Introduction Syphilis persists as a major and ascendant health issue. However, the impact of this disease during the adolescence, a period of behavioural, sexual and psychologic vulnerabilities, is still underexplored. We aimed to evaluate the follow-up of syphilis infected adolescents attended at a reference service of sexually transmitted infections (STI).

Methods A retrospective cohort study using data from medical records of adolescents (10 to 19 years old) with diagnosis of syphilis attended at the states STI reference centre, from January to August 2012.

Results Among 776 adolescents attending the service, 58 had a diagnosis of syphilis (7.47%). The majority was male (51.7%), mean age was 16.8 (±1.35) years, 92.3% attended school, and 58.1% had ≤8 years of schooling; 39.4% referred drinking alcohol and 39.5% drug use. Among the adolescents, 98.3% had already initiated sexual life, with the mean age of sexual debut of 14.2 (±1.48) years, with an average of 2.33 (±2.55) lifetime sexual partners. About 14.0% declared to be homosexual, 85.4% referred irregular condom use, 22.2% of the girls were pregnant, with mean age at first gestation of 16.0 (±1.09) years. A parcel of 4.8% of the adolescents were HIV-infected, 31.0% reported a previous STI (p=0.02, OR 2.68, 95% CI 1.16–6.17), and 52.3% had another current STI. The mean number of medical visits was 2.33, 22.8% had primary syphilis, 17.5% had the secondary phase of the disease and 59.6% had latent or late syphilis. The social and demographic variables were not statistically different among the adolescents in the different stages of syphilis. The genital ulcer complaint was related to the diagnosis of primary or secondary syphilis (p=0.01, OR 8.53, 95% CI 1.61–45.1). 91.4% of adolescents received treatment for syphilis and 56.6% performed a cure control.

Conclusion The high prevalence of other STIs associated with syphilis in adolescents demonstrates the limited knowledge of this population to care and prevention strategies, and remains a challenge for specialised services in the diagnosis and treatment of STI/HIV.