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Chlamydia most prevalent STD in Northland; Duluth monitors HIV, syphilis outbreaks

Compared to 2019 and 2020 data, cases of chlamydia remained similar to past Northland data, while gonorrhea cases have continued to increase in the region.

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Minnesota Department of Health logo
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DULUTH — The Northland's seven Minnesota counties diagnosed 1,075 cases of chlamydia in 2021, according to the Minnesota Department of Health's 2021 Sexually Transmitted Disease statistics and report. Cases were slightly higher than 2020, but were lower than in 2019.

According to Department of Health staff, it is believed cases in 2020 were lower across all categories of STDs and HIV because of the coronavirus pandemic.

"The CDC (Centers for Disease Prevention and Control) also highlighted that they saw a decrease in 2020 due to COVID, and due to a decline in screening of chlamydia and gonorrhea," Khalid Bo-Subait, STD surveillance coordinator, said in a webinar on Wednesday. "The CDC believes, similar to what I have been saying, is that with chlamydia we saw a decline due to the nature of it tending to be more asymptomatic, especially amongst females, which is where we get most of our cases for the total counts for the year."

Chlamydia was the most prevalent STD diagnosed in the Northland and across Minnesota in 2021, followed by gonorrhea. Gonorrhea saw a 5% increase across the state from 2020 to 2021, while chlamydia saw a 3% increase statewide. There were 22,578 cases of chlamydia diagnosed in Minnesota and 9,671 cases of gonorrhea in 2021. In the last decade, chlamydia rates in Minnesota have increased by 34%, and gonorrhea's rate of infection has increased by 324%.

Cases of gonorrhea in the Northland's Minnesota counties (Aitkin, Carlton, Cook, Itasca, Lake, Pine and St. Louis) rose again this year, with 425 new cases diagnosed. In 2020, 390 cases were diagnosed, and 364 in 2019.


Across Minnesota, syphilis cases increased the most from 2020 to 2021, with a 33% increase in cases. Statewide, 1,457 cases were diagnosed in 2021. Of those, 15 were congenital syphilis, where the mother passes the infection to her baby during pregnancy.

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Duluth syphilis, HIV outbreaks

Outbreaks of both syphilis and HIV in the 30-mile radius around Duluth have been monitored by the Minnesota Department of Health. Cases in both outbreaks were diagnosed after Sept. 1, 2019.

As of June 21, 84 cases of syphilis are linked to the Duluth area outbreak. Of those, 75 are in St. Louis County, seven are in Carlton County and two are in Lake County.

Across the Northland's seven Minnesota counties, 79 cases of syphilis were diagnosed in 2021. In 2020, 43 cases were diagnosed. So far in 2022, 39 cases have been diagnosed across the Northland.

As of June 28, 25 cases of HIV have been linked to the Duluth-area outbreak, which includes people who are unhoused; people who have been known to be in the area; people who are incarcerated; or people who are in chemical dependency treatment centers. Of the 25 cases, 24 are in St. Louis County and one is in Lake County.

In the Northland's Minnesota counties, eight cases of HIV were diagnosed in 2021. In 2020, the region recorded 11 cases. So far in 2022, three cases have been diagnosed. Statewide, cases increased 8% from 2020 to 2021, with 298 new diagnoses.

Across Minnesota, syphilis cases have seen a resurgence over the last decade, with men who have sex with men and those also infected with HIV being especially impacted, according to the report. Female impacts are at near-record highs in the last decade. In the past decade, cases of syphilis across Minnesota have increased by 305%.


Health officials have alerted health care providers to be aware of measles symptoms in patients and said if any additional cases develop they will likely occur between now and July 1.

Racial disparities

While race and ethnicity data was not provided in the report for each county, across the state, people of color are disproportionately impacted by STDs.

"This is echoed nationwide," Bo-Subait said. "Disparities and rates of STDs are not explained by differences in sexual behavior, but are due to differences in health insurance coverage, employment status and access to health care with preventative, screening and treatment services."

Chlamydia cases per 100,000 Minnesotans by race and ethnicity

  • Black, non-Hispanic: 2,024
  • American Indian: 970
  • Hispanic: 900
  • Asian/Pacific Islander: 382
  • White, non-Hispanic: 196

Gonorrhea cases per 100,000 Minnesotans by race and ethnicity

  • Black, non-Hispanic: 1,370
  • American Indian: 609
  • Hispanic: 223
  • Asian/Pacific Islander: 98
  • White, non-Hispanic: 67

Syphilis cases per 100,000 Minnesotans by race and ethnicity

  • American Indian: 86.1
  • Black, non-Hispanic: 51.3
  • Hispanic: 16
  • Asian/Pacific Islander: 6.8
  • White, non-Hispanic: 5.2

HIV cases per 100,000 Minnesotans by race and ethnicity

  • Black, non-Hispanic, African-born: 53.8
  • Black, non-Hispanic, non-African-born: 36.5
  • American Indian: 18
  • Hispanic: 17.2
  • Asian/Pacific Islander: 5.5
  • White, non-Hispanic: 2.4

Population estimates per 100,000 people are based on 2010 Census data. People of Hispanic ethnicity can be any race, according to the Minnesota Department of Health's data.

At a roundtable discussion with the Minnesota Ambulance Association and the Center for Rural Policy & Development, EMTs said rural ambulance departments are struggling with short staffing, underfunding and increased transfers outside their communities.

Laura Butterbrodt covers health for the Duluth News Tribune. She has a bachelor of arts in journalism from South Dakota State University and has been working as a reporter in Minnesota and South Dakota since 2014.
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