Seroprevalence of Syphilis and Associated Factors Among Pregnant Women Attending Antenatal Care at Hawassa Zuria Woreda Public Health Facilities, Sidama, Ethiopia, 2024

<i>Introduction:</i> Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum, and it continues to be a major public health problem worldwide. It can spread through various means, such as unprotected sex, mother to fetus, and blood transfusion. This study aimed to assess the seroprevalence of syphilis and associated factors among pregnant women attending antenatal care at public health facilities in Hawassa zuria woreda, Sidama, Ethiopia. <i>Methods:</i> A facility-based cross-sectional study design was conducted in Hawassa Zuria public health facilities from November 1-30, 2024. A total of 482 study participants were selected using systematic sampling techniques. Data were collected through structured interviews using a pretested questionnaire and reviewing records. Epi-data version 4.4 was used to code and enter the data, and SPSS version 26 was used for analysis. Bivariable logistic regression was employed to identify candidate variables for multivariable logistic regression with a significance level of ≤ 0.25. A multivariate logistic regression model was used to investigate factors associated with syphilis infection, p-value of <0.05 was considered statistically significant. <i>Result:</i> The seroprevalence of syphilis among pregnant women attending ANC clinics was 3.8% (95% CI: 3.61-3.99). Having multiple sexual partners (AOR = 3.68; 95% CI: 1.22 - 11.11), alcohol use (AOR =7.34; 95% CI: 2.31 - 23.36), and HIV positive women (AOR =10.22; 95% CI: 2.03 - 51.53) were significantly associated with syphilis infection. <i>Conclusion and recommendation:</i> Seroprevalence of syphilis was high. Having multiple sexual partners, HIV-positive women, and alcohol drinking were factors significantly associated with syphilis. Therefore, substantial efforts have to be made to provide regular health education for pregnant women at the antenatal clinic on the avoidance of risky behaviors, raise awareness on the transmission and prevention mechanisms of syphilis, promote safe sexual practices, and strengthen partner testing and treatment.