Counties with the Highest STD Rates
| County | Chlamydia Rate | Gonorrhea Rate | Notable Factors |
|---|---|---|---|
| Shelby (Memphis) | 959.7 | 561.6 | Highest overall rates in state |
| Montgomery (Clarksville) | 1,005.8 | High | Fort Campbell, Austin Peay State |
| Davidson (Nashville) | 824.8 | 395.5 | Tourism, nightlife, universities |
| Rutherford (Murfreesboro) | Elevated | Elevated | MTSU, rapid growth |
| Hamilton (Chattanooga) | Above average | Above average | Regional hub |
| Knox (Knoxville) | Above average | Above average | UT Knoxville |
Year-Over-Year Trends
Tennessee’s STD rates have fluctuated in recent years. While national rates showed declines in 2023 and 2024, certain Tennessee counties (particularly Shelby County) have seen significant increases in syphilis and HIV diagnoses. Shelby County reported a 36% rise in HIV rates and a 100% increase in syphilis rates since 2018, with the sharpest increases among people aged 15-35.
Why Tennessee’s Rates Are Elevated
Several factors contribute to Tennessee’s higher-than-average STD rates.
Urban Population Centers
Memphis and Nashville are major metropolitan areas with dense populations, active nightlife scenes, and high rates of social mixing. Memphis consistently has one of the highest STD rates of any major U.S. city.
College and University Populations
Tennessee is home to numerous colleges and universities including the University of Tennessee, Vanderbilt, University of Memphis, Middle Tennessee State, Austin Peay, and Tennessee State. The 18-24 age group accounts for the highest proportion of STD diagnoses nationally.
Military Presence
Fort Campbell, located on the Tennessee-Kentucky border near Clarksville, brings a large population of young adults to Montgomery County. This contributes to that county’s elevated chlamydia rates.
Healthcare Access Disparities
Rural areas of Tennessee often have limited access to healthcare services, including STD testing and treatment. This can lead to delayed diagnoses and continued transmission.
Tourism Corridors
Nashville’s tourism industry attracts millions of visitors annually, and the Great Smoky Mountains draw visitors to East Tennessee. These tourism patterns create opportunities for disease transmission.
Private labs like Quest Diagnostics, LabCorp, and Priority STD Testing offer same-day walk-in testing with results typically within 1-3 business days. Rapid HIV tests available at some community testing events can provide results in as little as 20 minutes.
No. Tennessee law allows healthcare providers to test and treat minors for sexually transmitted infections without parental knowledge or consent. This applies to both public health clinics and private providers. The law is designed to remove barriers that might prevent young people from getting tested.
Yes. At-home STD tests use the same CLIA-certified laboratory technology as in-person testing. The accuracy is comparable to clinic-based testing when samples are collected correctly. Most reputable at-home testing services include clear instructions and physician review of all results.
Chlamydia is by far the most commonly reported STD in Tennessee, followed by gonorrhea and syphilis. Tennessee ranks in the top 15 states nationally for both chlamydia and gonorrhea rates. HIV also remains a significant concern, particularly in urban areas like Memphis.
Costs vary widely. Public health clinics offer free or sliding-scale testing (typically $0-$25). Private labs charge $50-$300+ depending on the tests ordered. At-home test kits range from $35-$200. Many insurance plans cover routine STD screening, though using insurance creates a record.
Private testing services and at-home kits offer the most privacy—results go directly to you without involving insurance or your regular doctor. Public health clinics provide confidential testing (your information is protected but recorded). True anonymous testing using code numbers may be available at certain HIV testing events.
Free testing is available through county health departments, Planned Parenthood (for those who qualify), Nashville CARES, and various community health centers. Most public clinics use sliding-scale fees based on income, so even if testing isn’t completely free, costs can be minimal.
Public vs Private STD Testing in Tennessee
| Feature | Public/Community Clinics | Private Labs |
|---|---|---|
| Cost | Free–$25 (sliding scale based on income) | $50–$400+ (fixed pricing) |
| Turnaround Time | 1–2 weeks | 1–3 days |
| Privacy | Confidential; recorded in system | Confidential; can pay out-of-pocket to avoid insurance records |
| Appointment Needed? | Often required; may have wait times | Walk-ins accepted at most locations |
| Types of Tests | Common STDs (chlamydia, gonorrhea, syphilis, HIV) | Comprehensive panels available |
| Insurance Accepted? | TennCare, some private plans | Most plans accepted; direct pay available |
| Best For | Those needing affordable care, uninsured, or seeking ongoing support | Those prioritizing speed, convenience, and privacy |