STDs Expert Forum
Prevention
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The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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Prevention

Hi,
Occasionally I have encounters with sex workers and am married.  I am extremely attentive to proper condom usage.  That said, it is impossible to prevent transmission of lice.  I am interested in taking preventive measures, aggressive if necessary, to prevent infection.  Directly following the encounter (i.e. before going to bed, sleeping, etc. and losing any chance of containment), what steps would you recommend taking to reasonably achieve this?  

1.  Can I simply use a lice comb and carefully inspect?  Should it be before showering, after, while wet?  Do I need a magnifying glass?  Obviously if something is found treatment is required.  If so what is the proper treatment regime? There appears to many chemicals with a wide range of controvery and effectiveness - please advise.  Leaving on something with the smell of Malathion on all night is not an option.

2.  If it is not possible to detect easily per the above, is chemical treatment the only other option to achieve a high degree of confidence (realize there is no such thing as 100%)?  Not crazy about dousing myselves in chemicals, but wondering if this is required to achieve such a degree of confidence, what the least detrimental to my health approach is?

Thank you.
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I would help if I could, but there simply are no data on the frequency, risks, and prevention of sexually transmitted pubic lice -- or body lice for that matter.  The procedures you describe imply early detection and treatment, rather than prevention per se. I cannot say whether any of the procedures you describe would work.  The best prevention probably is careful partner selection.  If you pick up streetwalkers, bar pick-ups, or brothel workers, there may be significant risk.  In more upscale settings, e.g. escorts, probably the risk is near zero.  Another approach would be to purchase one of the over-the-counter treatments (e.g., Rid) and use it routinely a few days after your nonmarital encounters.

Good luck--  HHH, MD
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H. Hunter Handsfield, M.D.Blank
University of Washington
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