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The eligible participants are adult people living with HIV (PLWH) who are newly diagnosed with early syphilis. Participants will be randomized in a 1:1 ratio to receive single-dose benzathine penicillin G (BPG) (2.4 MU intramuscularly once) plus doxycycline (100 mg orally twice daily for 7 days) or single-dose BPG. The primary outcome is serologic response, defined as a decline of rapid plasma reagin (RPR) titer by 4-fold or greater, at week 24 and week 48; and the secondary outcomes include microbiologic response of syphilis and bacterial sexually transmitted infections (STIs) assessed by nucleic-acid amplification test (NAAT) at week 4.",[170],"Early Syphilis, Latent, Serological Relapse After Treatment",[172,173],"syphilis","rapid plasma reagin","2026-08-03",{"date":176,"type":177},"2026-08-06","ACTUAL",{"date":179,"type":177},"2024-01-01",{"date":181,"type":164},"2028-12-31",{"name":5,"class":6},9]