There has been an alarming rise in gonorrhea, chlamydia, and syphilis in states and counties across the country, according to data released last week. Health professionals attribute the uptick to numerous factors, including better testing and fewer public health efforts focused on STIs, and they agree that prevention is the key to stemming the increasing number of cases.

Minnesota’s overall rate of sexually transmitted infections, for example, hit a new record high last year. Counties in California, Nevada, and Texas are all reporting rising rates of STIs as well.

And in Montana, the rate of gonorrhea in particular nearly doubled from 2013 to 2014. Montana’s Department of Health and Human Services found that cases of gonorrhea had risen to more than 400 in 2014, which represents a rate of about 40 cases per 100,000 people in the state. That’s up from 23 cases per 100,000 in 2013, and just 11 cases per 100,000 in 2012.

The trend seems to be continuing in 2015. There have been 61 cases reported in the county this year compared to 15 in the same timespan in 2014, according to RiverStone Health, Yellowstone County’s health department.

“Every day we get one or two more,” Kim Bailey, the department’s communicable disease program manager, told the Missoulian. “We’re doing everything we can to try to mitigate it.”

Gonorrhea and chlamydia are caused by bacteria that can infect the genitals, throat, or anus. Though both can be easily cured with antibiotics if caught early, but if left untreated they can lead to pelvic inflammatory disease in women and subsequently to infertility. There have been concerns recently about new strains of gonorrhea that are resistant to antibiotics.

Meanwhile, Minnesota’s Department of Health released its report on STIs last week and found that overall cases of these three diseases had gone up 6 percent from the previous year. In 2014, there were about 24,500 cases reported, including almost 20,000 cases of chlamydia, 4,000 cases of  gonorrhea, and about 30 cases of primary and secondary syphilis. Those syphilis numbers represented a 17 percent rise over 2013 numbers.

Syphilis can also be treated if caught early, but left untreated it can damage the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints. Signs and symptoms of late-stage syphilis include difficulty coordinating muscle movements, paralysis, numbness, gradual blindness, and dementia. Today, more than 75 percent of syphilis cases in the United States occur in men who have sex with men.

This is also the case in Minnesota. However, a department spokesperson told Minnesota Public Radio that the number of cases among women in the state, especially pregnant women, was particularly concerning.

The Twin Cities of Minneapolis and Saint Paul saw most of the STI cases, with one in three cases of chlamydia and about 80 percent of gonorrhea cases occurring in the metropolitan area. Most chlamydia cases occurred in teens and young adults ages 15 to 24, and the infection rates for both chlamydia and gonorrhea were higher among communities of color than among white communities. Rates of gonorrhea were higher among men than women for the first time.

On a more local level, the 2015 County Health Rankings, a report done by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, examined counties in Texas and found that El Paso had a much higher rate of chlamydia than other parts of the state and the nation. There were about 4,700 chlamydia cases reported in El Paso in 2014, which puts chlamydia just behind the flu as the top communicable disease in the county.

Humboldt County in California has seen cases of chlamydia and gonorrhea rising over the past several years, particularly in the last three months in particular. The county’s department of health said in a press release that since 2010, there has been a tenfold increase in cases of gonorrhea. Since January of this year, there have been 82 cases reported, suggesting that this trend will continue into 2015 as well.

Clark County, Nevada—home of Las Vegas—has also seen remarkable rises in reportable STIs. There was a 50 percent increase in the number of 2014 cases of primary and secondary syphilis. Cases of gonorrhea and chlamydia were up as well.

Officials in these counties had different explanations as to why STD rates are on the rise.

Robert Resendes, director of El Paso City Health Department, told the El Paso Times that young people were driving the epidemic.

“We do have a chlamydia problem in here. We have a younger population and people tend to be sexually active. We have a military base—men looking for love in all the wrong places,” Resendes said.

Cheryl Radeloff, a disease and intervention specialist in Nevada, told the local public radio station, KNPR, that the rise can be attributed to several factors, including multiple sex partners, fewer public service campaigns focused on STIs, an explosion of hookup mobile apps, and improved testing and screening.

“There is a lot of shame, there is a lot of silence talking about sexually transmitted infections and that unfortunately helps in the spread of these infections,” Radeloff said.

Many of the health departments reporting data had the same advice for people in their states and communities: concentrate on preventing infection by limiting your number of partners, always using latex condoms, and seeking out testing and treatment when needed.

William Smith, executive director of the National Coalition of STD Directors agrees with this emphasis on prevention.

“These increasing STD rates seen at the local and state level continue to be a harbinger of national trends,” he told told Rewire in an email. “While we may not know the causes of these increases that occur year after year, we do know this: more testing and treatment is needed as is a re-commitment to the best protection against all STDs, including HIV, for those having sex: the condom.”