Introduction Syphilis is a common but curable sexually transmitted infection (STI). Nevertheless the limited access to medical care among Female Sex Workers (FSWs) can reduce individual treatment, thereby indirectly facilitating transmission within the population. There is increased risk of HIV acquisition and transmission of HIV because of ulcerative syphilis. This study aimed to provide, for the first time using response driven sampling (RDS), baseline information on the prevalence and treatment rate of syphilis among FSWs in Morocco.

Methods This study was conducted from December 2011 to January 2012 in four Moroccan regions: Agadir, Rabat, Fes and Tangier. A total of 1447 FSWs participants were recruited using RDS. All participants completed an anonymous questionnaire on sex behavioural information and were tested for syphilis by using a combination of two tests; a non treponemal test (venereal diseases research laboratory VDRL) and treponemal test (treponema pallidum haemmaglutination assay: TPHA).

Results Among1447 FSWs (17.68%) were reactive for syphilis with 21.4% in Agadir, 18.8% in Fes, 13.9% in Rabat and 13.3% in Tangier. Only 25.54% of FSWs reported being tested for HIV in the past 12 months and 4% ever been tested for HIV, 50.25% reported using a condom at last transactional sex.

Conclusion The prevalence of syphilis was high among female sex workers and majority of them were treated for syphilis. Achieving good treatment coverage therefore will help not only to reduce syphilis incidence but also HIV disease burden in the high risk population and general population since the relationship between syphilis and HIV is well established. This study has shown syphilis continues to be highly prevalent among female sex workers and targeted intervention programs need to focus on curable STI like syphilis.