Chlamydia, Gonorrhea, and Syphilis are the most common sexually transmitted diseases (STDs) diagnosed in the US. In Maryland, the rates of these STDs have been rising steadily within the past five years. The Centers for Disease Control and Prevention (CDC) statewide analysis for the year 2018 suggests that Maryland ranks 12th for the number of chlamydia and primary and secondary (P&S) syphilis cases, 9th for congenital syphilis, and 24th for gonorrhea cases.
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Medically reviewed by one or more members of the editorial boardWhy Testing Matters?
Many reasons are responsible for the sustained rise in STD cases. The most prominent ones include lack of awareness about protective measures to avoid sexually transmitted infections (STIs) that later convert into STDs and delayed testing.
STDs and STIs come at a high cost for all vulnerable sections of the population, especially women and babies. In Maryland, there were 29 newborn babies diagnosed with syphilis in 2018, while the state's infection rate for infants is the 9th highest in the US. These are tragic figures, but the pandemic doesn't impact infants only.
There were a record number of cases reported in all main STDs in Maryland, while the rate of congenital syphilis was highest in newborns. CDC states that an improvement in the nation's overall health and addressing issues like infertility, congenital disabilities, infant deaths, and HIV rely on curbing STDs.
STIs are chronic infections that often lead to lifelong health conditions, such as inflammation and scarring of the reproductive organs, infertility, pelvic inflammatory disease, and complicated pregnancy, to name a few. Timely screening and treatment, particularly in women of childbearing age, is important.
In Maryland, congenital syphilis is among the most concerning issues because undiagnosed and untreated pregnant females are at a higher risk of stillbirth and miscarriage. Similarly, for untreated newborns, congenital syphilis can cause detrimental health concerns. It can affect their skin, eyes, bones, ears, brain, and heart, and can cause developmental problems and even death soon after birth. Maryland was featured in the top seven US states for the highest rates of congenital syphilis between 2012 and 2017, which makes timely testing for pregnant women even more crucial.
Compared to older adults, young people, especially young females, are more vulnerable to chlamydial infections in Maryland. Nevertheless, all sexually active individuals are at risk of contracting chlamydia. Therefore, CDC recommends annual testing and screening of chlamydia in sexually active individuals aged 25 or above. Those who have multiple sex partners, men who have sex with men, and those who already have an STI should get tested at least once a year.
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Sexual and gender minorities.
2530 N Charles St, 3rd Fl, Baltimore, Maryland 21218
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Use our confidential STD symptom checker to get an idea of what STDs/STIs your symptoms align with and what STD tests are recommended to you.
Start Symptom CheckerWhich Method of STD Testing is Suitable for Me?
Every sexually active individual must protect their sexual health. Regular STD testing is the only way to care for your sexual health. However, sometimes it becomes confusing to select the right testing method as there are so many options available. For your convenience, we have gathered information about all available STD testing methods in Maryland. Check them out to find out which option is suitable for you.
This is one of the most popular ways to get tested for STDs today. These tests combine the best of both worlds for convenience and accuracy. You will order the test online at home, but you can walk into a professional lab testing center to get tested.
Another option is to simply visit your regular clinic and talk to your doctor.
If you do not want to visit a testing center, then a great alternative is an at-home test kit. You don’t even need to leave your house to get tested for STDs this way, which makes it the most discreet option. Everything is done through email and snail mail.
One last option for STD testing is a trip to a free clinic. If you go to a public STD-testing clinic, then you may get a free or discounted test, depending on your financial situation.
Learn more in our ultimate guide to STD testing.
It can be, but it does not necessarily have to be. What many people need to understand is that laboratory tests would most often than not be relatively pricey due to the technology that is being utilized behind these diagnostic techniques. However, opting for specific laboratories that offer more convenient testing procedures and discounted prices for diagnostic tests would help ensure that the price will not be much of an issue in providing you with the conclusive diagnosis of your condition. It might take some independent scanning to find the right testing center for you in the most acceptable price range, but it is not as impossible as many people make it out to be.
Considering that a wide variety of testing kits and laboratory procedures can be performed to determine conclusively whether you have a particular STD or not, the time that it will take for your results to return will also be subject to the same inconsistency. Although there are specific laboratories that could produce your results even by the end of the day (albeit, it is extremely rare for institutions to do so unless necessary), most would often take a few days to a week before the results are either delivered or posted online through your secure personal profile (in the case of online transactions). In addition to that, the capability of the laboratory performing the test may also contribute to the overall timeframe of result delivery – causing delays in cases where there are several requests or understaffed to provide expedited results.
For more information, skip to the FAQs section on this page.
Test Advisor
Know all about STD testing options, and the costs of different STD tests.
Maryland STD Data
The total number of STDs (chlamydia, gonorrhea, and P&S syphilis) cases reported in Maryland showed a 53% increase from 2009 to 2018, according to the Maryland Department of Health's Center for STI Prevention's annual report. The P&S syphilis infection rate increased from 5.5 cases/100,000 people in 2009 to 12.2 cases/100,000 people in 2018, recording a 222% increase overall.
According to the CDC's 2018 STDs surveillance report, the prevalence of the three main STDs described above has increased drastically in Maryland. The most impacted area is the Baltimore metropolitan area. InnerBody reported that Baltimore had 2,004 STD cases per 100,000 people in 2018, 207 HIV cases, 7,636 chlamydia diagnoses, 4,231 gonorrhea cases, and 210 syphilis cases in 2018. Furthermore, the state's congenital syphilis cases increased at a rate of 39.7/100,000 people, which was the 9th highest in the US as per 2018-2019 estimations.
In 2018, the rate of syphilis' most infectious stages rose significantly among adults in Maryland. Reportedly, the number of cases increased to 737 at the rate of 12.3/100,000 people. It was the country's 12th worst rate. The number of chlamydia cases in Maryland also increased considerably in comparison to 2017. The state recorded 35,483 total cases of chlamydia in 2018, at a rate of 586 cases/100,000 residents. It was the 12th worst rate countrywide. Gonorrhea rate dropped to 10,300 cases in 2018, at a rate of 170 cases/100,000 Marylanders. It was the nation's 24th highest rate.
Baltimore metro area is the worst affected zone in Maryland. In 2018, there were over 17,400 cases of STDs in Baltimore, Columbia, and Towson combined. Out of these, 1,392 were syphilis and 5,998 gonorrhea cases. Statewide, there were 2,536 cases of STDs in 2018, while in 2017, 2,059 cases were diagnosed. Overall, the number of gonorrhea cases went down in Maryland during 2018, with around 10,305 cases. Comparatively, in 2017, the state reported 10,970 cases.
According to the Maryland Department of Health and Centers for Disease and Control (CDC), Maryland has been ranked as the 6th highest in estimated active HIV cases in the year 2018. During the year 2019, Baltimore City and Prince George County had the highest rates of new cases. The total number of newly diagnosed HIV cases was 931, out of which the majority, 74%, were black or African-American residents. About 11% of the total newly diagnosed cases were Non-Hispanic Whites, and 2% accounted for the other ethnic groups present in the State.
Maryland Department of Health states that around 10.8% of the people living with HIV (PLWH) are still undiagnosed. Owing to the rise in HIV cases, the CDC recommends all the individuals living in HIV populated areas to get tested at least once a year. There are numerous ways the virus spreads, and it is essential to get tested if the locality or the community of residence has HIV active cases. Individuals belonging to the age group 13 to 64 years should at least get tested once in their lifetime.
As per the US Census Bureau, the total population of Maryland State in 2019 was over 6 million. Of the total population, the largest population is that of non-Hispanic White Americans (58.5%). The second-largest ethnic groups of Maryland are African Americans (31.1%). Minority groups in Maryland include the Non-Hispanic Asians as well as the Hispanic whites and other small minority groups.
According to the Maryland Department of Health, during the year 2019, a total of 931 HIV diagnoses were made. Of the total number, the largest percentage was that of the Black Americans. In 2018, the total headcount of people living with HIV in Maryland was 33,194. During the same year, 996 people were newly diagnosed with the virus.
Maryland ranked 12th in chlamydia cases, which means the state reported over 586 cases per 100,000 residents. Women aged 35 or above were disproportionately affected by chlamydia, whereas males above 35-years reported a higher number of chlamydia cases. The highest number of chlamydial infection was reported among females aged 20 to 24, with 4,525 cases/100,000 population.
Females aged between 15 and 24 accounted for the highest number of gonorrheal infections, with 44% of all reported cases. In comparison to males, females below 20 years of age had higher infection rates, while males had higher rates for the rest of the age groups. Males aged 20-24 were the most at-risk group among males as they reported 727 gonorrhea cases/100,000 people in 2018.
Between 2014 and 2015, the rate of chlamydia increased for nearly all racial groups in Maryland. African-Americans are the worst affected population group in Maryland. The black population continually reported higher chlamydia and gonorrhea infection rates with 858 cases and 361.1 cases/100,000 residents.
Syphilis is the most common STI in Maryland that is diagnosed with HIV. Around 40% of diagnoses in 2018 were co-infected with HIV. Gonorrhea and chlamydia's co-infection with HIV is relatively less common. Older adults were affected the most, as around 20% of co-infections were diagnosed in people aged 40-45. Fewer than 5% of females aged between 20-24 years were diagnosed with gonorrhea co-infected with HIV. Around 23% of chlamydia infections among men who have sex with men were chlamydia reinfections, 19% of cases among African-Americans, and 20% of cases reported in other racial groups were also chlamydia reinfections.
According to the AidsVU Survey document, in 2018, the total number of HIV active cases in Maryland was 33,194. Of the total number, 65.9% were males, while 34.1 % were females. African Americans still accounted for the largest percentage of the total diagnosis, i.e., 71.1 %. Individuals with Latin and White backgrounds followed at 7.1 and 12.7%, respectively.
The majority of the cases were that of individuals belonging to the age group 45+ (36.5%). 27.5% of the total diagnosis belonged to 35-44, 18.1% belonged to 25-34 years. Around 17 % of cases were that of young adults age 13 to 24 years. The rate of black Americans living with HIV was 8.1 times that of white males. The data of the year 2018 showed that the rate of Black American females living with the virus was 17.3 times that of white females. It is evident that Black Americans were still the bigger health disparity group considering HIV.
The prevalence of HIV in Maryland is more in Gay or bisexual males, transgender females, young adults who inject drugs, and black females who most commonly contract the virus through sexual contact.
The rates of HIV
in Maryland dropped to an all-time
low of the last 30 years in 2018. While the
stats show the downward trend of a new diagnosis, the black population has
still been disproportionately affected. Reports from the Maryland Department of
Health have shown that the prevalence of the virus was three to ten times more
in the non-Hispanic Black Americans as compared to their Hispanic or White
counterparts. The report further states the probability of death for Black
Americans having HIV in Maryland was five times higher than any other ethnic
group.
Maryland comprises 24 jurisdictions, including Baltimore City and 23 counties, each having an independent local health department. The state has introduced several initiatives to address the rising rate of STDs in Maryland. For instance, the Baltimore City Health Department's HIV/STD Prevention Program was launched to focus on activities and efforts to prevent the spread of STDs across Baltimore City.
Two categorical STD clinics are operated under this program. The clinics offer testing, diagnosis, and treatment services for commonly occurring STDs, family planning services, hepatitis B immunization via the Vaccine for Children's program, and Ryan White primary care services for HIV patients. Through this program, over 30,000 patients are treated annually. The program also supports health education services to community groups and schools, but this service is strictly offered upon request.
The Center for STI Prevention (CSTIP) is responsible for performing STI surveillance in Maryland. The CSTIP monitors disease trends and early detection of outbreaks. It also implements evidence-based practices to manage resources effectively and identify common risk factors and disparities among the impacted communities. Moreover, CSTIP offers technical, epidemiological, and programmatic consultation services to local health care providers, health departments, and organizations across the state to increase public awareness and reduce transmission of STIs. It also monitors reported chlamydia, syphilis, and gonorrhea cases.
Reinfection is very common in people who have been diagnosed or treated for chlamydia and gonorrhea. In Maryland, HIV and syphilis cases are given comprehensive follow-up services, also called Partner Services. This includes additional testing and treatment and notifying partners of the individuals regarding the risk of exposure and the need for testing. However, the follow-up service isn't offered for gonorrhea and chlamydia cases because the number of cases is too high to provide partner services.
Health Resource and Service Administration (HRSA), an agency of the US Department of Health located in North Bethesda, Maryland, functions to improve the healthcare services in the State. The agency primarily targets the vulnerable, uninsured, and medically isolated patients and works to facilitate them.
HRSA has been working in the state for the last two decades for the eradication of HIV. In line with the National HIV/AIDS strategy, the four basic goals of HRSA for the year 2020 were to reduce new HIV infections, easy access, and improvement in healthcare services for people living with HIV. Reduction in HIV related health disparities and health inequalities and ensuring a more coordinated response for the HIV epidemic are part of the HRSA HIV goals for 2020.
HRSA is further working to reduce the HIV rates by at least 25% in the state and encourage as well as increase the testing capacity. Maryland and Baltimore have significantly improved new diagnosis services. Reduction of disparities is still a challenge, though.
The Institute of Human Virology at the University of Maryland School Of Medicine has initiated a program called the JACQUES Initiative. JACQUES initiative works towards supporting the most vulnerable individuals living with the virus. Under this initiative, efforts are made to minimize the stigma related to HIV and overcoming the health disparities. JACQUES initiative is focused on the holistic care approach by involving individuals from all walks of life through a journey of wellness.
Along with the stated initiatives, the State of Maryland receives grants for the medical services under the Ryan White Part b program that runs in almost all states of the country. The funds received through the Ryan White Part B program are also used for creating awareness among the general public. The awareness and educational sessions are mostly based on enlightening the public about the benefits of early testing and diagnosis as well as the measures to be taken for preventing the spread of the virus.
How Does it Work?
Most people experience feelings of hesitation when going to get tested for STD, despite knowing they might have contracted one. EasySTD was created to change that.
Visit your nearest lab or clinic, order your home testing kit online, and follow the given instructions from an STD testing provider.
After ordering your STD test, visit the testing center to get tested or take a self sample including urine, cotton swab, or finger prick with the home testing kit and mail it back.
Receive the lab-certified results of your STD test from your test provider via mail or phone within 2 to 3 days. If the test comes positive, consult your doctor immediately.
Cities Nearby
It does vary on a case-to-case basis. Insurance policies are often particular with the instances that they would be covering with their program. Some may cover severe accidents, some may even consider “orphan disease,” and yes, some may also cover the expenses for performing STD diagnostic tests. However, considering that your insurance provider will have to verify the person's identity availing of the program, STD testing laboratories that employ a minimal collection of patient information may not accept insurance policies to prioritize privacy over affordability.
A nucleic acid amplification test is a laboratory procedure that professionals often perform to make detecting a particular nucleic acid or gene being targeted easier and more convenient while still ensuring that the sample being collected is relatively minimal. Nucleic acid amplification tests, or NAATs, are usually the mainstay diagnostic test for most STDs due to their ability to detect the presence of pathogenic nucleic acids and genes in the patient sample with utmost accuracy and speed. NAATs depends on their ability to replicate the target RNA and DNA to create numerous copies – resulting in an increased convenience in the detection of the desired molecules instead of trying to either blindly look for one strand in a minuscule sample or collecting a large sample that could make the patient uncomfortable throughout the process. Although NAATs are often preferred for a more conclusive diagnosis of STDs, certain exceptions such as the availability of resources and instances of intermittent viral shedding could make NAATs less desirable than other tests. Fret not, however, as your physician is knowledgeable regarding these instances and would often request the best diagnostic procedure for your instances.
It would vary depending on the condition that is being tested. STDs behave differently due to the varying pathogenicity of each STD’s causative organism. In some instances, you can get accurately tested as early as two weeks following exposure, while some are intermittently inaccurate due to its recurrence (much like in the case of herpes infections). To avoid this, be sure to discuss the intricacies of the test with your physician to understand whether a particular test could provide you with a conclusive diagnosis or if it still needs another confirmatory test to establish its premise.
Similar to how other testing procedures behave, false-positive results are still evident even in STD testing. False-positive and even false-negative results are standard instances that showcase the imperfection of the test’s design – a factor that is present everywhere. However, despite certain inconsistencies in laboratory tests as such, physicians commonly use confirmatory tests that would often take another path entirely to arrive at the same conclusion – solidifying the initial test’s diagnosis while still ensuring that the second test is not following the inconsistencies of the first.
Similar to what was previously mentioned, herpes infections are known for their recurring tendencies – causing outbreaks now and then and thus causing an intermittent spike in the patient’s viral load for specific instances. In addition to that, other STDs also take time to proliferate and produce a sufficient viral load that could warrant a positive and, more importantly, accurate diagnosis and detection from the tests being administered. As such, detecting an STD a few days following exposure is often complex and unpredictable – leading physicians to follow a certain timeframe instead for testing STDs instead of blindly testing immediately following exposure. Physical exams, however, may supplement inaccurate laboratory diagnoses, especially in cases where the test is prone to false results.
Help stop the spread of STDs by knowing your status. Get tested today!
