Background The number of cases of acquired syphilis are increasing in many countries. In Brazil, a previous official report based on compulsory notifications showed a sustained increase from 2.0 to 58.1 cases per 100,000 inhabitants over the last six years (2010–2017). We aimed to evaluate the prevalence of self-reported syphilis among women and men aged 16 to 25 years who use the public health system in Brazil.

Methods This is a cross-sectional, nationwide, multicenter study with 8,581 sexually active young adults recruited from 119 primary care units in all 26 Brazilian capitals and the Federal District. Data on sociodemographic and sexual behavior characteristics were obtained by face-to-face interviews. To evaluate syphilis, we asked the participants if they had ever had syphilis during their lives (current or in the past). We weighted the measures by population size in each capital and by sex.

Results Of all participants (49.17% women), 8,076 provided information about syphilis, and 224 (2.86%, 95%CI2.29%–3.43%) reported having the disease. The prevalence was similar between genders (p=0.240), with frequencies of 3.20% for men and 2.54% for women. The participants who self-reported syphilis were older [22.35 years (22.01–22.70)] than those without the disease [21.38 years (21.32–21.44); p<0.001] and had earlier sexual intercourse [14.81 years (14.53–15.09) vs. 15.22 years (15.17–15.27); p=0.006]. Syphilis was not associated with income and skin color/race, but it was significantly associated with educational level. Illiterate and elementary students had higher prevalence than other groups (4.88% among elementary, 2.16% secondary and 2.49% graduate students, p<0.001).

Conclusion Our results showed a high prevalence of self-reported syphilis in young adults of Brazil with significant difference between education level. Income and skin color/race were not associated with syphilis showing a disseminate outbreak. These data reinforce the importance of implementing strategies to combat this disease in young adults, especially among those with low educational level.

Disclosure No significant relationships.