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Abstract：
BACKGROUND: Syphilis remains a significant global public health issue, and female sex workers (FSWs) are highly vulnerable to the etiological agent of this disease. This study aimed to describe the prevalence of exposure to Treponema pallidum, as well as the vulnerability factors among FSWs in the state of Pará, Brazilian Amazon.
METHODS: A cross-sectional, retrospective study involving 360 FSWs from five cities in Pará was conducted from 2005 to 2007. Blood samples were collected for treponemal and non-treponemal testing, and epidemiological information was obtained through interviews.
RESULTS: The exposure rate to T. pallidum was 37.7% (136/360), and the majority of FSWs had serological results indicating past exposure (21.1%). Among the FSWs exposed to T. pallidum, most of them were single, aged 23 to 42 years old, had less than 8 years of schooling, and had a family income of between 1 and 3 minimum wages. They reported using condoms during sexual intercourse and had no history of sexually transmitted infection (STI). Furthermore, many of the FSWs exposed to T. pallidum reported having more than 20 sexual partners per month, and had partners from other Brazilian states, but not from other countries. An age over 42 years and a reduced level of education were factors associated with exposure to T. pallidum. Finally, a high rate of exposure to T. pallidum among FSWs in the Brazilian state of Pará (from 2005 to 2007) was detected. In later years, epidemiological studies conducted with FSWs recorded that this rate remained high. Measures to control, treat, and prevent syphilis among FSWs were necessary between 2005 and 2007, and they are still imperative today. Actions related to educational programs and STI control, treatment, and prevention measures contained in Brazilian policies aimed at women\'s health have not changed the vulnerability scenario of FSWs regarding their exposure to T. pallidum, even after 16 years, and must be reviewed and adapted to the conditions of the Brazilian Amazon.
METHODS: A cross-sectional, retrospective study involving 360 FSWs from five cities in Pará was conducted from 2005 to 2007. Blood samples were collected for treponemal and non-treponemal testing, and epidemiological information was obtained through interviews.
RESULTS: The exposure rate to T. pallidum was 37.7% (136/360), and the majority of FSWs had serological results indicating past exposure (21.1%). Among the FSWs exposed to T. pallidum, most of them were single, aged 23 to 42 years old, had less than 8 years of schooling, and had a family income of between 1 and 3 minimum wages. They reported using condoms during sexual intercourse and had no history of sexually transmitted infection (STI). Furthermore, many of the FSWs exposed to T. pallidum reported having more than 20 sexual partners per month, and had partners from other Brazilian states, but not from other countries. An age over 42 years and a reduced level of education were factors associated with exposure to T. pallidum. Finally, a high rate of exposure to T. pallidum among FSWs in the Brazilian state of Pará (from 2005 to 2007) was detected. In later years, epidemiological studies conducted with FSWs recorded that this rate remained high. Measures to control, treat, and prevent syphilis among FSWs were necessary between 2005 and 2007, and they are still imperative today. Actions related to educational programs and STI control, treatment, and prevention measures contained in Brazilian policies aimed at women\'s health have not changed the vulnerability scenario of FSWs regarding their exposure to T. pallidum, even after 16 years, and must be reviewed and adapted to the conditions of the Brazilian Amazon.
摘要：
背景：梅毒仍然是一个重要的全球公共卫生问题，和女性性工作者（FSW）非常容易受到这种疾病的病因。本研究旨在描述梅毒螺旋体暴露的患病率，以及帕拉州FSW之间的脆弱性因素，巴西亚马逊。
方法：横截面，2005年至2007年,我们对来自帕拉市5个城市的360个FSW进行了回顾性研究.收集血样进行螺旋体和非螺旋体检测，流行病学信息是通过访谈获得的。
结果：梅毒螺旋体的暴露率为37.7%（136/360），大多数FSW的血清学结果表明过去的暴露(21.1%)。在暴露于梅毒螺旋体的FSW中，他们大多数都是单身,23至42岁，受过不到8年的教育，家庭收入在1到3个最低工资之间。他们报告在性交期间使用避孕套，并且没有性传播感染（STI）的病史。此外，许多暴露于梅毒螺旋体的FSW报告每月有20多个性伴侣，有来自巴西其他州的合作伙伴，但不是来自其他国家。年龄超过42岁和教育水平下降是与暴露于梅毒螺旋体相关的因素。最后,在巴西帕拉州（2005年至2007年）的FSWs中，发现了较高的梅毒螺旋体暴露率。在后来的几年里,使用FSW进行的流行病学研究表明，这一比率仍然很高。控制措施，请客,在2005年至2007年之间，FSW中预防梅毒是必要的，并且在今天仍然势在必行。与教育计划和STI控制相关的行动，治疗,巴西针对妇女健康的政策中包含的预防措施并没有改变FSW暴露于梅毒螺旋体的脆弱性情景，16年后,并且必须经过审查并适应巴西亚马逊的条件。
方法：横截面，2005年至2007年,我们对来自帕拉市5个城市的360个FSW进行了回顾性研究.收集血样进行螺旋体和非螺旋体检测，流行病学信息是通过访谈获得的。
结果：梅毒螺旋体的暴露率为37.7%（136/360），大多数FSW的血清学结果表明过去的暴露(21.1%)。在暴露于梅毒螺旋体的FSW中，他们大多数都是单身,23至42岁，受过不到8年的教育，家庭收入在1到3个最低工资之间。他们报告在性交期间使用避孕套，并且没有性传播感染（STI）的病史。此外，许多暴露于梅毒螺旋体的FSW报告每月有20多个性伴侣，有来自巴西其他州的合作伙伴，但不是来自其他国家。年龄超过42岁和教育水平下降是与暴露于梅毒螺旋体相关的因素。最后,在巴西帕拉州（2005年至2007年）的FSWs中，发现了较高的梅毒螺旋体暴露率。在后来的几年里,使用FSW进行的流行病学研究表明，这一比率仍然很高。控制措施，请客,在2005年至2007年之间，FSW中预防梅毒是必要的，并且在今天仍然势在必行。与教育计划和STI控制相关的行动，治疗,巴西针对妇女健康的政策中包含的预防措施并没有改变FSW暴露于梅毒螺旋体的脆弱性情景，16年后,并且必须经过审查并适应巴西亚马逊的条件。
