Pubic lice

If you have pubic lice (or genital crabs), don’t feel alarmed or ashamed. Many people get crabs and while they can be annoying and cause discomfort, it’s easy to treat them.

What are pubic lice (crabs)?

Pubic lice are tiny insects (2mm long) and grey-brown in colour. They can be hard to spot, but sometimes you may be able to see them in your hair. They most often live on pubic hair around the penis or vagina but can also be found in hair on the chest, armpits, face, and eyelashes. They do not affect hair on the head.

What are the symptoms of pubic lice?

  • Intense itching, which is usually worse at night
  • Small red or blue spots on your skin (lice bites)
  • White/yellow dots attached to your hair (lice eggs)
  • Dark red or brown spots in your underwear (lice poop)
  • Crusted or sticky eyelashes, if eyelashes are affected

How do you get crabs?

You can get genital crabs through close contact with another person, such as during sex.

Are pubic lice an STI?

Pubic lice often get lumped in with sexually transmitted infections (STIs). That’s because people get pubic lice most often during sex. But pubic lice aren’t an actual disease or infection.

How do you treat pubic lice?

Crabs can cause intense itching but are treatable. Pubic lice treatment usually involves special shampoos or creams to kill the lice.

Who is most at risk of pubic lice?

Pubic lice are usually spread through sexual contact and are most common in sexually active teens and people in their 20s. Having multiple sexual partners increases the chances of getting crabs. It’s important to note that people who have other sexually transmitted infections are at higher risk for pubic lice.

Does PrEP or condoms protect against crabs?

PrEP or condoms do not protect against pubic lice.

Should my sex partner(s) get treated for crabs?

Get in touch with your sexual partner(s) from the previous two months. They may have pubic lice too and will need treatment.

Does shaving get rid of crabs?

No, shaving your pubic area with a razor isn’t a treatment to get rid of crabs.

Does rubbing alcohol kill pubic lice?

You shouldn’t attempt to use rubbing alcohol to kill pubic lice. This may be effective in adult lice, but it’s not effective against nits or eggs. You should only use the medications your healthcare provider recommends.

How can I prevent genital crabs?

The only way to prevent pubic lice is to avoid any close physical contact with people who have it. Still, you can take reasonable steps to lower your risk for crabs and prevent them from coming back:


  • Avoid sharing personal items like clothes or towels.
  • Use pubic lice treatment which usually involves special creams or shampoos to kill the lice. After treatment, make sure to comb any nits (eggs) out of your hair.
  • Make sure your partner(s) get treated if you had pubic lice.
  • Wash clothing, bedding, and towels in hot water.
  • Finish treatment and check that the crabs are gone before resuming sex.


  • Have sex or close physical contact with someone who has pubic lice.
  • Share clothing, bedding, or towels with a person who has pubic lice.
  • Use insecticide sprays. They don’t control pubic lice and can be harmful to you.
  • Try on bathing suits when shopping. If you do try them on, wear underwear.

Can I use pubic lice shampoo preventively?

Perhaps you found out that a sexual partner from the past month has pubic lice. It’s fine to use one of the lice shampoos or creams before you have symptoms to be safe.

Will frequent showers prevent pubic lice?

Getting pubic lice has nothing to do with your hygiene. You get pubic lice by having close physical contact with a person who has them.

Are pubic lice dangerous?

No, pubic lice won’t cause serious health concerns. Usually, the main problems that the lice cause are itching and discomfort. You may get a bacterial infection if you end up scratching your skin a lot.

How long does it take to get rid of pubic lice?

Most treatments take about two weeks. If the lice don’t go away completely, you may need to repeat treatment.

Can I get pubic lice more than once?

Yes, you can get pubic lice again. Take steps to prevent pubic lice so you don’t get them again.

When can I resume sex?

Pause your sex life until both you and your partner(s) have finished treatment. Check that the lice haven’t returned. This could take about two weeks.

When should I see a healthcare provider?

In most cases, over-the-counter treatment from your pharmacy is effective in killing the lice. If this doesn’t work, contact a healthcare provider who may need to prescribe a stronger medication.

Does EMH prescribe treatment for pubic lice?

No, EMH does not. But you can get over-the-counter treatment without a doctor’s prescription from any Dischem, Clicks, or other pharmacy.


Engage Men’s Health offers free and friendly sexual health services to gay, bi and other men who have sex with men in Johannesburg, Nelson Mandela Bay and Buffalo City. Our services include HIV testing, treatment of HIV and other STIs, PrEP, PEP, and HIV self-testing kits. For more information or to book an appointment call/WhatsApp 082 607 1686.

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In addition to the challenges that the general population face, members of the LGBTQ+ community are burdened with experiences related to stigma, marginalisation, and discrimination. These factors make mental health challenges at least twice as likely for this population.

Traumatic experiences and emotional pain from the past can significantly impact our current state of mind without us always being aware of it. These can manifest in various ways, and it is not always easy to recognise the symptoms. However, it is crucial to address mental health challenges as they can significantly impact your quality of life. So, how do you know if you have mental health issues that need to be addressed?

Here are some signs that may indicate you have mental health issues:

  1. Persistent sadness or anxiety
    If you experience persistent feelings of sadness or anxiety, it may be a sign of a mental health problem. These emotions can interfere with your daily activities, such as work,
    school, or relationships.
  1. Social withdrawal
    If you find yourself withdrawing from social activities that you once enjoyed, it may be a sign of a mental health issue. Social withdrawal can be a symptom of depression or anxiety, and it can worsen the condition if left unaddressed.
  2. Poor concentration
    If you struggle to concentrate or have difficulty completing tasks, it may be a sign of a mental health problem. Poor concentration can be a symptom of various conditions such as ADHD (Attention-deficit/hyperactivity disorder), depression, or anxiety.
  3. Sleep disturbances
    Sleep disturbances such as insomnia (difficulty sleeping) or oversleeping can be a sign of a mental health issue. These problems can cause fatigue, irritability, and difficulty functioning during the day.
  4. Mood swings
    If you experience sudden and extreme changes in mood, it may be a sign of a mental health problem. These changes can be severe and disruptive to your daily life.
  5. Substance abuse
    If you turn to drugs or alcohol to cope with stress or emotions, it may be a sign of a mental health problem. Substance abuse can worsen the symptoms of an existing condition and can lead to addiction.
  6. Physical symptoms
    Physical symptoms such as headaches, stomach problems, and chronic pain can be a sign of a mental health issue. These symptoms should also be addressed by your doctor or health care provider, but they can often be triggered by stress or anxiety.
  7. Unusual behaviour
    If you engage in unusual behaviour or find yourself doing things that are out of character, it may be a sign of a mental health problem. These behaviours can be a symptom of a variety of conditions such as bipolar disorder or schizophrenia.
  8. Thoughts of self-harm
    If you experience thoughts of self-harm or suicide, it is crucial to seek help immediately. These thoughts are a sign of a mental health problem and require immediate attention.
  9. Difficulty coping with stress
    If you find it challenging to cope with stress, it may be a sign of a mental health issue. Coping mechanisms such as self-care or therapy can help you manage stress and improve your mental health.

If you experience any of these symptoms, it is essential to consult a counsellor, mental health professional, or at the very least talk about it with someone you trust.

Having mental health difficulties is nothing to be ashamed of; many of us experience some of these challenges at least once in our lives. Mental health is just as important as physical health, and taking care of your mental health is essential for overall well-being.



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Despite significant advances in HIV treatment and prevention, some men still lack knowledge about HIV, perpetuate HIV stigma, and shame those who take care of their sexual health. This may be due to their lack of exposure to relevant and current information, having incorrect information, or fear.

There are a few key points to consider about PrEP, ARVs, and HIV risk.

  • PrEP is a daily pill that has been proven to be up to 99.9% effective in preventing HIV transmission when taken as prescribed. This is important because research has shown that men do not always use condoms consistently, even when not using any other HIV protection method.
  • Although slut-shaming men on PrEP was more common when it first became available, it still occurs today. When a man mentions that he is on PrEP, other men may assume that he is promiscuous or engaging in risky sexual behaviour. This stigma is similar to the shame that women may face for using birth control.
  • Most HIV infections occur when men do not know their own HIV status, assume that their sexual partner is negative, or take someone’s word for it when they say they are negative. Statements such as “I’m clean, you be too,” “Neg4Neg,” “Disease-free,” or “Sorry, no poz guys” are common and reflect the stigma surrounding those living with HIV. They also indicate ignorance about the reality of dating HIV-positive men.
  • The U=U campaign is an international effort to raise awareness about the benefits of ARVs. U=U stands for “Undetectable = Untransmittable,” meaning that an HIV-positive person on ARVs who has an undetectable HIV viral load cannot transmit HIV, even without using condoms.
  • A person living with HIV is considered to have an “undetectable” viral load when ARV treatment has brought the level of the virus in their body to such low levels that blood tests cannot detect it. Scientists have proved that someone who is HIV-positive with an undetectable viral load because of treatment cannot transmit the virus during sex to their partners.

It is important to avoid judgment and prejudice rooted in ignorance, which are always unattractive qualities in a man. Men who take ARVs and PrEP are more likely to be informed and in control of their sexual health, which means that their HIV risk is lower than those who are uninformed or unaware of their HIV status. Let’s recognise and celebrate men who take care of their sexual health and that of their partners. What a man!

Engage Men’s Health offers free and friendly sexual health services to gay, bi and other men who have sex with men.
Our services include:
* HIV testing   
* Treatment of HIV and other STIs
* PrEP               
* HIV self-testing kits
For more information or to book an appointment call/WhatsApp 082 607 1686. 


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Infidelity is one of the most devastating things that can happen in a relationship or marriage. According to research, 30-60% of marriages deal with an affair, many of which end in divorce.

Why do people cheat? All relationships change over time and with it changes the dynamics in the relationship. Gay men that have been together for a long time often find that a relationship that started off as passionate and where sex played a big role, transforms into something more like ‘brothers’ or ‘besties’.

Some people cheat because they feel unsatisfied or unfulfilled in their current relationship, while others cheat because they have a desire for novelty or excitement. Some people cheat as a way to cope with personal issues such as low self-esteem, insecurity, or a lack of emotional intimacy in their current relationship.

Additionally, some people cheat due to external factors such as being away from their partner for long periods of time.

Besides the emotional damage of infidelity, it can also significantly impact health. If partners have unprotected sex as a couple but one (or both partners) also have high-risk sex with other people, this puts both at risk for HIV and other STIs. It is very cruel and selfish if one partner has unprotected sex outside the relationship while the other partner is unaware that they are also at risk.

If you have experienced infidelity, it can be difficult to know where to begin to repair the damage. Many, though deeply hurt from the affair, still want to salvage the relationship. Here are some steps you can take to try help you renew trust and work towards rebuilding a relationship:

  • Look at problems that existed in the relationship before the affair happened. Affairs don’t happen in a vacuum and understanding the events and emotions that led up to the affair can help bring healing and potential restoration.
  • Communicate openly and honestly. This is key to rebuilding trust. Both partners must be willing to be open and honest about their feelings, thoughts, and actions.
  • Take responsibility. Accepting responsibility for what has happened is an important step in rebuilding trust. It shows that you are aware of the harm that has been caused and are willing to make amends.
  • Make amends. Apologise and take action to make things right. This might include things like therapy or counselling, or even something as simple as writing a letter of apology.
  • Be patient. Surviving an affair includes much rebuilding of trust and patience on both sides. It can be a bumpy emotional roller coaster ride during the post-affair recovery. Rebuilding trust takes time. Be patient with yourself and your partner as you work through the process.
  • Be open to forgiveness. Forgiveness is a vital step in rebuilding trust. If you were the one who was cheated on, it is normal to feel hurt and angry. Some relationships don’t survive after infidelity because the unfaithful partner’s cheating is used by the other person to keep punishing or controlling them. If you really want it to work, it is important to be open to the possibility of forgiving your partner, even if it takes time. At some point, you may need to let go of the past and focus on the future. This can be difficult, but it is necessary for rebuilding trust.
  • Seek professional help. A therapist or counsellor can help you work through the issues that have led to the breach of trust. They can also help you develop the skills you need to rebuild trust.
  • Trust is built over time through consistent behavior. You need to show up for your partner and stay true to your word by consistently doing what you say you will.
  • Be willing to compromise. Rebuilding trust requires a willingness to compromise. Be open to making changes in your relationship to make things right.
  • Remain committed and show your commitment by making time for each other, doing things together and spending quality time together. Put the phones away and actively listen to your partner.

Rebuilding trust is a process. It’s important to remember that it is not something that you can demand or force; trust is something that must be earned.

Are you having relationship problems and looking for a relationship counsellor? The EMH Mental Health Support Team offers free in-person counselling for gay, bi or other MSM individuals or couples in Johannesburg. To make an appointment or for more info, WhatsApp call or message 063 649 5116.

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