COVID 19 and Sexual Health

Currently, the government advice to stop the spread of COVID-19 is to stay at home and only see those within your household. This is essential if we want to protect not only ourselves but those that may be more vulnerable such as the elderly. Everyone can play their part and help reduce the demand on NHS services.   

As one of the key measures is social distancing this also extends to sexual distancing and we advise that you do not meet up for sexual relations with others outside your home at this time. That means no in-person hook ups! Although you may be creative with today’s technology and toys and think about other ways you can get off.  

At this time you may want to just reflect on the sexual relationships you were having and if they were fulfilling and right for you. That’s ok to - in fact taking the time to consider what you want and how you can ensure you and your partner(s) have safer and more pleasurable sex in the future is a great opporunity. 

Let’s not forget that sex with yourself is awesome and is great for your mental and phsyical welbeing. Masturbation will not spread COVID -19, especially if you wash your hands (and any sex toys) with soap and water for at least 20 seconds before and after sex. If you share a computer, phone or touch screen whilst masturbating make sure to disinfect it afterwards.

If you live with your sexual partner and you are both feeling well; you haven’t been exposed to COVID-19 and are not in the at risk group of having a severe illness with COVID-19; then sex might actually be a really great way to have fun, stay connected and relieve anxiety during this potentially stressful time. However, if you have symptoms of COVID-19 (these include a new persistent cough or fever of 37.7°C or above) then the advice is that you should self-isolate for 7 days to prevent further transmissions. 

If someone you live with or someone you have recently had sex with (within or outside of your household) has these symptoms then you need to self-isolate for 14 days. Self-isolating means no physical contact – no hugging, sex or kissing and have separate sleeping arrangements. Irrespective of symptoms, if you or sexual partner has a medical condition that may lead to a more severe illness with COVID-19, you should avoid sex.

 

How can I make sex safer?

If you are going to have sex, you can reduce the harm to yourself and your partners.

Condoms and dental dams can reduce contact with sperm (“cum”), saliva (“spit”) and faeces (“poo”), especially during oral and anal sex.

You can get condoms for free, by ordering online at lgbt.foundation/condomsbypost, or emailing india@thebha.org.uk

 

• Kissing passes on COVID-19. Avoid kissing anyone who is not part of your household.

• Rimming (mouth on anus) is very likely to spread COVID-19 as the virus in faeces can enter your mouth so you should avoid it during this time.

• Washing before and after sex is essential. Wash your hands and sex toys with soap and warm water. Do not share sex toys during this time.

 

Starting and Stopping PrEP

PrEP (pre-exposure prophylaxis) is an effective HIV prevention medication for those that are HIV negative.

You can start and stop PrEP anytime you like. PrEP is used to prevent you from acquiring HIV when you might be at risk of exposure to HIV. If you are not having sex - you don’t need to take PrEP.  

Some people maybe thinking that as they are not planning to have sex during this time they may stop PrEP. If this is so, we have some information and advice for you on stopping and starting PrEP. 

 

Stopping PrEP

For CIS men (people who were assigned male at birth and still identify as a man) and non-binary people assigned male at birth, you should keep taking PrEP (one pill a day) until you have two sex free days. 

For trans women who are not taking gender affirming hormones, you need to keep taking one PrEP pill per day until you have two sex-free days.

For everyone else including CIS women (people who were assigned female at birth and still identify as a woman), trans women taking gender affirming hormones, non binary people assigned female at birth and trans men, keep taking one PrEP pill per day until you have seven sex-free days.

 

Re-starting PrEP

CIS men and trans women not taking gender affirming hormones can take a double dose (i.e. two PrEP pills) between two to 24 hours before sex then follow up with one pill daily for as long as needed. For some people this will be a return to daily PrEP dosing, for others it might be 'on-demand' use, so remember to keep taking one PrEP pill until you have two sex-free days (as above).

For everyone else, take one PrEP pill per day for seven days before you have sex. Follow up with one PrEP pill per day for as long as needed and remember – you need to take one PrEP pill per day after the last sex, until you have had seven sex-free days when stopping (as above).

If you think you've been exposed to HIV in a period when you haven't been taking PrEP, we recommend that you contact a sexual health clinic and ask about PEP (post-exposure prophylaxis) and that you have an HIV test before restarting PrEP.

 

What if I want to keep taking PrEP?

We totally understand that PrEP offers a lot of people additional benefits beyond the prevention of HIV. We know taking PrEP can help reduce stress and anxiety around sex and in our lives in general. That is particularly pertinent at this current time.

If continuing to take PrEP offers you some comfort and reassurance in this current climate then carry on taking PrEP.  We want people to look after their mental health and wellbeing and much as we want them to take care of their physical and sexual health.

 

Will I still be able to get my PrEP pills?

Clinics are taking a different approach to how they manage things during the COVID-19 outbreak so it's best you contact your local clinic to find out what is happening. Please check their website first and only call or email if you need to.

If you access PrEP via the NHS or a trial you should still be able to get your PrEP pills, but some services may have to ‘pause' things during the lockdown or if they don't have enough staff. Some clinics will be issuing PrEP users with a six-month (six pack) supply so you don't need to come to the clinic as often.

There's no current issue with the supply chain of these drugs and we don't expect to see any shortage or interruption of drug supply for PrEP users or for people living with HIV who also rely on these drugs.

If you self-source PrEP (buy it online) you might experience some delays in delivery. It's always advisable to order a PrEP refill at least four weeks before you are due to run out to ensure you have plenty of medication and allow some time for delays.

 

Will I still be able to get my regular HIV and STI check ups?

There'll be changes to sexual health services and this includes changes to regular monitoring for PrEP users. It's likely that most clinics will move consultations online or by phone. In an effort to reduce unnecessary travel and social contact many sexual health services will move to home testing/home sampling. Check your local clinic's website for information or give them a call.

 

Will PrEP protect me from COVID-19?

There's no evidence that the drugs in PrEP provide any protection against COVID-19.

Currently the best protection remains staying at home, isolating from others and regular hand washing. Please follow government advice and updates.  

 

Sexual Distancing

The current  guidance from the government  is to practice physical distancing with people outside of your household  to reduce health risks to individuals and the spread of COVID-19. These new measures may change the type of sex we have. It may even require the need to stop having sex altogether.

People living with and in close contact with an infected person have a high risk of contracting the virus so if you live with your sexual partner(s), sex is unlikely to increase that risk. Some people have been identified as at higher risk from COVID-19 and need to avoid contact even with people who live with them.

If you can’t have sex with your partner right now, that doesn’t mean everything sexy is off limits! You could use this time to try out something a bit different - whether this is new sex toys, phone sex, sharing sexy snaps, or video calls.

If you’re exploring digital sex it’s important that you’re feeling able to advocate for yourself, consent freely and enthusiastically, and have a good understanding of how to play safe on the internet. You might want to consider hiding your face and/or any identifying features on you such as tattoos, and blurring out the room around you to protect your identity and privacy.

If you’re not having sex for the time being, this may be a time to reflect on how your sex life was before, and any changes you’d like to make to your sex life once lockdown is over. Are you getting everything you want, physically and emotionally, from your sex life? If there are elements of your sex life or relationships you want to talk through with an advisor, get in touch with us.

 

Hook Ups

The current guidance from the government is to stay away from people who you don’t live with to prevent the spread of COVID-19.

Hooking-up is discouraged at this time to protect you from picking up the virus passing it along. Not everyone shows symptoms so it’s extremely difficult to know if someone that we’re in contact with has COVID-19.

Using hook-up and dating apps during lockdown is a great way to stay connected whilst avoiding physical contact. Make sure to look after your personal information and wellbeing.

 

• Set boundaries with partner(s) before starting a video or audio call. Only show what you want to or feel comfortable showing.

• Worrying about pictures of us being shared without our consent can make us feel anxious. Remember that our faces and features like tattoos can show our unique identities.

• It’s easy to forget when we’re sharing our details. If someone wants to take the video or audio chat to WhatsApp, remember that they’ll then have your phone number. Or if they’re wanting to chat through Messenger, they’ll then have your Facebook profile details. If you want to share pictures, try sending them directly through the app instead of sharing your personal Instagram account. There’s a number of online platforms such as ZOOM which can anonymise yourself, especially if you choose a username instead of using your name.

• Don’t allow someone to pressure you into sharing your location. If someone asks where you live, you don’t have to tell them exactly where and you don’t have to send a location pin- especially right now, when we can’t physically hook-up during lockdown.

• If something doesn’t feel right when you’re chatting with someone, screenshot their profile information in case you want to report it and need evidence.

• Remember, the Internet is a great tool for us to socialise and meet new people but it can also be a place that can affect our self-esteem and make us feel vulnerable. Feeling rejected is a common part of the human experience, but that can be intensified, magnified, and much more frequent when it comes to digital dating. If someone doesn’t reply to your message or if they block you, try and take a break from the app and do something that makes you feel better.

 

Our friends over at Prepster have created a useful resource to help reduce the risk of COVID-19.

 

Right now, it’s not clear exactly what sex acts might pass on COVID-19. There’s some evidence that COVID-19 might be transmitted through feces (poop). Avoiding rimming, or any other sex that could lead to traces of poop getting into the mouth, will reduce your risk. Washing your hands thoroughly after taking off a condom, or after anal sex, will also help reduce your risk. - Prepster

Access to Sexual Health Services

Sexual health services are still running but they may be operating differently or open during different times. If you need sexual health support or need a sexual health test, you should contact your local service or check their website for opening times. Many sexual health services are offering telephone appointments. They will only see patients in person when this is absolutely necessary, and you should only go to a service if their staff tell you to. 

Services are prioritising urgent cases, such as:

• If you have had a reactive result on a HIV test

• If you need PEP because you may have been at risk of HIV

• If you have been sexually assaulted

• If you are under 16

• If you need emergency contraception because you may be at risk of being pregnant.

• If any of these things apply to you, you can call your local sexual health service for support and they may ask you to come in for an appointment.

 

Can I get my medication?

If you are taking prescribed medications, including HIV antiretroviral medication, then you should be able to pick these up at your pharmacy like you normally do.

If you are shielding and you cannot leave the house you should contact your pharmacy and ask for your medication to be sent to your home.