Background: - Syphilis, HIV and HBV are the most common public health problems inrnSub-Saharan countries. Ethiopia is among the countries where syphilis, HIV and HBVrninfections are highly prevalent. These infections are interrelated, since syphilis enhancesrnHIV and, HBV infection is complicated by HIV co-infection. Although syphilis, HBV andrnHIV have the similar route of transmission, screening services for syphilis and HBV are notrncommon in most of the voluntary counseling and testing centers (VCT). Therefore, morerninformation is required on prevalence of HBV and syphilis in VCT centers, and the rate ofrnco-infection of syphilis and HBV in HIV positive individuals.rnrnObjectives: To assess sero-prevalence of hepatitis B surface antigen (HBsAg) and syphilisrnamong provider initiated counseling and testing (PICT) and VCT clients. It is designed torndetermine the sero-prevalence of Hepatitis B Virus and syphilis among HIV positive andrnnegative and co-infection of these infections with HIV. Hepatitis B virus infections andrnHIV are highly prevalent and they are among the major public health concern inrndeveloping countries including Ethiopia investigating this problem is of paramount benefit.rnrnMETHODS: A cross-sectional study was conducted from November 2011 to Februaryrn2012 in St. Paulâ€™s Hospital Millennium Medical College. 292 consecutive samples wererncollected using convenient sampling method from PICT and VCT clients. Data on sociodemographicrnrncharacteristics and sexual behaviors were collected using a questionnaire.rnBlood specimen was tested for the presence Hepatitis B surface antigen using commercialrntest kits and syphilis serology was examined using rapid plasma reagin (RPR) and the datarnwas analyzed using version16 SPSS (statistical package for the social science) software. rnResultsrnThe prevalence of HIV was 8/292 (2.7%), HBsAg was 43/292 (14.7%), and syphilis wasrn5/292(1.7%). HBs antigen prevalence among HIV positive clients was 2/8 (25%) whilernamong HIV negative was 41/287 (14.3%). All HIV positive clients were negative for syphilis. Sex statistically affects HBV infection (p=0.02), but there was no significantrnassociation with syphilis.rnConclusionrnIn this study syphilis prevalence was low. But a substantial percentage of the attendants seenrnin the PICT and VCT centers have HBV and HIV infections, which otherwise would remainrnundiagnosed without serological screening.rnRecommendationrnTherefore, strong HBV control strategies should be designed parallel with HIV and actionsrnshould be taken to avert the extent of the problem including provision of better healthrneducation, screening services in PICT and VCT centers and provision of vaccination forrnHBV.