Sexually transmitted disease (STD) rates in the U.S. are at a record high for the fourth year in a row, according to new data from the Centers for Disease Control and Prevention (CDC).

All told, nearly 2.3 million cases of chlamydia, gonorrhea and syphilis were diagnosed in the U.S. in 2017. That’s 200,000 more cases than were diagnosed in 2016, a year that also had a record-high number of cases, according to the CDC.

“We are now very concerned about this steep and sustained increase that we’re seeing,” says Dr. Gail Bolan, the director of the CDC’s Division of STD Prevention. “We’ve seen an ebb and flow of STDs in decades past, but now we’re at the highest level of our reportable conditions that we’ve seen in two decades.”

Read more