Sexually Transmitted Diseases and Mental Health
Updated: Aug 20
Sexually Transmitted Infections (STIs):Statistics, Mental Health & Tennessee Resources
Educational resource for counseling, psychoeducation, and community referral | Updated August 2026
Important scope note: The newest CDC national surveillance data are 2024 provisional data for chlamydia, gonorrhea, and syphilis. CDC does not include HPV and HSV in those annual nationally notifiable STI case totals, so HPV/HSV statistics below are population-prevalence estimates from national surveys/modeling and are labeled by their data year. These figures should not be interpreted as an individual's personal risk.
1. Latest U.S. STI Statistics
2024 provisional national totals: CDC reported 1,515,985 chlamydia cases, 543,409 gonorrhea cases, and 190,242 total syphilis cases. Congenital syphilis totaled 3,941 cases. The combined number of chlamydia, gonorrhea, and syphilis cases was more than 2.2 million, down 9% from 2023. Because the 2024 data are provisional, age-specific national trends are presented using the latest finalized 2023 surveillance tables.
2. Reported STI Rates by Age Group — 2023
Rates are reported cases per 100,000 population. Female and male rates are shown separately because surveillance rates differ by sex. These are reported-case rates, not individual probabilities.
Age | Chlamydia Female / Male | Gonorrhea Female / Male | Primary/Secondary Syphilis Female / Male |
15–19 | 2,566.1 / 886.1 | 476.7 / 337.1 | 8.3 / 10.9 |
20–24 | 3,435.1 / 1,557.1 | 610.5 / 691.1 | 20.1 / 44.5 |
25–29 | 1,621.3 / 1,057.9 | 353.8 / 671.2 | 22.7 / 58.7 |
30–34 | 783.3 / 711.1 | 229.0 / 585.8 | 21.5 / 62.0 |
35–39 | 395.6 / 435.7 | 141.1 / 387.9 | 18.8 / 49.5 |
40–44 | 206.9 / 259.6 | 84.2 / 246.9 | 14.2 / 37.7 |
45–54 | 87.0 / 130.0 | 36.1 / 130.4 | 7.4 / 24.8 |
55–64 | 25.3 / 58.3 | 10.1 / 65.4 | 2.3 / 16.2 |
65+ | 2.9 / 10.6 | 1.3 / 11.8 | 0.2 / 3.5 |
Source: CDC Sexually Transmitted Infections Surveillance, 2023. The 20–24 age group has the highest reported chlamydia rates for both sexes and the highest gonorrhea rates for both sexes. CDC reports them per 100,000 population. How to interpret the above data?
Females ages 15–19: 2,566.1 reported chlamydia cases per 100,000 females
Males ages 15–19: 886.1 reported chlamydia cases per 100,000 males
3. HPV and HSV - What the National Data Can and Cannot Tell Us
Why these are presented differently: HPV and HSV are common infections, but they are not reported through the same annual national case-surveillance system as chlamydia, gonorrhea, and syphilis. Therefore, prevalence estimates from NHANES and other national modeling are more appropriate than a simple annual 'case count.'
Infection | Population | Latest cited national prevalence estimate | Data period | Clinical meaning |
HPV any genital infection | Adults 18–59 | 42.5% overall; 45.2% men; 39.9% women | 2013–2014 NHANES | No eradication treatment for the virus itself; many infections clear naturally. Warts/precancerous changes can be treated. Vaccine prevents many HPV-related infections. |
HPV high-risk genital types | Adults 18–59 | 22.7% overall; 25.1% men; 20.4% women | 2013–2014 NHANES | Persistent high-risk HPV can contribute to cervical, anal, penile, vulvar, vaginal, and oropharyngeal cancers. |
HSV-1 | 14–49 | 47.8% overall; 27.0% ages 14–19; 41.3% ages 20–29; 54.1% ages 30–39; 59.7% ages 40–49 | 2015–2016 NHANES | Lifelong infection; often asymptomatic. Antivirals can reduce outbreaks and transmission risk. |
HSV-2 | 14–49 | 11.9% overall; 0.8% ages 14–19; 7.6% ages 20–29; 13.3% ages 30–39; 21.2% ages 40–49 | 2015–2016 NHANES | Lifelong infection; often asymptomatic. Antivirals can reduce symptoms and transmission risk. |
Data limitation: The CDC pages used here identify these as the latest national estimates available in their respective reports; they are older than the 2024 STI surveillance figures and should not be described as 2026 prevalence.
4. Curable vs. Chronic / Not Currently Curable
STI | Type | Curable? | Key point |
Chlamydia | Bacterial | YES | Antibiotics can cure the infection. |
Gonorrhea | Bacterial | YES | Antibiotics can cure it; resistance is an important public-health concern. |
Syphilis | Bacterial | YES | Antibiotics can cure the infection, especially when treated promptly. |
Trichomoniasis | Parasitic | YES | Prescription antiparasitic medication can cure it. |
Genital herpes (HSV-1/HSV-2) | Viral | NO | No current cure; antivirals can shorten/prevent outbreaks and reduce transmission risk. |
HIV | Viral | NO | No current cure, but antiretroviral treatment can suppress the virus and support long, healthy lives. |
HPV | Viral | NO direct cure for the virus | Most infections clear naturally. Treatment is available for warts and abnormal/cancerous cell changes; vaccination prevents many infections. |
Chronic hepatitis B | Viral | NO for chronic infection | Antiviral treatment can suppress the virus and reduce liver damage; vaccination prevents infection. |
5. Mental Health Impact of STI Diagnoses
An STI diagnosis can be medically manageable while still being psychologically distressing. The mental-health impact is shaped by the infection itself, symptoms, chronicity, stigma, prior trauma, relationship context, access to care, and the person's beliefs about sexuality and self-worth.
Shame and self-stigma
· One may interpret an STI as evidence that they are 'dirty,' irresponsible, promiscuous, damaged, or unworthy.
· Internalized stigma can become more distressing than the medical symptoms themselves.
· Therapy can separate a medical diagnosis from identity, morality, and personal worth.
Anxiety and health anxiety
· Common concerns include fear of transmission, waiting for test results, recurrence, reinfection, or discovering another infection.
· Some will develop repeated symptom checking, internet searching, reassurance-seeking, or avoidance.
· CBT, ERP can target catastrophic interpretations while maintaining appropriate medical follow-up.
Depression and loss of self-worth
· Some experience sadness, hopelessness, withdrawal, reduced confidence, or difficulty imagining a satisfying future.
· Chronic infections such as HIV or recurrent HSV may require ongoing adjustment and grief work.
· Assess mood, functioning, social isolation, and suicide risk when clinically indicated.
Dating, disclosure, and fear of rejection
· Some may fear that no future partner will accept them or may avoid dating and intimacy altogether.
· Disclosure can be practiced through role-play, values clarification, boundary-setting, and coping planning.
· Therapy can help clients distinguish realistic disclosure concerns from shame-driven assumptions.
Relationship conflict and trust
· An STI diagnosis can trigger anger, jealousy, blame, fear, or concerns about infidelity.
· An STI diagnosis does not automatically establish when an infection was acquired or prove infidelity.
· Couples work can address communication, trust, intimacy, and shared medical decision-making.
Sexual functioning and intimacy
· Anxiety, shame, pain, fear of transmission, and relationship stress can contribute to reduced desire or avoidance of sexual activity.
· Medical causes should be evaluated by an appropriate healthcare professional rather than assumed to be psychological.
Trauma-related reactions
· For survivors of sexual assault, coercion, intimate-partner violence, or medical trauma, an STI diagnosis can reactivate fear, shame, bodily vigilance, or avoidance.
· A trauma-informed approach emphasizes safety, autonomy, pacing, grounding, and client choice.
Social isolation
· Some may avoid telling friends or family because they fear judgment or loss of confidentiality.
· Strengthening safe social support can reduce isolation and improve coping.
6. Can sexually transmitted diseases alter brain chemistry and thereby impact mental health?
Yes, sexually transmitted infections (STIs) can alter brain chemistry and directly or indirectly impact mental health. This occurs through two distinct pathways: direct biological invasion of the central nervous system, and indirect systemic/psychological stress responses.
Direct Neurobiological Pathways (Brain Chemistry Changes)
Certain STIs directly enter the central nervous system, crossing the blood-brain barrier and causing structural damage, neuroinflammation, and altered neurotransmitter activity:
Syphilis (Neurosyphilis): The bacterium Treponema pallidum can invade the nervous system at any stage of infection. In late-stage neurosyphilis (general paresis), chronic neuroinflammation damages cortical neurons. This directly alters dopamine, serotonin, and glutamate function, leading to severe psychiatric symptoms including mania, profound depression, paranoia, psychosis, personality shifts, and early dementia.
Cleveland Clinic+ 1
HIV (HAND / NeuroHIV): HIV crosses into the brain early after infection. While it does not infect neurons directly, it infects supporting glial cells (microglia and astrocytes). This triggers the release of neurotoxic proteins and inflammatory cytokines (like TNF-alpha and IL-6), leading to HIV-Associated Neurocognitive Disorders (HAND). The resulting neuroinflammation affects dopamine pathways, causing apathy, clinical depression, executive dysfunction, and memory impairment.
Herpes Simplex Virus (HSV Encephalitis): Though rare, HSV-1 or HSV-2 can occasionally spread to the central nervous system, causing herpes simplex encephalitis—an acute brain infection primarily targeting the temporal lobes, which damages regions controlling emotion and memory.
Indirect Pathways (Systemic & Psychological Drivers)
Even STIs that do not directly infect brain tissue can alter neurochemistry through physiological and psychological stress responses:
Chronic Systemic Inflammation: Persistent viral or bacterial infections elevate systemic inflammatory markers (cytokines). High levels of circulating cytokines alter tryptophan metabolism, reducing serotonin synthesis and increasing neurotoxic byproducts (like quinolinic acid), which is strongly linked to clinical depression and fatigue.
HPA Axis Dysfunction: Navigating an STI diagnosis, managing symptoms, or facing social stigma triggers chronic psychological stress. This over activates the hypothalamic-pituitary-adrenal (HPA) axis, resulting in chronically elevated cortisol levels that disrupt serotonin and GABA regulation, often manifesting as generalized anxiety or major depressive episodes.
Summary of Impact
Pathogen / STI | Mechanism | Potential Mental Health Outcomes |
Syphilis | Direct neuronal destruction & cortical inflammation | Psychosis, mania, dementia, severe mood swings |
HIV | Glial cell infection & neurotoxic cytokine release | Apathy, major depression, cognitive slowing |
Herpes / Others | Systemic inflammation & chronic cortisol release | Anxiety, depressive episodes, chronic stress response |
Early STI screening and treatment (such as standard antibiotics for bacterial infections or antiretroviral therapy for HIV) prevent or reverse most of these neurological and psychiatric complications. -Simply Meds Online
7. Flash Therapy Support: Practical Clinical Interventions
· Psychoeducation: explain the difference between infection, symptoms, transmission, treatment, and chronic disease while referring medical questions to healthcare providers.
· Cognitive restructuring: identify catastrophic thoughts such as 'my life is over' or 'nobody will love me' and evaluate evidence for and against them.
· Self-compassion and shame reduction: challenge moralized beliefs about sexual health and reinforce the person's identity beyond the diagnosis.
· Disclosure planning: develop a safe, respectful plan for communicating with current or future partners and rehearse possible responses.
· Relationship counseling: address trust, blame, communication, boundaries, intimacy, and shared coping when appropriate.
· Trauma-informed care: prioritize safety, autonomy, grounding, stabilization, and pacing for clients with sexual or medical trauma histories.
· Anxiety-management skills: breathing, grounding, mindfulness, distress tolerance, reducing reassurance-seeking, and coping plans for testing/appointments.
· Adjustment to chronic illness: grief, identity, future planning, resilience, medication adherence support, and rebuilding a meaningful life.
· Risk assessment: assess depression, hopelessness, severe isolation, self-harm or suicidal thoughts when clinically indicated; coordinate higher levels of care when necessary.
· Medical collaboration: encourage appropriate STI testing, treatment, vaccination, HIV PrEP/PEP when indicated, and follow-up with qualified medical providers.Tennessee Resources Free, Confidential, and Low-Cost Options
8. Wilson County / Mount Juliet Area Resources
Wilson County Health Department — Lebanon
Wilson County Health Department — 927 E. Baddour Pkwy., Lebanon, TN 37087 | (615) 444-5325
· TDH identifies county health departments as providing STD/HIV screening and treatment, preventive education, confidential testing, and partner-notification services.
· TDH's STI program specifically states that local health departments offer free and confidential testing.
· Call before sending a client because exact services, eligibility, fees, appointment availability, and which tests are offered can vary.
Metro Public Health Department -Sexual Health Center, Nashville
· Lentz Public Health Center, 2500 Charlotte Ave., Nashville, TN 37209.
· STD/HIV testing appointments: (615) 340-5647.
· The Sexual Health Center provides confidential STI/HIV testing and related services; appointments are recommended and walk-ins may depend on staffing/demand.
· Useful referral option when a client wants a public-health clinic in Nashville.
· CDC's testing-site listing identifies testing for chlamydia, gonorrhea, syphilis, HIV, and herpes, along with prevention/education, HPV vaccination, PrEP/PEP, STI treatment, and sliding-scale/other payment options subject to eligibility.
· Call to confirm current services, cost, and appointment availability.
CARES 360 Community Clinic — Nashville
· 633 Thompson Ln., Nashville, TN 37204 | (615) 499-7406.
· Community clinic focused on HIV/sexual health services, including STI screening/treatment, HIV prevention, PrEP/PEP, and wraparound care.
· Behavioral health counseling/therapy and psychiatry are also listed among the clinic's broader services, which may be useful for clients needing integrated medical and behavioral-health support.
Neighborhood Health at Lebanon
· 217 E. High St., Suite 200, Lebanon, TN 37087 | (615) 227-3000.
· Community health center offering primary and supportive healthcare; public health directories identify sexual-health/testing and prevention-related services.
· Call to confirm STI testing, HIV services, PrEP-related navigation, costs, and eligibility before referral.
9. Tennessee Prevention and Education Resources
CDC STI Information -Disease education, prevention, treatment guidelines, surveillance, and patient/provider resources.
CDC Get Tested - Searchable locator for HIV, STI, and viral-hepatitis testing and prevention services.
Tennessee STI Program -Tennessee-specific STI prevention, testing, treatment, hotline, and epidemiology resources.
Tennessee Public Health Dashboards -State and regional health data; includes Tennessee HIV data and links to STI resources.
AIDSVu Service Locator - Locator for HIV testing, PrEP, and HIV-related services.
WHO STI Information -Global STI education and public-health information.
Tennessee 211 - Community resource navigation for health, emotional, housing, food, and other support needs.
10. Tennessee Department of Health (TDH) STI Program.
TDH states that local health departments offer free and confidential STI testing. The program also provides information about HIV/STI prevention and care, counseling/testing resources, and Tennessee STI statistics.
Tennessee HIV/STD Hotline: 1-800-525-2437 (Tennessee only), Monday–Friday, 8:00 a.m.–4:30 p.m. CST.
TDH HIV/STI Program: (615) 741-7500 | STD.Health@tn.gov
11. Quick Client Handout: What a Therapist Can Help With
A diagnosis does not define you. Therapy can help with the emotional and relationship impact of an STI while medical professionals address testing and treatment.
· Managing anxiety after testing or diagnosis
· Reducing shame and self-stigma
· Rebuilding self-esteem and confidence
· Preparing for disclosure to a partner
· Coping with rejection or fear of rejection
· Improving communication and relationship trust
· Working through sexual or medical trauma
· Managing health anxiety and repetitive reassurance-seeking
· Adjusting to a chronic diagnosis such as HSV or HIV
· Developing healthy boundaries and a positive sense of identity
12. Sources & Notes
References
Fadel, A., Hussain, H., Hernandez, R. J., Clichy Silva, A. M., Estil-las, A. A., Hamad, M., Saadoon, Z. F., Naseer, L., Sultan, W. C., Sultan, C., Schnepp, T., & Jayakumar, A. R. (2024). Mechanisms of Neurosyphilis-Induced Dementia: Insights into Pathophysiology. Neurology International, 16(6), 1653–1665. https://doi.org/10.3390/neurolint16060120 Cited by: 21
Clifford, D. B. (2017). HIV-associated neurocognitive disorder. Current Opinion in Infectious Diseases, 30(1), 117–122. https://doi.org/10.1097/qco.0000000000000328 Cited by: 122
Miura, H., Ozaki, N., Sawada, M., Isobe, K., Ohta, T., & Nagatsu, T. (2008). A link between stress and depression: Shifts in the balance between the kynurenine and serotonin pathways of tryptophan metabolism and the etiology and pathophysiology of depression. Stress, 11(3), 198–209. https://doi.org/10.1080/10253890701754068 Cited by: 375
Saylor, D., Dickens, A. M., Sacktor, N., Haughey, N., Slusher, B., Pletnikov, M., Mankowski, J. L., Brown, A., Volsky, D. J., & McArthur, J. C. (2016). HIV-associated neurocognitive disorder — pathogenesis and prospects for treatment. Nature Reviews Neurology, 12(5), 309–309. https://doi.org/10.1038/nrneurol.2016.53 Cited by: 1359
Taki El-Din, Z., Iqbal, H., & Sharma, A. (2023). Neurosyphilis-Induced Psychosis: A Unique Presentation of Syphilis With a Primary Psychiatric Manifestation. Cureus, 15(3), e36080. https://doi.org/10.7759/cureus.36080 Cited by: 7
Prepared as an educational/counseling resource. Statistics and service availability can change. Verify current testing availability, eligibility, cost, and appointment requirements. This resource does not replace individualized medical evaluation or current CDC/Tennessee clinical guidance.
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