide Outlook (2022)

LabCafe calculated two separate STI-Risk Scores—one calculated at the state level and one at the county level—but both use the same variables, combining local STI infection burden rates (such as chlamydia, gonorrhea, syphilis, and new HIV diagnoses) and socio-economic vulnerability factors (like poverty, low education, and lack of insurance) to assess risk consistently across different geographic scales.

• Florida’s STI Risk Score is 41.4 (on a 0–100 scale), ranking 12th highest among U.S. states.
• The infection burden is higher than average (about 35.6),  ranking 12th highest among U.S. states.
• Florida is ranking 9th for the socio-economic strain indicator (about 53.1), reflecting challenges like poverty, uninsured rates, and housing instability.
• These structural vulnerabilities, combined with moderately high disease rates, elevate Florida’s overall STI risk profile.

County-Level Risk Variation (2022)

Highest-risk counties:

• Gadsden County (risk score: 23.7)
• Hamilton County (19.2)
• Union County (18.1)
• Washington County (17.9)
• Leon County (17.7)

Lowest-risk counties:

• St. Johns County (risk score: 5.9)
• Sumter County (6.2)
• Nassau County (6.4)
• Santa Rosa County (6.8)
• Wakulla County (7.7)

Results by County

Implications

• Rising STI rates—especially for syphilis and gonorrhea—demand renewed prevention efforts.
• The gap between the highest- and lowest-risk counties is about fourfold, illustrating how unevenly STI risk is distributed across Florida.
• Targeted interventions in the highest-risk counties could yield significant impact, while low-risk counties provide models for effective prevention.

Methodology

Data sources

• U.S. figures came from the CDC’s 2023 STI  surveillance tables. Each line gives one pathogen-specific rate (chlamydia, gonorrhea, primary & secondary syphilis, or new HIV diagnoses) for a state or territory.
• County-level microdata:CDC NCHHSTP Atlas.

County risk score 

• Gather four pathogen rates per county (chlamydia, gonorrhea, primary + secondary syphilis, new HIV) and four ACS percentages (poverty, no-HS diploma, uninsured, vacant housing).
• Min-max scale each variable to 0–100 so the lowest county becomes 0 and the highest becomes 100.
• Infection burden = average of the four scaled pathogen measures.
   Socio-economic strain = average of the four scaled structural measures.
• Combine with a 2-to-1 weight:
   Risk=0.67×Burden+0.33×StrainRisk=0.67×Burden+0.33×Strain
• National mean ≈ 9.9; scores above that signal elevated exposure or barriers to care.

State risk score 

• Gather four pathogen rates per state(chlamydia, gonorrhea, primary + secondary syphilis, new HIV) and four ACS percentages (poverty, no-HS diploma, uninsured, vacant housing).
• Min-max scale each variable to 0–100 so the lowest county becomes 0 and the highest becomes 100.
• Infection burden = average of the four scaled pathogen measures.
   Socio-economic strain = average of the four scaled structural measures.
• Combine with a 2-to-1 weight:
   Risk=0.67×Burden+0.33×StrainRisk=0.67×Burden+0.33×Strain