A recent state health report card finds cases of chlamydia, gonorrhea, and syphilis increased among women - particularly black women - from 2002 to 2007. The reason for the rise is unclear, said Dr. Katherine Hartmann, director of women's health research at Vanderbilt University, noting that the 2009 Tennessee Women's Health Report Card is the state's first.

Health officials looked at the health profiles of more than 3 million women in the state, giving an "F" for infections after finding a rise in STDs. This mirrors a trend revealed in a federal 2007 report. According to CDC, Tennessee has one of the highest STD rates in the country for chlamydia, gonorrhea, and syphilis: For every 100,000 people, the state ranks in the top 10 for each of the three diseases.

Chlamydia cases rose 67 percent among Tennessee women, from 425 per 100,000 in 2002 to 633 in 2007. Cases among black women increased from 852 per 100,000 to 2,032 during the report card's timeframe. There were some improvements, however, with Hispanic women reporting no syphilis cases in 2007 and white women having fewer reported HIV cases.

"At the moment, we're hoping we're seeing great reporting and great screening," said Hartmann, who worked on the report. The next assessment comes out in two years, and health experts anticipate they will have a better sense of whether an outbreak is occurring or if doctors and clinics are testing more women for STDs.

Women must take control of their sexual health and discuss risks and behaviors with their doctor, Hartmann noted. "Whenever you have a new partner, you are integrating all that individual's partners as well," she said. "There is no room to not be hard-nosed about mutually monogamous relationships. Get testing before a new partner or after a new partner."