Texas’s near-total abortion ban, its concerning rate of teen pregnancies and its abysmal number of health clinics played into its ranking. Credit: Pexels / cottonbro studio
San Antonio has the highest rate for sexually transmitted infections, or STIs, of any large Texas metro, according to a new study, which also ranked our city 22nd in the nation for infection rates.

Health information site Innerbody Research this week released its 8th annual report ranking the 100 largest U.S. metro areas on their STI rates. The analysis is based on 2023 data from the Centers for Disease Control and Prevention (CDC), the most recent released by the federal agency.

The San Antonio area recorded 1,182 STI cases per 100,000 people, according to the study, placing it well above Killeen, the Texas metro with the next-highest infection level. That military-heavy Central Texas town reported 1,076 cases per 100,000 residents, while Fort Worth and Amarillo ranked 2nd and 3rd in the state, respectively.

The Alamo City’s overall infection numbers for 2023 included 14,191 new chlamydia cases, 6,622 new gonorrhea cases, 578 new syphilis cases and 396 new HIV cases.

While Detroit grabbed the study’s unenviable No. 1 spot, Southern states once again accounted for the largest share of the cities with the highest STI rates. Even though South is home to just 39% of the U.S. population, it accounted for 60% of the metros in the list’s top 25.

Overall, U.S. STI rates dropped by 1.8% in 2023 from 2022, according to the data. That continues to reverse a trend that edged upward for the better part of two decades leading up to the COVID-19 pandemic.

While the report’s authors noted that the drop is a positive sign, more public-health investment and focus is likely needed to reverse the alarming rise leading up to COVID.

“While a drop of nearly 2% in the national STI rate is something to celebrate, this rate remains 90% higher than it was in 2004,” the report states. “What seems like a scant 1% increase overall in the syphilis infection rate still translates to the highest levels of syphilis infection in our country since 1950.”

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This article appears in Jan 8-21, 2025.

Sanford Nowlin is editor-in-chief of the San Antonio Current. He holds degrees from Trinity University and the University of Texas at San Antonio, and his work has been featured in Salon, Alternet, Creative...