A new analysis from an online lab-testing firm puts a stark spotlight on Texas: the state now ranks fourth-highest in the nation for risk of sexually transmitted infections, and Bexar County, home to San Antonio, logged the highest STI rate among major Texas metros at about 1,182 cases per 100,000 residents. The review also shows that statewide STI totals climbed between 2017 and 2022, with especially sharp increases in syphilis and gonorrhea after a brief dip during the pandemic years.
What the analysis measured
The findings were first reported by San Antonio Current, which notes that researchers at LabCafe drew on the Centers for Disease Control and Prevention’s 2023 STI surveillance tables and the CDC NCHHSTP atlas. They compared chlamydia, gonorrhea and syphilis across states and counties, a method that flagged Texas as a high-burden state and produced county-level rankings that placed Bexar near the top among large Texas metros.
Insurance, clinic access and local drivers
LabCafe’s analysis links the state’s high STI burden to access gaps, citing Texas’ persistently high uninsured rate and recent clinic capacity problems. LabCafe reports Texas’ overall uninsured rate at about 16.7%, and the group quotes LabCafe CEO Jim Gebhart: "Lack of insurance creates barriers to routine STI screening, preventative care and timely treatment, all critical for controlling community transmission."
State data and how numbers differ
State health records add local context, although they do not produce identical counts. The Texas Department of State Health Services’ 2022 STD Surveillance Report lists the state chlamydia rate at about 519.9 cases per 100,000 residents for 2022 and documents rising gonorrhea and syphilis cases in recent years. The differences between the LabCafe figures and state totals stem from varying data sources, aggregation methods and the timing of CDC and state releases. Texas DSHS provides the official state counts that local clinics and public-health planners rely on.
How San Antonio is responding
Local health agencies have been expanding testing and outreach as rates rise. The San Antonio Metropolitan Health District runs walk-in and mobile STI testing clinics and publishes resources on testing and treatment, and local coverage has highlighted mobile-clinic deployments aimed at reaching neighborhoods with limited access to care. For more background on the local response, see San Antonio Metro Health’s STI pages and recent reporting. San Antonio Metro Health and coverage on mobile clinics offering free STI testing describe those services and clinic schedules.
Practical advice for residents
Public-health guidance remains straightforward: get tested regularly, treat infections promptly and use barrier protection where appropriate. State recommendations and CDC screening guidance, cited in the DSHS surveillance materials, stress annual chlamydia screening for sexually active women 25 and younger, prompt treatment for positive tests and partner notification to interrupt transmission. For testing locations and resources in Bexar County, Metro Health and local clinics publish schedules and walk-in options. Texas DSHS provides prevention and testing guidance used statewide.
What comes next
Researchers and advocates say reversing the trend will take more than reminders to book a test. They point to bigger policy fixes, including expanded coverage, stable funding for public testing programs and restored clinic capacity, if Texas hopes to bring STI rates down. LabCafe’s analysis and local reporting both underscore how access and social determinants shape who gets screened and treated, and officials in San Antonio are working to push resources into neighborhoods with the greatest need.
