The most sexually diseased city in America is...

Montgomery, Alabama skyline. CC photo by Spyder Monkey.
Montgomery, Alabama skyline. CC photo by Spyder Monkey.

Montgomery, Ala., is the most sexually diseased city in the nation.

It ranks higher than larger cities such as Philadelphia, Baltimore and New Orleans.

The rankings use 2013 data from the Centers for Disease Control and Prevention that was compiled by rent-application.com and released this week.

The study reflects reports of syphilis, gonorrhea and chlamydia. Herpes data is not collected. To normalize the data, rates were measured per 100,000 people, and cities with a significant amount of population were chosen. Rural counties weren't included.

"It's pretty sobering to look at those three as a total," said Tom Miller, chief medical officer for the Alabama Department of Public Health. "When we check numbers and try to get to the same point as was reported in this (ranking), we think the numbers are in the ballpark in terms of the numbers cited for Montgomery.

"The take home here is that with 2014 data, Montgomery will look a whole lot different. The caveat there is that if other cities see the same downward trend, it wouldn't make a difference in our rankings."

Montgomery had 4,371 reported cases of STDs, according to the CDC.

The total number of diseases per 100,000 is 1,899.20. Following Montgomery is St. Louis, which had 1,867.54 reported cases per 100,000, and, with a population of only 25,545, West Memphis, Arkansas, ranked third, with 1,717.20 reported cases per 100,000.

Several in the top 10 are in the southern region of the U.S., including New Orleans, Killeen, Texas, and Fayetteville, North Carolina. And, in the top-10 list, data includes three cities which have large military populations: Norfolk Naval Base in Norfolk, Virginia; Fort Hood in Killeen, Texas; and Fort Bragg in Fayetteville, N.C.

They took the fifth, ninth and 10th spots, respectively.

Montgomery, with a population of 201,332, according to the U.S. Census Bureau, was reported to have the following cases, per 100,000:

* Chlamydia: 3,039

* Gonorrhea: 1,309

* Syphilis: 23

* Total STDs reported: 4,371

Miller, who doesn't readily recall a time the city was No. 1 in the rankings for Sexually Transmitted Diseases, believes there is a balance between the diseases coming from both transients and those from the Montgomery area.

"It's difficult to quantify how much is contributed by specific groups," he said.

Statewide, the 2013 numbers from the CDC aren't much better. Alabama ranks third in chlamydia cases, with 611 cases per 100,000, or 29,464. The state ranks second in gonorrhea cases, with 173.7 cases per 100,000 reported, or 8,377. The only exception was primary and secondary syphilis, in which the state is ranked 23rd with 183 cases, or 3.8 cases per 100,000.

"Obviously, we stay at the wrong end of the state rankings," Miller said.

In 2013, the state implemented the CDC's Expedited Partner Therapy model for chlamydia and trichomonas, which is the clinical practice of treating the sex partners of patients diagnosed with chlamydia or gonorrhea by providing prescriptions or medications to the patient to take to his/her partner without the health care provider first examining the partner.

"In reality, a lot of people aren't going to name names," Miller said. "EPT allows us to give educational material and the actual medication for the individual to take to his or her partners. We believe that has made a difference."

Jefferson Underwood, a Montgomery physician, and a regular contributor to the Advertiser, stated in an April 22, 2014, column that vaccines available to prevent certain types of STDs include vaccinations for hepatitis A and hepatitis B as well as HPV, or the human papilloma virus.

Individuals who really should consider this type of vaccination, he stated, are men who have sex with other men, IV drug users and those who have chronic liver disease.

Education and counseling are the cornerstones of STD prevention, he wrote. In addition, identification of asymptomatic individuals who are infected but not seeking treatment also will be enhanced through awareness.

Emerging treatments include pre-exposure vaccinations. These are intended for persons at risk for sexually transmitted diseases which can possibly be prevented through vaccinations.

Short of abstinence, safe sex has been defined as having mutual monogamy, which means you agree to be sexually active with only one person who is only having sex with you and no one else. Also, barrier contraceptives such as latex condoms are advised.

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