STD Rates By Country

This ranking tracks estimated sexually transmitted infection cases per 100,000 people in 2021, drawn from Global Burden of Disease data. It is not measuring just HIV, and it is not just counting the cases that showed up at a clinic. The World Health Organization says more than 30 bacteria, viruses, and parasites can be transmitted through sexual contact, and that more than 1 million curable infections are acquired every day worldwide.

The gap from top to bottom is enormous. South Africa sits first at 44.0K cases per 100,000 people. Kazakhstan anchors the last spot at 1.5K. That is a 29-fold difference between the two ends of the table.

The upper tier is not scattered across the globe. South Africa, Botswana (41.2K), and Lesotho (40.6K) fill the first three slots. Right behind them sit Malawi (39.6K), Eswatini (39.0K), and Namibia (35.2K). All six countries share the same belt of southern and eastern Africa.

Below that cluster, the table widens. Bermuda, Brazil, and Barbados all land in the top 12, pulling the Caribbean and Latin America into the picture.

The middle of the table is tightly packed. Most countries cluster around 20,000 cases per 100,000, and the distribution is nearly symmetrical. Strip away the extremes, and the bulk of the world sits far closer to each other than either end sits to the middle.

The countries at the top of the STI ranking also crowd the top of the HIV table, and that is not a coincidence. Eswatini leads the world in adult HIV prevalence at 23.4%. South Africa sits second at 17.2%, and Lesotho third at 17.1%. All three also land in the top five for overall STI burden.

The WHO explains part of the connection: herpes, gonorrhoea, and syphilis can raise the risk of acquiring HIV, and HIV in turn weakens immune defenses against other infections. UNAIDS still describes eastern and southern Africa as the region most affected by the HIV pandemic. When one sexually transmitted epidemic runs deep, the others tend to follow.

But the two rankings are not interchangeable. Brazil ranks 8th for STI rate at 32.7K while sitting 52nd for HIV prevalence. Its adult HIV rate is just 0.7%, a fraction of southern Africa's. Bermuda ranks 7th for STI burden but does not appear near the top of the HIV table at all. The STI ranking captures a much wider set of infections than HIV alone.

The intuitive explanation is that countries near the top of the ranking simply have more sexual partners. The data does not support that. Turkey reports the highest average number of sexual partners in this dataset at 15, yet it sits 157th for STI rate at 12.9K. That is barely above the bottom third of the table.

That does not mean partner count is irrelevant at the individual level. The CDC lists multiple partners as a risk factor for STI acquisition, but pairs it with condom use, regular testing, and partner treatment. At the country level, what matters is whether infections already circulating get found and treated quickly. A nation with fewer partners but weaker public health infrastructure can carry a heavier burden than one with more partners and better screening.

Circumcision tells a similar story. Morocco is nearly universally circumcised at 99.9%, and it sits comfortably in the lower half of the STI table. Gabon also sits above 99% circumcision, yet it ranks 9th for STI rate. The WHO says circumcision reduces men's risk of heterosexually acquired HIV by about 60%, based on three randomized controlled trials. But the agency presents it as one tool inside a broader prevention package, not a blanket defense against all sexually transmitted infections.

Across 193 country pairs, circumcision rate and STI rate show essentially no statistical relationship. The procedure targets one specific transmission pathway for one specific virus. Expecting it to reshape an entire country's STI map is asking more than the biology supports.

The bottom of this ranking can look reassuring. It should not, at least not without a caveat. The WHO says the global STI burden is difficult to estimate because the majority of curable infections are asymptomatic, molecular diagnostic tests are largely unavailable in low- and middle-income countries, and many health systems still rely on syndromic management that only catches infections with visible symptoms.

That means a low number on this page can reflect genuinely lower transmission, weaker detection, or both. Kazakhstan at 1.5K sits more than two and a half standard deviations below the dataset's mean, making it a massive statistical outlier at the low end. Whether that reflects a real epidemiological reality or a measurement gap is a question the data alone cannot answer.

The same caution applies to the secondary metrics. HIV prevalence data comes from 2024, while circumcision estimates date to 2016. The partner-count metric covers only 46 of the 203 countries in the STI ranking and relies on self-reported survey data, which the CDC notes is shaped by social desirability bias. So the safest conclusions are the broadest ones. Southern Africa carries a disproportionate STI burden, and HIV helps explain that cluster. Neither sexual behavior nor circumcision alone accounts for where a country lands on the map.