title: Prevalence of syphilis among female sex workers and their clients in Togo in 2011.
abstract: During the last ten years, a resurgence of syphilis has occurred in many countries worldwide, including Togo. Previous studies have shown a wide range of syphilis infection among the female sex workers (FSWs), from 1.5 to 42.1%. In Togo, Key populations, including FSWs, are rarely involved in the sentinel surveillance programs to determine the prevalence of HIV and syphilis. The aim of this study was to determine the prevalence of syphilis among female sex workers (FSWs) and their clients in Togo.
  
  
  
  We conducted a cross-sectional study in December 2011 targeting FSWs and their clients in Togo. Among participant who consented, we collected blood samples for syphilis and HIV testing.
  
  
  
  In total, 1,836 participants (1,106 FSWs and 730 clients) were included in the survey. Their mean age was 28.6 ± 9 years. The prevalence of syphilis was 2.2% (2.2% among FSWs compare to 2.3% among their clients, p = 0.82). This prevalence was higher among FSWs over 30 years old compare to those less than 30 years old (Odd Ratio (OR) =5.03; 95% CI [1.95-13.49]). Single FSWs were three times less likely to have syphilis than those living in couple or married (OR = 3.11; CI 95% [1.16-8.83]). Brothel based or declared FSWs were 4 times more likely to be infected by syphilis than secret ones (OR = 3.89; CI 95% [1.60-9.54]). Out of the 1,836 participants of the survey, 165 (8.9%) were HIV positive. Having syphilis was associated with HIV infection (OR = 3.41; IC 95% [1.53-7.41]).
  
  
  
  This study showed that: i) the prevalence of syphilis among FSWs and their clients was high; ii) syphilis was significantly associated with HIV infection. It is necessary to increase awareness campaigns and emphasize on condom use among this key population group.
authors.affiliation: Institut National d'Hygiène de Lomé, Lomé, BP 1396, Togo. hjacky78@yahoo.fr.
authors.forename: Wemboo Afiwa
authors.initials: WA
authors.lastname: Halatoko
authors.affiliation: World Health Organization, country office of Togo, Lomé, Togo.
authors.forename: Dadja Essoya
authors.initials: DE
authors.lastname: Landoh
authors.affiliation: Service de Dermatologie et IST, CHU Sylvanus Olympio, Université de Lomé, Lomé, Togo.
authors.forename: Bayaki
authors.initials: B
authors.lastname: Saka
authors.affiliation: Institut National d'Hygiène de Lomé, Lomé, BP 1396, Togo.
authors.forename: Koffi
authors.initials: K
authors.lastname: Akolly
authors.affiliation: Institut National d'Hygiène de Lomé, Lomé, BP 1396, Togo.
authors.forename: Yao
authors.initials: Y
authors.lastname: Layibo
authors.affiliation: Laboratoire de Santé Publique (EA 3279), Aix-Marseille Université, Marseille, France.
authors.forename: Issifou
authors.initials: I
authors.lastname: Yaya
authors.affiliation: Unité de Recherche Démographique, Université de Lomé, Lomé, Togo.
authors.forename: Dodji
authors.initials: D
authors.lastname: Gbetoglo
authors.affiliation: Institut National d'Hygiène de Lomé, Lomé, BP 1396, Togo.
authors.forename: Abiba Kere
authors.initials: AK
authors.lastname: Banla
authors.affiliation: Service de Dermatologie et IST, CHU Sylvanus Olympio, Université de Lomé, Lomé, Togo.|Conseil National de lutte contre le VIH/Sida et les IST (CNLS/IST), Lomé, Togo.
authors.forename: Palokinam
authors.initials: P
authors.lastname: Pitché
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D006801:Humans; D008875:Middle Aged; D015995:Prevalence; D021841:Safe Sex / Q000706:statistics & numerical data; D018571:Sentinel Surveillance; D060386:Sex Workers / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D013587:Syphilis / Q000453:epidemiology*; D014037:Togo; D055815:Young Adult
keywords: Clients; Female sex workers; HIV; Syphilis; Togo