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STD Rates in San Antonio: What the Latest Data Shows

Updated · Sources are cited in the text

STD Rates in San Antonio: What the Latest Data Shows

This page is general health information, not medical advice. It cannot tell you whether you have an infection. A clinician can, and the testing options on this site are a good place to start.

STD rates are counts of reported infections, usually shown per 100,000 residents so that places of different sizes can be compared. They describe a community, not any one person. This guide walks through the most recent published figures for San Antonio's home county, Bexar County, and for Texas, and explains how to read them fairly.

Every number below names its year and its source. Where a figure is not published, the guide says so instead of filling the gap. The last section covers free and low-cost testing in the city.

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How to read STD rates

Three ideas make the numbers easier to use.

Counts and rates are different

A count is the number of reported cases. A rate divides that count by the population and scales it, usually to 100,000 people. A big county will have more cases than a small one even if the two have the same rate. When you compare places, use rates.

Reported cases are not all infections

Surveillance counts only infections that were tested for, diagnosed and reported. CDC notes that many STIs cause no symptoms, so some infections are never found. A rise in reported cases can mean more infection, more testing, or both.

Each source has its own year and definitions

Texas DSHS, CDC and the local health department publish on different schedules. The latest Texas DSHS STD report available for this guide covers 2022. CDC's most recent state STI tables cover 2023, and CDC's HIV tables cover 2024. DSHS also says prior-year numbers can shift slightly as records are cleaned and deduplicated. This guide never mixes sources inside one comparison.

In Texas, chlamydia, gonorrhea, syphilis, HIV and AIDS are notifiable conditions, according to the Texas DSHS Texas Notifiable Conditions 2026 list. Clinicians and labs report them to the health department. That reporting is what makes these figures possible.

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Bexar County: the latest figures

San Antonio is served by the San Antonio Metropolitan Health District (Metro Health), and Bexar County is the county those figures describe. The most recent county STI figures in the Texas DSHS Texas STD Surveillance Report cover 2022.

Infection (Bexar County, 2022)Reported casesRate per 100,000
Chlamydia12,305Not printed in the report
Gonorrhea5,983290.5
Syphilis, primary and secondary stages50024.3
Syphilis, all stages2,602Not printed in the report

Source: Texas DSHS, Texas STD Surveillance Report 2022 Annual Report. The report prints a county rate only where the county ranks among the top 25 in Texas, which is why two rows show no rate. This guide does not calculate rates the report did not publish.

Chlamydia

Texas DSHS counted 12,305 chlamydia cases in Bexar County in 2022. Chlamydia is the most commonly reported bacterial STI, and CDC says it often has no symptoms. It is curable with treatment prescribed by a clinician.

Gonorrhea

Bexar County's 2022 gonorrhea rate was 290.5 per 100,000 people, from 5,983 cases (Texas DSHS). Gonorrhea is also curable with treatment from a clinician. CDC's 2021 STI Treatment Guidelines are the reference clinicians use to choose that treatment.

Syphilis

Texas DSHS reported 500 primary and secondary syphilis cases in Bexar County in 2022, a rate of 24.3 per 100,000. Across all stages, the county had 2,602 reported cases. Syphilis is curable, and it is easier to treat when found early. Because stages can pass without obvious signs, testing is the way to find it.

HIV

CDC's HIV Surveillance Data Release Tables for 2024 list 373 new HIV diagnoses in Bexar County, a rate of 21.1 per 100,000 people aged 13 and older. HIV is not curable, but it is treatable, and people who start treatment and stay on it can live long, healthy lives. Metro Health's STI and HIV page separately lists 332 new diagnoses in the county for 2021. Those two figures come from different sources and years, so this guide does not treat the gap as a trend.

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Texas statewide figures and how Bexar compares

To compare Bexar County with Texas fairly, both numbers have to come from the same source and year. Here is the like-for-like comparison from the Texas DSHS 2022 report.

Measure (2022, Texas DSHS)Bexar CountyTexas
Chlamydia, cases12,305156,131
Chlamydia, rate per 100,000Not printed519.9
Gonorrhea, rate per 100,000290.5207.0
Primary and secondary syphilis, rate per 100,00024.315.5
Syphilis, all stages, cases2,60225,991
Syphilis, all stages, rate per 100,000Not printed86.6

On the two measures where both rates were printed, Bexar County's rate was higher than the state's. The gonorrhea rate was about 1.4 times the Texas rate, and the primary and secondary syphilis rate was about 1.6 times the Texas rate. That is a statement about a community, and it says nothing about any individual resident.

More recent Texas figures from CDC

CDC's Sexually Transmitted Infections Surveillance 2023 state ranking tables give the newest statewide STI numbers for Texas:

  • Chlamydia: 150,056 cases, 491.9 per 100,000.
  • Gonorrhea: 53,793 cases, 176.4 per 100,000.
  • Primary and secondary syphilis: 4,562 cases, 15.0 per 100,000.
  • Congenital syphilis: 930 cases, 238.6 per 100,000 live births.

For HIV, CDC's 2024 tables list 5,016 new diagnoses in Texas, a rate of 16.0 per 100,000 people of all ages. For the same 2024 data, the rate among people aged 13 and older is 19.4. That is the number to set beside Bexar County's 21.1, because both cover people aged 13 and older. Putting 21.1 next to 16.0 would be an unfair comparison.

Congenital syphilis is syphilis passed from a pregnant person to a baby. It is preventable with timely testing and treatment during pregnancy, which is why Texas law requires screening, covered below.

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STD rates by state and by city: comparing fairly

People often look for STD rates by state or STD rates by city to see where they stand. These comparisons are useful when they are done carefully, and misleading when they are not.

Comparing states

CDC publishes a state ranking table each year in its STI Surveillance report, with the number of cases and the rate per 100,000 for each state. Because every state is reported in one table with one method, it is the best place to compare states. The Texas figures above come from that table. A state's place in the ranking depends on how much testing is done and how completely cases are reported, not only on how many infections exist.

Comparing cities

Fewer cities than states publish their own tables, and cities use different boundaries. Some report for the city limits, others for the whole county. San Antonio's published numbers come at the county level, as Bexar County, so a comparison with another city is only fair if that city is also measured at the county level, from the same year and the same source.

A short checklist before comparing any two places

  1. Use rates per 100,000, not raw counts.
  2. Use the same infection and the same stage of syphilis.
  3. Use the same source and the same year for both places.
  4. Check the age group. The HIV rates above are per 100,000 people aged 13 and older for counties, but all ages for the Texas figure of 16.0.
  5. Remember that testing levels shape what is counted.

A higher rate in one place can mean more infections, or it can mean more people were tested and reported. Neither reading says anything about the people who live there.

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What the available data can and cannot say about change

A true year-on-year comparison needs the same source, the same definitions and consecutive years. The county figures that Texas DSHS has published for this guide cover a single year, 2022. The statewide figures from CDC (2023) and DSHS (2022) come from different sources, so subtracting one from the other would not be reliable. The same is true for Bexar County's HIV counts from 2021 (Metro Health) and 2024 (CDC).

For readers who want the trend, the clearest route is to open the DSHS annual reports and the CDC state tables for consecutive years and compare each source with itself. Check the health department's STI and HIV page for newer local updates, because DSHS says it has not yet published a newer annual STD report than the 2022 one used here.

What shapes reported rates

Public health agencies point to several things that move these numbers. None of them is about personal character.

  • Testing volume. More testing finds more infections that would otherwise go unnoticed, which can raise reported rates even when the true level has not changed.
  • No symptoms. CDC says chlamydia, gonorrhea and other STIs often cause no symptoms, so infections can pass between partners without anyone knowing.
  • Access to care. Cost, transportation, clinic hours, insurance and fear of being judged all affect whether someone gets tested and treated.
  • Timing of treatment. A bacterial infection that is found and treated early is less likely to be passed on or to cause complications.
  • Prenatal care. Congenital syphilis counts rise when pregnant people are not tested and treated in time.
  • Reporting. Texas requires clinicians and labs to report these conditions, so reporting quality affects what appears in the data.

This is why public health teams focus on making testing easy and low-cost. Better access finds infections sooner, and sooner is better for the person and for their partners.

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What the data means for screening and prevention

A community rate cannot tell a person whether they have an infection. Only a test can. What the data does show is why routine screening matters, and CDC's recommendations describe who should be tested and how often.

Screening recommendations from CDC and USPSTF

  • CDC's 2021 STI Treatment Guidelines recommend yearly chlamydia and gonorrhea screening for sexually active women under 25, and for older women with risk factors such as new or multiple partners.
  • The same guidelines recommend at least yearly screening for chlamydia, gonorrhea and syphilis for gay, bisexual and other men who have sex with men, with more frequent testing for those at higher risk.
  • CDC recommends that everyone aged 13 to 64 be tested for HIV at least once, and more often if they have ongoing risk. The USPSTF makes a similar recommendation for people aged 15 to 65.
  • Pregnant people should be tested for syphilis and HIV. See below for the Texas rules.

A clinician can help you work out which tests fit your situation. Testing is a routine part of health care for people of every gender and orientation.

Pregnancy and Texas law

The Texas Health and Safety Code Section 81.090 calls for a syphilis, HIV and hepatitis B test at the first prenatal visit, a syphilis and HIV test in the third trimester (not earlier than the 28th week), and a syphilis and hepatitis B test on admission for delivery. The law lets a pregnant person object to the HIV tests, but not to the syphilis tests. Metro Health also advises syphilis testing at least three times during pregnancy: at the first prenatal visit, in late pregnancy and at delivery.

Prevention options a clinician can discuss

Condoms, vaccination against HPV and hepatitis B, regular testing and talking with partners all lower risk. For HIV, PrEP is a medication a clinician prescribes to help prevent infection. In 2024, CDC also issued guidance on doxycycline post-exposure prophylaxis, often called doxy-PEP, which a clinician may offer to some people at higher risk of bacterial STIs. Whether either option fits you is a conversation for a prescriber.

If a test is positive

Chlamydia, gonorrhea, syphilis and trichomoniasis are curable with treatment from a clinician. Herpes, HPV and HIV are not curable, but each is treatable or manageable. A clinician will also talk about telling partners. In Texas, the Texas Medical Board rules, as summarized by CDC's page on the legal status of expedited partner therapy in Texas, allow a physician to prescribe STD medication for the partners of an established patient without first seeing those partners. Pharmacists may fill such prescriptions. Ask your clinician whether that option applies to you.

Privacy and young people

Under Texas Family Code Section 32.003, a minor of any age may consent to diagnosis and treatment of a reportable infectious disease, which covers reportable STIs and HIV, and parental consent is not needed. The same section says a physician may tell a parent or guardian about the treatment, so a provider cannot promise a teen that a parent will never be told. Anyone with concerns can ask the clinic about its privacy practices before the visit.

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Free and low-cost testing in San Antonio

Testing is the practical answer to what the data shows. San Antonio has several free and low-cost options, and the list below comes from each organization's own pages. Hours and services can change, so confirm by phone before you go. Our full guide to STD testing in San Antonio compares every option in more detail.

Public health clinic

  • Metro Health STI Walk-In Clinic, 512 E. Highland, Suite 150, San Antonio, TX 78210, 210-207-8830. Metro Health lists a $15 office visit administrative fee, with other fees varying by service. Hours are Monday to Thursday 7:45 a.m. to 4:30 p.m. (latest check-in 3 p.m.) and Friday 7:45 a.m. to 12:00 p.m. (latest check-in 10:30 a.m.). Check-in can close early when the clinic is at capacity. Metro Health says the clinic serves residents of San Antonio and Bexar County and people with no other way to get STI services, requires a photo ID and does not offer anonymous testing.

Free testing at community organizations

  • San Antonio AIDS Foundation (SAAF), 818 E. Grayson Street, San Antonio, TX 78208, (210) 225-4715. SAAF lists free rapid HIV, syphilis, gonorrhea and chlamydia testing with no appointment needed. SAAF says gonorrhea and chlamydia results take 7 to 10 days through the DSHS lab. It lists hours of Monday 8:30 to 4:00, Tuesday 12:00 to 8:00, Wednesday and Thursday 8:30 to 4:00, Friday 9:00 to 1:00 and Saturday 11:00 to 3:00, and it is closed Sunday. SAAF also lists PrEP and doxy-PEP.
  • Alamo Area Resource Center (AARC), 303 N. Frio, San Antonio, TX 78207, (210) 625-7200. AARC lists free testing for HIV, hepatitis C, syphilis, gonorrhea and chlamydia, with rapid fingerstick tests for HIV, syphilis and hepatitis C. Walk-ins are accepted Monday to Friday 8 a.m. to 4:30 p.m., and until 8 p.m. on Wednesday.
  • Kind Clinic, San Antonio (Isom), 730 Isom Road, San Antonio, TX 78216, general support line 833-937-5463. Kind Clinic lists free walk-in HIV and STI testing, STI treatment, PrEP and PEP. Its page says walk-in testing hours differ from clinic hours, so call for the current times. It also lists doxy-PEP for Kind Clinic patients only.
  • BEAT AIDS, 210.212.2266. BEAT AIDS lists free, confidential HIV and STI testing, treatment and PrEP. Its site does not say which location does the testing, so call first.

Sliding-fee health centers

  • CommuniCare Apollo Wellness Clinic, 6511 W Loop 1604 N, Ste. 105, San Antonio, TX 78254, (726) 224-3438. Open Monday to Friday 8:00 a.m. to 5:00 p.m. CommuniCare offers a sliding fee discount for self-pay patients with family income under 200% of the federal poverty guidelines.
  • CentroMed, 210-922-7000. CentroMed lists STD screening and treatment among its women's health services, on a sliding fee scale based on income and family size. Its page does not list which clinic location offers it, so call to ask.

PrEP

Metro Health's PrEP Clinic at 512 E. Highland Blvd., Ste. 150 (210-207-7292) offers PrEP evaluation by a nurse practitioner, in-clinic labs and a PrEP navigator for counseling and help with insurance and costs. Walk-ins are accepted, and Metro Health encourages appointments. Its page gives no price.

Free testing from home

Texas DSHS runs Test for Texas, which mails free at-home tests for HIV, syphilis, gonorrhea and chlamydia to anyone in Texas aged 13 or older, with no insurance needed. DSHS says results arrive in a secure portal seven business days after the sample reaches the lab. CDC also runs a national locator at gettested.cdc.gov, where you can enter your ZIP code to find more testing sites.

If you want a single place to start, call one of the free sites above and ask which tests fit your situation. A positive result on a curable infection leads to treatment from a clinician, and a negative result gives you peace of mind about the infections tested for.

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Sources