title: History of syphilis in women living with AIDS and associated risk factors in São Paulo, Brazil.
abstract: OBJECTIVE
  to describe the epidemiological profile, risk behaviors, frequency of prior history of syphilis in women living with AIDS and to investigate associated factors.
  
  
  METHODS
  a cross-sectional study conducted with women living with HIV attending at Reference Center for AIDS in São Paulo. Demographic, behavioral, and clinical data were analyzed based on medical records.
  
  
  RESULTS
  a total of 598 women were included in the study and the prevalence of previous syphilis was 6.2% (95% CI 4,3-8,1). Seventy-three percent of women were less than 40 years of age when diagnosed with AIDS and 49.6% had more than eight years of formal education. 67.2% were white and 65.9% were not married or living with a partner, 53.2% reported that their first sexual intercourse aged more than 15 years, 56.5% reported having only one partner in the last year and 13% reported drug use. Regarding laboratory data, 83.8% had CD4+ <500 cells/ mm3 upon diagnosis of AIDS. Previous syphilis was associated with the use of crack cocaine [AOR = 6.8 (95% CI 1.7 - 27.5)], >1 sexual partner in the last year [AOR = 6.6 (95% CI 1.2 - 37.1)], CD4 + <500 cells/mm3 [AOR = 3.8 (women 1.1 - 13.6)], HIV diagnosis > 8 years [AOR = 2.4 (95% CI 1.0 - 5.8)].
  
  
  CONCLUSIONS
  a high prevalence of previous syphilis was found in the population studied, and crack use was identified among the main associated risk factors. Interventions to reduce the risk of sexual transmission of HIV and syphilis must be strengthened, with the implementation of control actions, screening strategies, early diagnosis and treatment, preventing complications, reducing morbidity and improving sexual and reproductive health.
authors.affiliation: State STD and AIDS program of São Paulo, São Paulo State Health Department, STD/AIDS Reference and Training Center, São Paulo, Brazil.
authors.forename: Valdir Monteiro
authors.initials: VM
authors.lastname: Pinto
authors.affiliation: State STD and AIDS program of São Paulo, São Paulo State Health Department, STD/AIDS Reference and Training Center, São Paulo, Brazil.
authors.forename: Mariza Vono
authors.initials: MV
authors.lastname: Tancredi
authors.affiliation: Faculty of Public Health, University of São Paulo, São Paulo, Brazil.
authors.forename: Cassia Maria
authors.initials: CM
authors.lastname: Buchalla
authors.affiliation: Department of Social Medicine, Infectious Disease Center, Federal University of Espírito Santo, Vitória, ES, Brazil.
authors.forename: Angelica Espinosa
authors.initials: AE
authors.lastname: Miranda
mesh_terms: D001938:Brazil / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D015995:Prevalence; D012307:Risk Factors; D012309:Risk-Taking; D012959:Socioeconomic Factors; D013587:Syphilis / Q000453:epidemiology*; D014505:Urban Population