This survey reflects the dilemma in clinical practice; more than 50% of study participants believe that CD4+ cell counts below 350 cells/mm3 should still be a criterion for lumbar puncture; almost 30% would indicate lumbar puncture for patients with latent syphilis of unknown duration; and approximately 20% would refer PLHIV for lumbar puncture when VDRL titers are ≥ 1:32. This evidence concerns the gene CD4 and latent syphilis.