ABSTRACTBackground: Syphilis and human immunodeficiency virus (HIV) are both sexually transmitted and can both be contracted in a single unprotected intercourse, having a co infection can have potential adverse effects on clinical outcomes and HIV care.Methods: This hospital-based cross-sectional study was conducted among HIV patients attending the HIV clinic at a tertiary hospital in the south south senatorial district. Sociodemographic, behavioral, and clinical data were collected using a structured interviewer questionnaire and medical records review. Blood samples were screened for syphilis using rapid plasma reagin and confirmed with Treponema pallidum hemagglutination assay. Data were analyzed using descriptive statistics, bivariate tests, and multivariable logistic regression.Results: A total of 400 HIV positive patients were enrolled; 274 (68.5%) were female,126(31.5%) were males, the mean age was 43.6 ± 1 0.1 years. Syphilis was detected in 10 participants one male had a penile ulcer, giving an overall prevalence of 2.5% (95% CI: 1.36%-4.54%). Prevalence was significantly higher among males than females and was associated with educational level and number of sexual partners in bivariate analysis. On multivariable analysis, male sex remained the only independent predictor of syphilisConcIusion: Syphilis prevalence was low in the patients. Male sex was the only independent risk factor identified, there is a need for routine syphilis screening within HIV care, particularly among men.Keywords: HIV, syphilis, prevalence, risk factors, Nigeria