Cases of sexually transmitted diseases once again increased in the United States, making 2018 the fifth consecutive year in which the number of people infected with gonorrhea, chlamydia, and syphilis went up.

Reduced access to STD prevention and care, a decreased use of condoms and cuts to programs at the state and local levels continue to drive the increase in the prevalence of the diseases. The data comes from the Centers for Disease Control and Prevention’s annual report on sexually transmitted disease surveillance.

According to the agency, half of the STD infections are in young people ages 15-24.

The most common of the three diseases tracked in the report was chlamydia, with over 1.7 million cases in 2018, an increase of 3 percent from 2017 and the most that has ever been reported to the federal agency. There were nearly 600,000 gonorrhea cases in 2018, the highest number since 1991. Finally, more than 115,000 syphilis cases were diagnosed.

In Los Angeles County, there were 27,415 cases of chlamydia, 8,730 cases of gonorrhea and 565 cases of primary and secondary syphilis. Among counties of comparable size, Los Angeles County had the third-highest number of chlamydia cases and the fifth-highest number of both syphilis and gonorrhea cases.