US STI Positivity Trends

Updated: April 2025

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HealthTrackRx
Trend Update

With changing trends in prevalence, sexually transmitted infections (STIs) continue to present serious public health concerns that call for ongoing monitoring and surveillance. This report examines positivity rates of Chlamydia trachomatis and Neisseria gonorrhoeae from 2023 to 2024. These organisms can cause significant complications if left untreated,1 so having a thorough understanding of current positivity trends can help clinicians make more informed decisions on testing strategies.

US STI Positivity Trends

Updated: April 2025

Get Updates

HealthTrackRx
Trend Update

With changing trends in prevalence, sexually transmitted infections (STIs) continue to present serious public health concerns that call for ongoing monitoring and surveillance. This report examines positivity rates of Chlamydia trachomatis and Neisseria gonorrhoeae from 2023 to 2024. These organisms can cause significant complications if left untreated,1 so having a thorough understanding of current positivity trends can help clinicians make more informed decisions on testing strategies.

Gonorrhea

  • Gonorrhea positivity was highest among individuals under the age of 25 in both 2023 and 2024, aligning with CDC data that identifies this population as being at highest risk for this infection.3

  • While positivity rates in the 20–24 age group remained stable from 2023 to 2024, increases were observed across all other age groups in 2024.

  • These trends highlight the importance of early diagnosis and treatment—especially among individuals under 25—to curb further transmission.

Chlamydia

  • Chlamydia positivity remained highest among individuals aged 15–19 years in both 2023 and 2024, consistent with CDC findings that identify adolescents as the age group at greatest risk for this infection.2

  • Notably, this group also experienced the largest increase in positivity between 2023 and 2024. In contrast, positivity rates among individuals aged 25 and older remained stable during the same period.

  • From 2023 to 2024, chlamydia positivity rates shifted notably across states. The largest increases were observed in Washington, Maryland, and Delaware. In contrast, Nevada and South Dakota reported the largest decreases.

Gonorrhea

  • Gonorrhea positivity was highest among individuals under the age of 25 in both 2023 and 2024, aligning with CDC data that identifies this population as being at highest risk for this infection.3

  • While positivity rates in the 20–24 age group remained stable from 2023 to 2024, increases were observed across all other age groups in 2024.

  • These trends highlight the importance of early diagnosis and treatment—especially among individuals under 25—to curb further transmission.

Chlamydia

  • Chlamydia positivity remained highest among individuals aged 15–19 years in both 2023 and 2024, consistent with CDC findings that identify adolescents as the age group at greatest risk for this infection.2

  • Notably, this group also experienced the largest increase in positivity between 2023 and 2024. In contrast, positivity rates among individuals aged 25 and older remained stable during the same period.

  • From 2023 to 2024, chlamydia positivity rates shifted notably across states. The largest increases were observed in Washington, Maryland, and Delaware. In contrast, Nevada and South Dakota reported the largest decreases.

Year over Year
Year over Year
Change in Positives per 1000 tests for Chlamydia trachomatis from 2023 to 2024

This report reflects observed trends in HealthTrackRx testing positivity data, does not convey medical advice, and is provided for informational purposes only.  Individuals experiencing respiratory symptoms should consult with their healthcare provider.

This report examines positivity rates of Trichomonas vaginalis and Mycoplasma genitalium from 2023 to 2024. These organisms can cause significant complications if left untreated,1 so having a thorough understanding of current positivity trends can help clinicians make more informed decisions on testing strategies.

This report examines positivity rates of Trichomonas vaginalis and Mycoplasma genitalium from 2023 to 2024. These organisms can cause significant complications if left untreated,1 so having a thorough understanding of current positivity trends can help clinicians make more informed decisions on testing strategies.

Trichomonas

  • Unlike chlamydia and gonorrhea, trichomonas infection is more commonly seen in individuals over the age of 25.2 This pattern was reflected in the 2023–2024 data, with the highest positivity rates observed in the 40–54 age group.

  • In contrast to the upward trends seen with other STIs, overall Trichomonas positivity declined in 2024 compared to 2023.

  • Additionally, Trichomonas positivity in 2024 varied greatly on a geographic basis, with the highest positivity rates concentrated in the Deep South, as well as Nevada and Ohio.

Mycoplasma Genitalium

  • Mycoplasma genitalium is an emerging STI now recognized by the CDC as a significant pathogen of concern.4
  • In 2024, positivity rates were highest among individuals aged 15–19 years, mirroring the age distribution seen with other common STIs such as chlamydia and gonorrhea. Markedly, there was a minor spike in positivity among individuals aged 35-39, suggesting potential increased testing awareness in this age group.

Trichomonas

  • Unlike chlamydia and gonorrhea, trichomonas infection is more commonly seen in individuals over the age of 25.2 This pattern was reflected in the 2023–2024 data, with the highest positivity rates observed in the 40–54 age group.

  • In contrast to the upward trends seen with other STIs, overall Trichomonas positivity declined in 2024 compared to 2023.

  • Additionally, Trichomonas positivity in 2024 varied greatly on a geographic basis, with the highest positivity rates concentrated in the Deep South, as well as Nevada and Ohio.

Mycoplasma Genitalium

  • Mycoplasma genitalium is an emerging STI now recognized by the CDC as a significant pathogen of concern.4
  • In 2024, positivity rates were highest among individuals aged 15–19 years, mirroring the age distribution seen with other common STIs such as chlamydia and gonorrhea. Markedly, there was a minor spike in positivity among individuals aged 35-39, suggesting potential increased testing awareness in this age group.
Year over Year
Year over Year
Positives per 1000 tests for Trichomonas vaginalis in 2024

This report reflects observed trends in HealthTrackRx testing positivity data, does not convey medical advice, and is provided for informational purposes only.  Individuals experiencing respiratory symptoms should consult with their healthcare provider.

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Explore Our STI Testing Menus

Find the right STI tests for your patients with a variety of options to fit each individual’s needs as based on your clinical assessments. Explore videos, case studies, and more to make the best choice.

EXPLORE MY OPTIONS

Collaboration with UPS Healthcare®

Together with UPS Healthcare®, HealthTrackRx has transformed how tens of thousands of providers diagnose and treat infections, improving patient outcomes nationwide.

SEE HOW WE DELIVER NEXT-MORNING RESULTS

Boost Patient Health & Overall Satisfaction

HealthTrackRx offers providers the ability to choose one simple panel for STI testing to get the right diagnosis faster, treat more patients, and ultimately provide greater access to prompt treatment.

SEE THE BENEFITS

References

Chlamydia and Gonorrhea

  1. Workowski, K. A., Bachmann, L. H., Chan, P. A., Johnston, C. M., Muzny, C. A., Park, I., Reno, H., Zenilman, J. M., & Bolan, G. A. (2021). Sexually transmitted infections treatment guidelines, 2021. MMWR. Recommendations and Reports, 70(4), 1–187.
    https://doi.org/10.15585/mmwr.rr7004a1
  2. Centers for Disease Control and Prevention. (2021, July 22). Chlamydial infections – STI treatment guidelines.
    https://www.cdc.gov/std/treatment-guidelines/chlamydia.htm
  3. Centers for Disease Control and Prevention. (2022, September 21). Gonococcal infections among adolescents and adults – STI treatment guidelines.
    https://www.cdc.gov/std/treatment-guidelines/gonorrhea-adults.htm

Trichomonas and Mycoplasma Genitalium

  1. Workowski, K. A., Bachmann, L. H., Chan, P. A., Johnston, C. M., Muzny, C. A., Park, I., Reno, H., Zenilman, J. M., & Bolan, G. A. (2021). Sexually transmitted infections treatment guidelines, 2021. MMWR. Recommendations and Reports, 70(4), 1–187.
    https://doi.org/10.15585/mmwr.rr7004a1
  2. Centers for Disease Control and Prevention. (2022b, September 21). Trichomoniasis – STI treatment guidelines.
    https://www.cdc.gov/std/treatment-guidelines/trichomoniasis.htm
  3. Zhang, Z., Li, Y., Lu, H., Li, D., Zhang, R., Xie, X., Guo, L., Hao, L., Tian, X., Yang, Z., Wang, S., & Mei, X. (2022). A systematic review of the correlation between Trichomonas vaginalis infection and infertility. Acta Tropica, 236, 106693.
    https://doi.org/10.1016/j.actatropica.2022.106693
  4. Centers for Disease Control and Prevention. (2021c, July 22). Mycoplasma genitalium – STI treatment guidelines.
    https://www.cdc.gov/std/treatment-guidelines/mycoplasmagenitalium.htm

References

Chlamydia and Gonorrhea

  1. Workowski, K. A., Bachmann, L. H., Chan, P. A., Johnston, C. M., Muzny, C. A., Park, I., Reno, H., Zenilman, J. M., & Bolan, G. A. (2021). Sexually transmitted infections treatment guidelines, 2021. MMWR. Recommendations and Reports, 70(4), 1–187.
    https://doi.org/10.15585/mmwr.rr7004a1
  2. Centers for Disease Control and Prevention. (2021, July 22). Chlamydial infections – STI treatment guidelines.
    https://www.cdc.gov/std/treatment-guidelines/chlamydia.htm
  3. Centers for Disease Control and Prevention. (2022, September 21). Gonococcal infections among adolescents and adults – STI treatment guidelines.
    https://www.cdc.gov/std/treatment-guidelines/gonorrhea-adults.htm

Trichomonas and Mycoplasma Genitalium

  1. Workowski, K. A., Bachmann, L. H., Chan, P. A., Johnston, C. M., Muzny, C. A., Park, I., Reno, H., Zenilman, J. M., & Bolan, G. A. (2021). Sexually transmitted infections treatment guidelines, 2021. MMWR. Recommendations and Reports, 70(4), 1–187.
    https://doi.org/10.15585/mmwr.rr7004a1
  2. Centers for Disease Control and Prevention. (2022b, September 21). Trichomoniasis – STI treatment guidelines.
    https://www.cdc.gov/std/treatment-guidelines/trichomoniasis.htm
  3. Zhang, Z., Li, Y., Lu, H., Li, D., Zhang, R., Xie, X., Guo, L., Hao, L., Tian, X., Yang, Z., Wang, S., & Mei, X. (2022). A systematic review of the correlation between Trichomonas vaginalis infection and infertility. Acta Tropica, 236, 106693.
    https://doi.org/10.1016/j.actatropica.2022.106693
  4. Centers for Disease Control and Prevention. (2021c, July 22). Mycoplasma genitalium – STI treatment guidelines.
    https://www.cdc.gov/std/treatment-guidelines/mycoplasmagenitalium.htm
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