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STD Rates in St. Louis: What the Latest Data Shows

Updated · Sources are cited in the text

STD Rates in St. Louis: What the Latest Data Shows

This page is general health information, not medical advice. It cannot tell you whether you have an infection. A clinician can, and the testing options on this site are a good place to start.

People often search for STD rates to answer a simple question: how common are these infections where I live? The honest answer has several layers. Rates describe groups of people, not any one person. They depend on how much testing is done. And in St. Louis, the picture differs between the City of St. Louis, St. Louis County and the state of Missouri.

This guide gathers the most recent figures published by local and state sources. It gives the year and the source for each number. It also says plainly where a current figure is not published, so you are never left guessing. At the end, it points to free and low-cost testing in the city.

Key Takeaways

  • In 2021, the City of St. Louis had 108 new HIV diagnoses, a rate of 36.0 per 100,000 people. St. Louis County had 143 (15.0 per 100,000). Missouri had 633 (10.0 per 100,000). Source: City of St. Louis Fast-Track Cities HIV Data.
  • From 2019 to 2020, the St. Louis County gonorrhea and syphilis rates rose 13%. In the City, the gonorrhea rate rose 5% and syphilis did not change significantly. Source: City of St. Louis Department of Health news release, April 2022.
  • Reported chlamydia fell in 2020, by 15% in the City and 10% in the County. The health department attributes the City drop to reduced pandemic testing, so a lower number does not necessarily mean fewer infections.
  • 56 congenital syphilis cases were reported in the City and County combined from 2020 through 2022, according to the City of St. Louis Department of Health.
  • Testing is free at the City's Health Stop, and no ID is needed. Several other clinics offer low-cost or sliding-scale testing.

Table of Contents

  1. How to read STD rates (and why they differ)
  2. HIV: city, county and state rates
  3. Chlamydia, gonorrhea and syphilis in the St. Louis area
  4. Congenital syphilis and prenatal testing
  5. STD rates by state and by city: making fair comparisons
  6. What shapes the numbers
  7. Free and low-cost testing in St. Louis
  8. Sources

How to Read STD Rates (and Why They Differ)

Before the numbers, a few ideas make them easier to use.

Cases versus rates

A case count is the number of people reported. A rate adjusts for population size, usually as cases per 100,000 people. Rates let you compare places of different sizes. The City of St. Louis has fewer residents than St. Louis County, so a raw count alone would be misleading.

Reported is not the same as total

Public health data count infections that were tested for, diagnosed and reported. Many chlamydia and gonorrhea infections cause no symptoms, so they are found only when someone is tested. More testing can raise a reported rate. Less testing can lower it, even when nothing else has changed.

Two health departments

The City of St. Louis is an independent city and is not part of St. Louis County. The City of St. Louis Department of Health and the Saint Louis County Department of Public Health are separate agencies. They publish separate numbers. This guide keeps them apart.

What rates cannot tell you

A rate describes a community. It cannot tell any person whether they have an infection. Only a test and a clinician can do that. Anyone who is sexually active can be tested, regardless of the neighborhood they live in.

HIV: City, County and State Rates

The most complete recent HIV figures come from the City of St. Louis Fast-Track Cities HIV Data page. For 2021 it reports:

AreaNew HIV diagnoses (2021)Rate per 100,000
City of St. Louis10836.0
St. Louis County14315.0
Missouri63310.0

Source: City of St. Louis Fast-Track Cities HIV Data, 2021. The state row is as reported on that page.

What the comparison shows

The County had more new diagnoses than the City in 2021 (143 compared with 108). The City's rate was higher because it has a smaller population. At 36.0 per 100,000, the City rate was more than three times the statewide rate of 10.0.

What is not published here

A 2023 city and county HIV rate was not available to us at the time of writing. If you need the newest HIV figures, ask the City of St. Louis Department of Health at (314) 612-5100, or contact the Missouri Department of Health and Senior Services HIV, STI and Hepatitis program at 888-252-8045 or [email protected].

HIV is treatable

HIV is not curable, but it is treatable and manageable with care from a clinician. The City's Linkage to Care Intake Line is 314-356-0200 for people who want help connecting to care. The City of St. Louis HIV page says a free, confidential rapid HIV test is available at many places in the area.

Chlamydia, Gonorrhea and Syphilis in the St. Louis Area

The newest local detail on bacterial STIs comes from a City of St. Louis Department of Health news release (April 2022) that summarized a CDC report on 2020 data. These numbers are a few years old. We have no current city or county rates for these infections, so treat them as a snapshot rather than today's picture.

City of St. Louis, 2020

  • Chlamydia: the reported rate fell 15% in 2020. The health department attributed this to reduced testing during the pandemic.
  • Highest group: women ages 15 to 24 had the highest chlamydia rate, at 6,071 per 100,000.
  • Gonorrhea: the rate rose 5% from 2019.
  • Syphilis: incidence did not change significantly.

St. Louis County, 2019 to 2020

  • Gonorrhea and syphilis: rates were up 13% from 2019 to 2020.
  • Chlamydia: the reported rate was down 10% in 2020.

Missouri chlamydia, 2023

America's Health Rankings, citing CDC AtlasPlus data, lists Missouri's 2023 chlamydia rate at 498.6 per 100,000 people and ranks the state 33rd among states. This is a secondary source, so confirm it against CDC AtlasPlus if you need to cite it formally. We do not have 2023 state-level gonorrhea or syphilis rates to report.

A note on the year-over-year change

The 2020 figures were affected by pandemic-era disruptions to clinics and testing. Falling chlamydia numbers that year should not be read as a sign that infections truly dropped by the same amount. The health department's own explanation points to less testing.

These infections are curable

Chlamydia, gonorrhea and syphilis are bacterial infections. Each is curable with treatment prescribed by a clinician. Finding them early is the reason testing matters, because many cause no noticeable symptoms.

Congenital Syphilis and Prenatal Testing

Congenital syphilis happens when syphilis passes from a pregnant person to a baby. It is one of the clearest signals that testing and care are not reaching everyone in time. Local data show:

  • City of St. Louis: 10 cases in 2020, up from 5 in 2019 (City of St. Louis Department of Health, April 2022).
  • St. Louis County: 4 cases in 2020, or 3.8 per 10,000 live births (same source).
  • City and County combined: 56 cases reported from 2020 through 2022, according to the City of St. Louis Department of Health (November 2023 health advisory).

What Missouri law says about prenatal blood tests

Under Missouri Revised Statutes section 210.030, a person providing obstetrical care must, if the pregnant woman consents, take a blood sample at the first prenatal visit or within 20 days after it. The sample is tested for syphilis, hepatitis B, hepatitis C and HIV. The statute also describes later draws. Because a 2025 House bill proposes to amend this section, check the current text of the statute, or ask your prenatal clinician, before relying on the timing.

Why this matters

Syphilis in pregnancy can be treated by a clinician. Being tested early gives the care team time to act. If you are pregnant or planning a pregnancy, ask your clinician which tests are part of your visits.

STD Rates by State and by City: Making Fair Comparisons

Many people look up STD rates by state or STD rates by city to see how their community compares. That is a reasonable goal, but a few cautions apply.

Comparing states

CDC AtlasPlus is the national tool that lets you view reported chlamydia, gonorrhea, syphilis and HIV rates by state. A state ranking, like Missouri's 33rd place for chlamydia in 2023, depends on the infection, the year and how many people were tested. A single rank says little about your own risk or about what is happening on your block.

Comparing cities and counties

City and county rates can differ sharply from state rates, as the 2021 HIV figures show. The City of St. Louis rate (36.0) sits well above the County (15.0) and the state (10.0). A county line on a map does not stop people from traveling, working or having partners across it. For that reason, the City, the County and Missouri are best read together.

Comparing years

Be careful with year-over-year change. A 13% rise or a 15% fall can reflect changes in testing, reporting or clinic access as much as changes in infections. Look for several years in a row before drawing a conclusion.

Checking the newest numbers yourself

  • CDC AtlasPlus for state and county data on reported infections.
  • The City of St. Louis Department of Health for city news releases and HIV data.
  • The Missouri Department of Health and Senior Services for statewide surveillance, at 888-252-8045 or [email protected].

What Shapes the Numbers

Rates come from a mix of factors. The sources we rely on support several of them directly.

How much testing happens

Because many infections have no symptoms, testing volume has a large effect on reported rates. The City of St. Louis Department of Health linked the 2020 chlamydia drop to reduced pandemic testing. When more people have easy access to testing, more infections are found, and more are treated.

Screening recommendations

The U.S. Preventive Services Task Force (USPSTF) recommends chlamydia and gonorrhea screening for sexually active women 24 and younger, and for older women at increased risk. USPSTF also recommends HIV screening for adolescents and adults ages 15 to 65. The CDC STI Treatment Guidelines (2021) give more detailed screening advice for other groups, including men who have sex with men, transgender and gender diverse people, and pregnant people. A clinician can tell you which tests fit your situation.

Age

The City's 2020 data show the highest chlamydia rate among women ages 15 to 24, at 6,071 per 100,000. That fits a national pattern in which younger people are tested more often and have more new infections reported.

Access to care and prevention

Access to a nearby clinic, to a clinician who can provide treatment, and to partner services all influence how quickly infections are found and treated. Prevention tools also matter. CDC's 2024 guidance on doxycycline post-exposure prophylaxis (doxy-PEP) describes it as an option that a clinician can prescribe for some people, including gay and bisexual men and transgender women who have had a bacterial STI in the past year. PrEP and PEP for HIV are also prescribed by a clinicians. The WashU Infectious Diseases clinic in Hazelwood lists PrEP, PEP and doxy-PEP among its services. Call to confirm what is currently offered.

Treating partners

Missouri allows expedited partner therapy for chlamydia and gonorrhea under Mo. Rev. Stat. 191.648, effective August 2010. This lets a clinician provide treatment for partners who have not been seen by that prescriber. The CDC page on the legal status of EPT in Missouri explains the details.

Free and Low-Cost Testing in St. Louis

Numbers are only useful if they lead to action. Testing is how a person finds out their own status, and it is the first step to treatment if needed. For a fuller walkthrough of costs and options, see where to get tested in St. Louis and what it costs. You can also jump to the local testing list.

City of St. Louis Health Stop Testing and Referral Center

  • Address: 1520 Market St, Suite 1625 (first floor), St. Louis, MO 63103.
  • Phone: (314) 657-1584 for scheduling, results help and linkage to care.
  • Cost: The City says there is no cost for the service, and no ID is necessary.
  • Hours: Monday to Thursday, 9 a.m. to 12 p.m. and 1 p.m. to 4 p.m. Closed Fridays and city holidays.
  • Tests listed: HIV (finger-prick or blood draw), hepatitis C (finger-prick), gonorrhea and chlamydia (urine, mouth swab or rectal swab), and syphilis (blood or finger-prick).
  • Timing: The City says STI results take 5 to 7 business days, and rapid tests take about 15 minutes.

The City page says walk-ins are accepted subject to availability. The CDC GetTested listing says an appointment is required. Calling ahead is the safest way to avoid a wasted trip.

Free HIV self-test kits

Health Stop provides a free oral-swab HIV self-test kit. The City page also says kits can be ordered by mail through TakeMeHome.org, which offers free kits after a short eligibility screen. TakeMeHome.org can be reached at [email protected] or 628-899-4663. The City does not list free at-home kits for other STIs.

Saint Louis County Sexual Health Clinic

This clinic is at 4000 Jennings Station Road, St. Louis, MO, phone 314-615-9736. According to WashU Infectious Diseases, which lists it, the clinic is walk-in only with no appointments. It offers STI prevention, testing and treatment, and everyone is welcome regardless of where they live or their insurance status. We could not find published hours or prices, so call ahead.

WashU Infectious Diseases, Village Square Clinic

Located at 1 Village Square Shopping Center, Suite 1, Hazelwood, MO 63042, phone 314-362-9098. A May 2024 WashU news article describes a CDC-funded expansion aimed at walk-in testing at no or low cost, with treatment for walk-in patients and their partners. Services mentioned include PrEP, PEP and doxy-PEP. Hours and exact prices are not listed, so confirm by phone.

Planned Parenthood Great Rivers, Central West End Health Center

At 4251 Forest Park Ave, St. Louis, MO 63108, phone 314-531-7526. The CDC GetTested listing shows tests for HIV, herpes, chlamydia, gonorrhea and syphilis, as well as PrEP navigation and HPV vaccine. It lists sliding-scale pricing, accepts insurance and Medicaid, and says an appointment is required. Hours are not listed.

CareSTL Health, Dr. Martin Luther King Health Center

At 5471 Dr Martin Luther King Dr, St. Louis, MO 63112, phone 314-367-5820. The CDC GetTested listing shows HIV, chlamydia, gonorrhea and syphilis tests, plus PrEP navigation and vaccines. It lists sliding-scale fees, and insurance, Medicaid and Medicare are accepted. An appointment is required, and hours are not listed.

Saint Louis County Department of Public Health, John C. Murphy Health Center

At 6121 N Hanley Rd, Berkeley, MO 63134, phone 314-615-0500. The CDC GetTested listing shows hepatitis A, hepatitis B and HPV vaccines, with a sliding scale and an appointment required. The listing did not show STI or HIV tests for this site, so ask the clinic what is available.

If you are under 18

Missouri Revised Statutes section 431.061 says a minor may consent for themselves to treatment in the case of venereal disease. The statute states no minimum age. If you have questions about how this applies to testing, ask the clinic when you call.

Finding more places

The CDC's GetTested locator lets you search by ZIP code for HIV and STI testing sites, including ones not listed here.

Questions to ask when you call

  • Do you take walk-ins, or do I need an appointment?
  • What does the visit cost, and is there a sliding scale?
  • Which infections are included in the tests?
  • How and when will I get my results?
  • If a test is positive, can you provide treatment or connect me to care?

Testing is a routine part of health care. Whatever your gender, orientation or relationship status, you are welcome to ask for it. If you are unsure which tests make sense, a clinician can help you decide. For questions about when a test can detect a recent exposure, ask the clinic or check CDC guidance, since the timing differs by infection.

Sources