Background The overall prevalence of HIV and active syphilis are 0.7% and 3% respectively revealed in 9th serosurveillance among most at risk population. High active syphilis rates suggest practise of unsafe sex and a surrogate marker of unsafe sex is active syphilis. STIs and HIV are linked as they share the same risk behaviour, STIs facilitate acquisition and transmission of HIV, and some STI pathogens become more virulent in presence of HIV-related immunodeficiency. Under Global Fund support and initiative Save the Children stepped in (2008) with essential service (primly STI management, Condom distribution, BCC session through DICs and outreach) for FSWs nationwide in 51 districts which includes all serosurveillance sampling sites for FSWs.

Methods 8th round serosurveillance was conducted between July and December 2007 where total 4797 FSWs in 15 cities were sampled. 9th serosurveillance was conducted between December 2010 to June 2011 where total 3568 FSWs were sampled from 13 cities of Bangladesh. Same sampling methodology followed in both the rounds. Sero-surveillance sampling site were under implementation coverage.

Results In 8th sero-surveillance, > 5% active syphilis was detected in five sites namely street FSWs of Chittagong, Rangpur, Dhaka, hotels FSWs of Sylhet (8.3%) and casual FSWs in Chandpur. In 9th serosurveillance, > 5% active syphilis was detected in three sites, street FSWs of Hili, Chittagong and hotel FSWs of Sylhet. Active Syphilis rate decreased in all the 5 sites except hotel FSWs in Sylhet (9.3%). Moreover, there is decreasing trends of active syphilis among FSWs in several sites in 9th round comparing to 8th.

Conclusion High active syphilis rate highlight the need for ongoing programme intensification to decline STI trend. Evidence with good programmatic implication extrapolated and translated through serosurveillance could tailor-made the ongoing intervention and also designing the future programme.