Introduction: This study aimed to estimate the prevalence and risk factors associated with Chlamydia trachomatis (CT) infection among women with HIV in São Paulo. Methods: This cross-sectional study included women with HIV who were receiving care from sixteen public health services in São Paulo (October 2013 to March 2014). All participants answered a questionnaire regarding their sociodemographic, behavioral, and clinical characteristics. A urine sample was tested for CT and Neisseria gonorrhoeae (NG) using the polymerase chain reaction. The chi-square test and a logistic regression model were used to test the associations with CT or NG infections. Results: We evaluated 853 women and ultimately included 836 (98%) women. The mean age was 40.5 ± 0.34 years, and the prevalences of CT and NG infections were 1.8% and 0.5%, respectively. CT infection was associated with CD4+ T-cell counts of <350 cells/mm 3 [adjusted odds ratio (OR adj ): 24.5], age of 18-25 years (OR adj : 23.2), the non-use of condoms during the last 6 months (OR adj : 10.2), a self-reported history of a sexually transmitted infection (OR adj : 9.4), and having two or more sexual partners during the last year (OR adj : 6.1). Conclusions: Although we observed a low prevalence of CT infection among women with HIV, younger age was associated with a high risk of infection. Therefore, it may be appropriate to include screening for CT as part of the routine care for this population.