Higher RPR titres at treatment and delivery are associated with an increased likelihood of syphilis VT [41]. Achieving serologic cure, a four-fold reduction in titre after adequate treatment, has been linked to younger age, higher baseline titres, and earlier stages of syphilis infection [64]. Associations between HIV status, CD4 count, and VL in WLHIV and syphilis serological outcomes remain inconsistent across studies [64] and limited among pregnant women. Here, CD4 is linked to syphilis.