Table 2 Summary of reported reasons why men did not attend clinic for syphilis treatment

1.0 Individual Characteristics

 1,1 Knowledge of Syphilis as Disease

  • Ignorance

  • Think women's treatment implied own treatment

  • Men think syphilis is a women’s disease

 1,2 Fear and Stigma

  • Not ready to be associated with HIV.

  • Fear of being arrested, due to unwanted pregnancy /illegal pregnancy

  • Self-medication

  • Fear of self and community stigma, Fear to be seen getting free treatment, would be laughed at

  • Alternative medicines e.g. herbal usage

 1,3 Work/Time Issues

  • Very busy work schedule being an employee leaves little or no room to get away from workplace

  • Non-disclosure at work place to seek permission to go to clinic

 1,4 Communication and Sexual Relationship Issues

  • Was not informed by wife.

  • Men’s ego

  • Blamed women for being promiscuous

  • Women suffered from domestic violence and found difficulty in convincing men

  • Unresolved marital conflicts

  • Poor communication skills by women.

  • Fear partner notification especially in polygamy

2.0 Characteristics of Disease

 • Disease while asymptomatic, men don’t not see need to seek care /come to clinic

 • Fear painful injection for syphilis treatment, Fear of injection some left clinic in fear

 • Fear of cost of treatment

3.0 Characteristics of Health Services

 3,1 Perceptions of Health Services

  • Negative attitude towards public facilities ( prefer private clinic)

 3.2 Capacity of Clinics

  • Limited resources of care, crowding, slow services, Left the clinic due to long waiting time, yet had other work to do to earn a living, Was not screened before being asked to receive treatment

 3.3 Accessibility

  • Poor accessibility of the clinic, failed to locate it, Failure to locate clinic

  • Getting a negative syphilis test from elsewhere (validation test).

  • Fear of lack of drugs at facility/No trust in clinic to have needed drugs