The Rising Tide of STIs in Utah: A County-by-County Look at a Growing Public Health Concern

Utah's numbers tell a story that's almost the opposite of what most states are dealing with right now. Chlamydia and gonorrhea have both fallen for two years running, and Utah's overall STI rate ranks among the lowest in the entire country. But follow just one line on that chart — syphilis — and the picture flips completely. Rates have climbed nearly 80% since 2019, congenital syphilis cases have more than quadrupled over the same stretch, and almost all of it traces back to one place: Salt Lake County. This report walks through what the Utah Department of Health and Human Services' own 2023 surveillance data says about Salt Lake City, Provo, Ogden, Layton, and St. George, and why a state with genuinely good overall numbers still has a real, fast-growing problem hiding inside them.

Common STIs and HIV in Utah

Four conditions make up almost every conversation about sexual health in this state.

• Chlamydia is, by a wide margin, Utah's most-reported infection, and it disproportionately shows up in teenage girls and young women, who get screened more often than young men.
• Gonorrhea is the one bucking Utah's "low incidence state" reputation the least — it's actually falling faster here than the national average.
• Syphilis is the infection driving Utah's numbers upward, and its most tragic form isn't in an adult — it's congenital syphilis, passed from an untreated pregnant person to their baby.
• HIV in Utah is genuinely rare compared to most states, but new diagnoses still cluster overwhelmingly around the Salt Lake Valley.

Statewide Trends: A Five-Year Look at the Numbers (2019–2023)

Utah's health department tracks these conditions closely, and its own five-year data shows chlamydia easing from 342.7 to 316.6 cases per 100,000 residents, and gonorrhea falling even further — from 89.1 down to 76.3, a second straight year of double-digit declines. Syphilis (all stages, including congenital) is the outlier: it went from 13.4 cases per 100,000 in 2019 to 24.1 in 2023, a jump of nearly 80%, with a 23% single-year rise in 2023 alone.

Nationally, Utah ranks 44th for chlamydia and 43rd for gonorrhea — meaning only a handful of states report less of either. Syphilis is a different story: Utah ranks 37th for both P&S syphilis and congenital syphilis, which is a meaningfully worse national standing than its other two numbers, and the direction of travel matters more than the ranking. Fifteen- to 24-year-olds make up just 17% of Utah's population but 55% of all reported STI cases, and the combined chlamydia/gonorrhea/syphilis rate in that age group (2,302 per 100,000) is more than double the rate in 25-to-34-year-olds (873.8 per 100,000).

HIV in Utah: A Small but Concentrated Picture

Utah's HIV numbers stay genuinely low by national standards — roughly 110 people were newly diagnosed statewide in the most recent year reported, and the state's diagnosis rate has hovered near 4 cases per 100,000 for over a decade. But "low" doesn't mean "spread out." Historically, 90%-plus of Utah's new HIV diagnoses come from the Wasatch Front, and Salt Lake County alone has accounted for the large majority of those on its own. The most recent county-level breakdown available put Salt Lake County's rate of residents living with diagnosed HIV at 158.8 per 100,000 — roughly three times Davis County's rate and well above every rural health district in the state. Around 3,200 Utahns are living with HIV today, and male-to-male sexual contact remains the single most common transmission route among men. Anyone concerned about their own exposure can look into PrEP and PEP, both of which are available in Utah without requiring a positive test first.

Salt Lake City, Provo, Ogden, Layton & St. George Compared

Utah's health department doesn't report by individual county the way some states do — it groups results into 13 local health districts, most of which line up neatly with a single major county or city. Here's how the state's five biggest population centers compared in 2023:

*Cases per 100,000 residents, 2023. Source: Utah DHHS, STI Surveillance Report 2014–2023.

A couple of other things stand out once you get past the biggest cities. Statewide, syphilis rates in women aged 15–44 climbed more than 3.5 times since 2019, with the sharpest jump among women in their early thirties — and that group's rates directly drive congenital syphilis, since the infection passes from mother to baby during pregnancy. Every one of Utah's 13 local health districts reported at least one syphilis case in 2023, small rural ones included, which is itself a change from a decade ago when the infection barely registered outside Salt Lake and Weber counties.

What's Driving Utah's Numbers

No single factor explains a trend like this, but a few keep showing up in the state's own reporting and local coverage:

• Explosive population growth along the Wasatch Front. Utah County alone added more than 16,000 residents in a single recent year — more growth, faster, than public health infrastructure can always keep pace with.
• The youngest population in the country. Utah has the lowest median age of any U.S. state, and 15-to-24-year-olds — who test positive at far higher rates than any other age group — make up an outsized share of residents.
• Conservative social norms around premarital sex. Utah's health department has flagged stigma as a real barrier — some residents are hesitant to get tested, ask a partner about their sexual history, or bring up symptoms with a doctor.
• Gaps in sex education. State law defaults to an abstinence-based curriculum unless a district or parent opts in for more, leaving plenty of young adults without a clear picture of transmission risk or where to get tested confidentially.
• Dating apps and casual encounters. Same shift seen nationally — we cover the mechanics in our piece on dating apps and STD risk.
• Underserved populations bearing a disproportionate load. Black, American Indian/Alaska Native, and Native Hawaiian/Pacific Islander Utahns make up just 3% of the state's population but a combined STI rate several times higher than everyone else — a gap the state itself links to poverty, education access, and healthcare availability rather than anything else.

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