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Background: Female sex workers (FSWs) are an especially vulnerable group for syphilis and other sexually transmitted infection (STIs). This study determined the prevalence of syphilis in FSWs and factors associated with this disease in the Marajó Archipelago (northern Brazil), as well as the frequency of point mutations (A2058G and A2059G) in the 23S rRNA gene of Treponema pallidum and coinfections with hepatitis B virus (HBV), hepatitis C virus (HCV) and hepatitis D virus (HDV)., Methods: FSWs were diagnosed using a rapid qualitative test and the isolates were evaluated for the presence of point mutations by real-time PCR. Blood samples with T. pallidum were tested for the presence of HBV, HCV and HDV by ELISA and confirmed by real-time PCR. The factors associated with syphilis were identified using Poisson regression models., Results: Overall, 41.1% FSWs tested positive for syphilis and 23.5% were infected with strains having A2058G/A2059G point mutations. HBV (23.0%) and HCV (8.1%) were detected among FSWs with syphilis. Six factors were associated with syphilis: low levels of education, reduced income, drug use, unprotected sex, a lengthy career in prostitution and a lack of regular medical check-ups., Conclusions: These findings indicate an urgent need for implementation of effective strategies to diagnose, prevent and treat syphilis, as well as other STIs, in this Brazilian region., (© The Author(s) 2020. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.)

This study determined the prevalence of human immunodeficiency virus (HIV) infection and its associated factors in female sex workers (FSWs) from the municipality of Bragança in the state of Pará, Brazil. A cross-sectional study using a respondent-driven sampling method was used to investigate 137 FSWs. They were interviewed using a questionnaire for the collection of data on their characteristics and risk behavior. Blood samples were collected for serological and molecular testing for HIV. Poisson regression models were used to estimate the reasons of prevalence (RP). The majority was single, young, poorly educated, had a low monthly income, and had worked in the sex trade for more than 7 years. Sexual services were offered either directly (easy identification of FSWs in street markets, town squares, street corners, bars, and gas stations) or indirectly/discretely (more complex identification of FSWs, offering services through a cryptic approach or an intermediary). Overall, 22 (16.06%) FSWs had anti-HIV-1/2 antibodies, and 21 (15.33%) also had complementary DNA-HIV. The use of illicit drugs [adjusted RP (aRP) = 3.13; 95% confidence interval (CI) = 1.27-8.41], unprotected sex (aRP = 4.09; 95% CI = 1.34-11.62), anal sex (aRP = 4.01; 95% CI = 1.37-10.15), the exemption of condoms for clients paying extra (aRP = 4.71; 95% CI = 1.52-10.89), more than 7 years working as a sex worker (aRP = 6.04; 95% CI = 1.20-16.33), low levels of education (aRP = 3.55; 95% CI = 1.15-11.02), and a lack of regular medical or gynecological examinations were all associated with HIV infection (aRP = 5.87; 95% CI = 1.26-15.71). The FSWs who offered their services indirectly suffered significantly less physical and sexual aggression, charged more for encounters, had a significantly higher monthly income, and were more likely to have undergone a medical or gynecological examination within the preceding 12 months. This study identified information relevant to the control and prevention of HIV in FSWs.

Introduction: Female sex workers (FSWs) are considered a bridge for transmission of pathogens from high-risk to general populations. We assessed the epidemiological status of syphilis in FSWs along the Pará highway system., Methods: Two hundred and twenty-two FSWs were interviewed and samples were analyzed using rapid qualitative tests and real-time polymerase chain reaction., Results: The prevalence of syphilis was high (36.94%). The high rate of prostitution, use of illicit drugs, and search for financial resources increased Treponema pallidum transmission through unprotected sex., Conclusions: Several characteristics of FSWs were identified, which reinforce the need for measures guaranteeing their health and protection.