The Centers for Disease Control and Prevention collects, analyzes, and disseminates surveillance data on Sexually transmitted diseases (STDs) diagnoses. The Atlas presents chlamydia, gonorrhea, congenital syphilis, and primary and secondary syphilis case report data submitted from all 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, and Guam for the years 2000 to 2014 and early latent syphilis case report data for 2003-2014. STD data are presented by disease, year of diagnosis, reporting area (state or territory), age group, race/ethnicity, and sex.
Nationally notifiable STD surveillance data are collected and compiled from reports sent to CDC’s Division of STD Prevention by the STD control programs and health departments in all 50 states, the District of Columbia, selected cities, U.S. dependencies and possessions, and independent nations in free association with the United States.
STD morbidity data presented in this report are compiled from a combination of data reported on standardized hard copy reporting forms and electronic data received through the National Electronic Telecommunications System for Surveillance (NETSS) for diagnosis years 2000 through 2014. NETSS phase-in began in 1996 and was completed by the end of 2002. As of 2003, all 50 states and the District of Columbia had converted from summary hard copy reporting to electronic submission of line-listed STD data through NETSS. Puerto Rico converted in 2006. Guam and the Virgin Islands continue to submit via hard copy form. Hard copy form data are collected using form CDC 73.2638, which contains summary data for primary and secondary syphilis, gonorrhea, and chlamydia by reporting state or territory age, race, sex, and source. Although all states and the District of Columbia currently report chlamydia, gonorrhea, and non-congenital syphilis data in the electronic NETSS format, some areas continue to submit the case-specific hard copy form CDC 73.126 for congenital syphilis.
For each disease, year, state, age, and sex, cases and rates are reported for all races combined. When specific race/ethnicity data are presented in this atlas, the following OMB compliant categories are reported: American Indian or Alaska Native, Asian, Black or African American, Hispanic or Latino, Native Hawaiian or Other Pacific Islander, White and multirace. States began reporting these OMB compliant race categories in different years. Therefore, specific race categories are reported for a state only in the years when that state reported 97% or more of its cases with OMB compliant race categories. Specific OMB compliant race categories are reported at the national level for the last five years based on the counts of the states that reported OMB compliant race categories for all five years.
Interpreting Rates of Reported Cases of Chlamydia:
Trends in rates of reported cases of chlamydia are influenced by changes in incidence of infection, as well as changes in diagnostic, screening, and reporting practices. As chlamydial infections are usually asymptomatic, the number of infections identified and reported can increase as more people are screened even when incidence is flat or decreasing. Expanded use of more sensitive diagnostics tests (e.g., nucleic acid amplification tests) can also increase the number of infections identified and reported independent of increases in incidence. Additionally, increasing use of electronic laboratory reporting has likely increased the proportion of diagnosed cases that are reported. Consequently, an increasing chlamydia case rate may reflect increases in incidence of infection, screening coverage, and use of more sensitive tests, as well as more complete reporting. Likewise, decreases in chlamydia case rates may suggest decreases in incidence of infection or screening coverage
Cases of a given STD refer to confirmed diagnoses during a given time period. For example, the 2012 data on gonorrhea infection would include persons with laboratory-confirmed infection diagnosed between January 1, 2012 and December 31, 2012 and reported to CDC through July 7, 2014
In the absence of direct data re-release agreements between CDC and the jurisdictions governing STD data, CDC follows the 1996 Council of State and Territorial Epidemiologists (CSTE) data re-release rules for STD data. For STD data, the data suppression rule is applied when the numerator for a given state is 3 or less. When suppressed, data are only displayed by state totals and age and sex demographic characteristics. Display of county-level data is limited to total rate or case count, with no demographic breakdown; therefore, no data suppression is used at the county level
Rates per 100,000 population were calculated for each STD. The population denominators used to compute these rates for the 50 states and the District of Columbia were based on the U.S. Census Bureau population estimates utilizing the OMB compliant race categories. Each rate was calculated by dividing the number of cases for the calendar year by the population for that calendar year and then multiplying the number by 100,000. Denominator data for Puerto Rico consist of unmodified estimates from the U.S. Census Bureau aggregated by year, age group, and sex. Race/ethnicity-specific population data are not available for Puerto Rico. Due to lack of data from the U.S. Census Bureau and small cell sizes, rates are not calculated for the U.S. territories (except Puerto Rico for age and sex). Natality data from the National Center for Health Statistics (NCHS) is used to calculate congenital syphilis rates at the national- and state- levels. County-level rates are not available for congenital syphilis