STD Epidemiology in Texas: A Data Analysis from 1992-2018

The report presents data on chlamydia and gonorrhea diagnoses in Texas from 1992 to 2018, highlighting trends in cases, demographics, and incidence rates by county. It also showcases chlamydia diagnoses among women by race/ethnicity during the period 2009-2018. The information sheds light on the epidemiological landscape of sexually transmitted diseases in Texas.

• STD Epidemiology Texas Data Analysis
• Chlamydia Diagnoses Trends
• Gonorrhea Statistics
• Public Health Surveillance

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1. STD Epidemiology in Texas, 2018 Prepared by the Epidemiology and Supplemental Projects Group HIV/STD Epidemiology and Surveillance Branch Texas Department of State Health Services

2. Chlamydia Diagnoses in Texas, 1992-2018 160,000 140,000 120,000 100,000 Diagnoses 80,000 60,000 40,000 20,000 0 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2 Year

3. Chlamydia Diagnoses by Year in Texas, 2009-2018 Male, all ages Female, 15-24 years Female, <15 or >24 years 160,000 140,000 22% 22% 22% 120,000 23% 22% 22% 21% 20% 20% 100,000 20% Diagnoses 80,000 47% 48% 49% 50% 52% 53% 55% 56% 60,000 57% 58% 40,000 31% 30% 29% 20,000 28% 26% 25% 24% 24% 23% 22% 0 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Year 3

4. Chlamydia Incidence Rates by County in Texas, 2018 4

5. Chlamydia Diagnoses Among Women by Race/Ethnicity in Texas, 2009-2018* 45,000 40,000 35,000 30,000 Diagnoses 25,000 20,000 15,000 10,000 5,000 0 Year 2009 16,949 23,513 35,249 45 71 718 58 1,326 3,610 2010 19,328 25,479 38,143 51 88 760 54 1,483 3,657 2011 20,929 25,893 40,147 80 85 851 68 1,465 4,170 2012 21,536 25,161 38,906 49 89 815 70 1,330 6,499 2013 22,843 23,065 38,306 66 94 785 83 1,422 7,140 2014 21,315 22,162 37,797 79 96 871 81 1,127 12,981 2015 20,489 21,055 35,605 65 56 746 80 1,549 17,620 2016 20,630 21,945 36,331 109 62 808 106 1,124 19,303 2017 20,725 24,014 39,070 102 67 991 97 1,941 14,490 2018 16,002 19,881 32,162 0 70 680 84 1,266 29,905 White Black Hispanic NHPI** AIAN# Asian Multi Race Other, unspecified Unknown **Native Hawaiian/Pacific Islander #American Indian/Alaskan Native 5 *A delay in updating the race/ethnicity field in the surveillance data has resulted in a large number of cases with race/ethnicity as unknown for 2018. Ongoing data quality improvement will address this for 2019 reporting. Numbers should be interpreted with caution.

6. Gonorrhea Diagnoses in Texas, 1992-2018 50,000 45,000 40,000 35,000 30,000 Diagnoses 25,000 20,000 15,000 10,000 5,000 0 Year 6

7. Gonorrhea Incidence Rates by County in Texas, 2018 7

8. Gonorrhea Diagnoses by Race/Ethnicity in Texas, 2009-2018* 18,000 16,000 14,000 12,000 Diagnoses 10,000 8,000 6,000 4,000 2,000 0 Year 2009 4,760 15,067 7,371 10 26 171 19 430 2010 5,534 15,587 7,959 16 45 158 27 443 2011 5,536 14,259 8,939 26 31 185 21 539 2012 6,334 14,222 9,154 14 38 218 32 512 2013 7,412 13,834 9,449 27 31 178 32 529 2014 7,645 14,034 9,421 32 48 228 45 432 2015 8,307 13,717 9,594 36 37 274 51 582 2016 9,437 15,230 10,444 51 36 272 64 486 2017 9,991 16,651 12,151 45 54 319 59 868 2018 8,709 15,038 10,789 1 32 304 101 671 White Black Hispanic NHPI** AIAN# Asian Multi Race Other, unspecified **Native Hawaiian/Pacific Islander #American Indian/Alaskan Native *A delay in updating the race/ethnicity field in the surveillance data has resulted in a large number of cases with race/ethnicity as unknown for 2018. Ongoing data quality improvement will address this for 2019 reporting. Numbers should be interpreted with caution. 8

9. Gonorrhea Diagnoses by Age Group & Race/Ethnicity in Texas, 2018* Other race in all other ages** 2% White ages 15-24 7% Unknown all other ages 11% Black ages 15-24 17% Hispanic all other ages 11% Hispanic ages 15-24 11% Black all other ages 15% Unknown ages 15-24 13% Other race ages 15- 24** 1% White all other ages 11% *A delay in updating the race/ethnicity field in the surveillance data has resulted in a large number of cases with race/ethnicity as unknown for 2018. Ongoing data quality improvement will address this for 2019 reporting. Numbers should be interpreted with caution. 9 **Other race includes: Native Hawaiian/Pacific Islander, American Indian/Alaskan Native, Asian, Multi-race, and other/unspecified

10. Primary & Secondary Syphilis Diagnoses in Texas, 1992-2018 4,000 3,500 3,000 2,500 Diagnoses 2,000 1,500 1,000 500 0 Year 10

11. Primary and Secondary Syphilis Incidence Rates by County in Texas, 2018 11

12. Primary & Secondary Syphilis Diagnoses by Race/Ethnicity in Texas, 2009-2018* 1200 1000 Diagnoses 800 600 400 200 0 Year 2009 303 981 334 0 0 6 0 7 8 2010 219 696 297 1 2 10 2 2 2 2011 269 525 358 0 3 9 4 6 1 2012 422 571 615 0 1 13 0 15 1 2013 391 511 535 3 1 15 4 8 3 2014 444 608 526 5 1 22 3 9 5 2015 450 539 677 1 1 23 5 10 14 2016 546 592 760 1 1 35 10 7 7 2017 590 633 832 3 4 35 9 9 34 2018 613 840 936 0 3 40 7 21 68 White Black Hispanic NHPI** AIAN# Asian Multi Race Other, unspecified Unknown **Native Hawaiian/Pacific Islander #American Indian/Alaskan Native *A delay in updating the race/ethnicity field in the surveillance data has resulted in a large number of cases with race/ethnicity as unknown for 2018. Ongoing data quality improvement will address this for 2019 reporting. Numbers should be interpreted with caution. 12

13. Primary & Secondary Syphilis Diagnosis Rates by Year of Diagnosis and Sex in Texas, 2009-2018 16 14 12 Rate per 100,000 10 8 6 4 2 0 2009 9.4 3.9 2010 7.1 2.6 2011 7.2 2 2012 10.5 2.1 2013 9.8 1.4 2014 10.3 1.8 2015 10.9 1.7 2016 12.4 1.7 2017 13.1 2.1 2018 14.8 2.9 Year Male Female Male Female Note: males and females include transgender persons 13

14. Primary & Secondary Syphilis Diagnoses by Sex and MSM* in Texas, 2009-2018 2,800 MSM Male Non- and Unknown MSM Female 2,400 17% 2,000 14% 12% 29% Diagnoses 21% 1,600 14% 22% 15% 17% 30% 13% 19% 20% 1,200 22% 22% 27% 22% 33% 800 24% 28% 64% 55% 66% 67% 65% 61% 65% 400 55% 38% 44% 0 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Year *MSM = men who have sex with men 14

15. Congenital Syphilis Diagnoses in Texas, 1998-2018 400 350 300 250 Diagnoses 200 150 100 50 0 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Year 15

16. Congenital Syphilis Diagnosis Rates in Texas, 2009-2018 400 350 Rate per 10,000 Live Births 300 250 200 150 100 50 0 2008 13.0 146.2 21.2 10.8 2009 8.1 136.3 25.9 10.7 2010 11.2 123.5 19.0 10.6 2011 9.8 116.0 19.2 10.2 2012 9.8 71.9 18.0 8.3 2013 7.5 68.0 16.7 4.1 2014 8.0 82.7 12.7 3.7 2015 5.1 46.3 21.5 7.1 2016 4.4 54.7 19.9 3.5 2017 14.6 138.9 39.3 10.6 2018 26.3 343.0 86.9 3.5 Year White Black Hispanic Other White Black Hispanic Other 16

17. Diagnoses and Rates of Primary & Secondary and Early Latent Syphilis among MSM* in Texas, 2010-2018 2000 350 1800 300 1600 250 1400 Rate per 100,000 1200 Diagnoses 200 1000 150 800 600 100 400 50 200 0 0 2010 2011 2012 2013 2014 Year 2015 2016 2017 2018 P&S Syphilis Diagoses Early Latent Syphilis Diagnoses P&S Syphilis Rate Early Latent Syphilis Rate 17 *MSM = men who have sex with men

18. Primary & Secondary and Early Latent Syphilis Incidence Rates Among MSM* by County in Texas, 2018 *MSM men who have sex with men 18