Sexually transmitted diseases are getting worse in the United States, increasing for the third year, with 2016 reaching an all-time high.

According to the Centers for Disease Control and data analysis by Backgroundchecks.org,

Here Are The 10 Most Sexually Diseased States In America

1. Alaska

2. Mississippi

3. Louisiana

4. Georgia

5. New Mexico

6. North Carolina

7. South Carolina

8. Arkansas

9. Delaware

10. Oklahoma



The 10 least Sexually Diseased States In America

1. Vermont

2. New Hampshire

3. West Virginia

4. Maine

5. Utah

6. Idaho

7. Wyoming

8. Connecticut

9. Massachusetts

10. New Jersey

The state moving up the highest in the rankings [as most diseased] is Maryland, jumping up six spots from #24 to #18, owing to significantly elevated rates of both gonorrhea and chlamydia. Next is Delaware, climbing five spots from #14 to #9. There is a four-way tie between Georgia (#4), Indiana (#23), Virginia (#25) and North Dakota (#26) for third greatest increase as they all moved up three places in the rankings.

Hawaii experienced the greatest drop in the rankings, falling eight spots from #20 to #28 due to a decrease in the chlamydia rate per 100k residents. Three states–Texas (#16), Tennessee (#22), and Michigan (#27)–fell four spots each, while three others–North Carolina (#6), Colorado (#30), Vermont (#50)–went down three spots.

STDs in all categories have seen an increase:

Chlamydia: 4.7 percent rate increase since 2015

Gonorrhea: 18.5 percent rate increase since 2015

Primary and Secondary Syphilis: 17.6 percent rate increase since 2015

Congenital Syphilis: 27.6 percent rate increase since 2015

“Increases in STDs are a clear warning of a growing threat,” said Dr. Jonathan Mermin, director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. “STDs are a persistent enemy, growing in number, and outpacing our ability to respond.”

The rise in primary and secondary syphilis over the last 17 years is primarily attributable to increases among men, specifically homosexuals.