Sex and COVID-19

Summary

The virus that causes COVID-19 is spread through contact between people and through contact with surfaces or objects contaminated with the virus. Sex that doesn’t involve contact (e.g., phone sex, video sex, masturbation) poses no risk for transmission. If someone has sex that involves in-person contact, limiting this contact to someone they live with or people in a small social circle can reduce the risk of virus transmission.

The information on this page is based on currently available research related to the transmission and prevention of COVID-19. This resource may be updated as evidence continues to emerge on these topics.

How is the virus transmitted?

SARS-CoV-2 is the virus that causes COVID-19 (i.e., “the virus”). It is transmitted through small droplets from the mouth, throat and nose of a person with the virus. Transmission occurs through contact with a person who has the virus. It can also be transmitted through contact with contaminated objects or surfaces.

Contact with people

The virus is transmitted through droplets from the mouth, throat and nose of a person when they breathe, talk, sing, laugh, cough, sneeze or kiss another person. During contact with someone who has the virus, these droplets containing the virus can enter the eyes, nose or mouth of another person. The closer and more prolonged the contact, the greater the chance of transmission.

Contact with aerosols

Very small droplets of the virus (called aerosols) may remain suspended in the air for longer periods of time. This means there is an increased risk of transmission when aerosols are present, particularly in indoor spaces and crowded outdoor space.

Contact with surfaces

The small droplets from the mouth, throat and nose of a person with the virus can also land on nearby objects and surfaces, thereby contaminating them with the virus. Transmission can happen if someone touches a contaminated surface or object and then touches their eyes, nose or mouth without washing their hands first.

How can transmission of the virus be prevented?

The following four methods should be combined to help prevent transmission:

  • Individuals should wear a new or clean face mask or face covering when they are in public spaces and may come into contact with others. They should also wear a new or clean face mask or face covering when they are in an indoor space with people not in their household or social circle. Social circles, sometimes called “bubbles”, are the limited groups of people that individuals have contact with, including the members of their household and those outside of their home. Some jurisdictions have made it mandatory to wear face masks or face coverings in public areas.
  • Individuals should reduce time in indoor spaces with people outside of their household or social circle, particularly if there is singing, shouting or heavy breathing (e.g., exercising).
  • Individuals should maintain a distance of at least two meters from people outside of their household or social circle to help prevent transmission of the virus.
  • To prevent transmission from contact with contaminated surfaces, individuals should wash their hands frequently with soap and water or use hand sanitizer. People should avoid touching their face with unwashed hands and regularly clean frequently touched surfaces with disinfectant.
  • Individuals should get vaccinated for COVID-19 when the vaccine becomes available. Vaccination prevents severe illness from COVID-19 and it may help to prevent transmission. People who have been vaccinated should still follow the prevention methods listed above.

If a person feels unwell, has symptoms of COVID-19 or has recently been exposed to someone with COVID-19, they should avoid contact with others and self-isolate. They should consider if they need to be tested for COVID-19.

The amount of virus in a community may change over time and therefore approaches to prevention may also change. When community transmission is very high, additional prevention measures may be recommended. People should consult their local public health authorities for the latest guidance on how to prevent transmission of the virus.

Managing risk

People will have different risk tolerance levels when it comes to COVID-19 and in-person socializing. Because of this, social activities might vary depending on what an individual is comfortable with.

There are a number of factors that could affect a person’s risk tolerance. These include their risk of contracting the virus or their risk of complications if they have COVID-19. Risk can be thought about at the individual and community level.

At the individual level, individuals might think of the number of COVID-19 cases in their community and how this affects their risk of contracting the virus. They might also consider if they have underlying health conditions like heart disease or diabetes or are older, as this can increase the risk of complications from COVID-19.

At the community level, individuals can think about the vulnerability of the people around them. For example, do individuals have contact with people who are at increased risk of COVID-19 complications (due to underlying conditions or older age)? More broadly, are there members of their larger community who are at increased risk?

How is the virus transmitted during sex?

The virus that causes COVID-19 can be transmitted during sex through contact with others, being in poorly ventilated  settings and touching contaminated objects or surfaces.

If someone has the virus, the risk of transmission is very high during sex that involves in-person contact (including vaginal, anal and oral sex). During sexual contact, people can be exposed to small droplets from the mouth, throat and nose of a person with the virus. In addition, saliva can transmit the virus through kissing. While traces of the virus have also been found in semen, urine and feces (and may also be in other bodily fluids), the risk of transmission through these fluids is not yet known. However, the virus is not considered to be a sexually transmitted infection.

The virus can also be transmitted through contact with objects or surfaces that have been contaminated, such as skin and sex toys. Objects and surfaces can be contaminated by respiratory droplets or saliva.

Should sex be avoided?

No, because consensual sex can contribute to people’s overall health and well-being. There are choices that people can make depending on their risk assessment (see section on managing risk) that either eliminate or reduce the risk of virus transmission. Sex-positive discussions around risk elimination and reduction are important to reduce potential stigma associated with sex during the COVID-19 pandemic.

How can someone eliminate or reduce the risk of transmitting the virus during sex?

Eliminating the risk of transmission during sex

Having sex that involves no in-person contact doesn’t pose any risk for transmission of the virus. Sex that involves physical distancing can include:

  • self-pleasuring (masturbation)
  • video sex
  • phone sex
  • chat rooms
  • sexting
  • writing erotic stories and sharing them
  • use of an Internet-connected sex toy where the partner controls the intensity of the toy

People should consider the potential privacy concerns associated with the use of online or telephone-based communications (e.g., screen grabs) when they engage in the activities described above.

Reducing the risk of transmission during sex

There are a few ways to reduce the risk of exposure to the virus during sex that involves in-person contact. These include limiting sexual contact to someone in the same household, to a regular partner outside of their household or to the small group of people in their social circle. In any scenario, sex should only be had with consenting partners.

Sex with someone in the same household is not any riskier than other forms of physical closeness that are common when people live together. Limiting sex to a household partner is the second-safest option, after sex that involves physical distancing.

If this is not an option, sex can be limited to one regular partner outside their household or with people in a small social circle to reduce the risk of virus transmission. Members of the social circle should mutually agree to practise physical distancing with people outside their social circle and follow other public health guidance (e.g., washing their hands frequently, wearing masks, self-isolating when necessary, avoiding contact with others if they feel unwell). Keeping the number of sex partners low will reduce the chance of transmitting the virus.

Before having sex, individuals should talk to their partner(s) about COVID-19, including whether they have symptoms, their potential exposures to the virus and any precautions that are being taken to limit potential exposure to the virus during sexual contact.

If any partner is feeling unwell or has had a suspected exposure to someone with COVID-19, it is important that in-person sex is avoided, as they may have transmissible virus. However, someone can also have transmissible virus even if they do not have any symptoms.

Since asymptomatic individuals (i.e., those that are not showing any symptoms) can transmit the virus, there are general prevention strategies that people can consider using before, during or after having in-person sex, although their effectiveness in the context of sex is not currently known. It is important to remember, however, that the biggest risk factor for transmission comes from contact, which cannot be avoided during in-person sex, so these strategies cannot be relied upon to prevent transmission.

  • Wash or shower with soap and water before and after sex.
  • Avoid kissing, saliva exchange, sexual positions with close face-to-face contact and face touching.
  • Wear a face mask that covers the nose and mouth while having sex or use other vapour barriers such as glory holes.
  • Thoroughly clean frequently touched objects (e.g., sex toys) and surfaces.

If sex is a part of a person’s job, they may want to consider moving their work online (e.g., web-based services) or using the telephone (e.g., text messages, phone sex). If this isn’t possible, they may consider ways to avoid face-to-face contact and use other strategies listed above.

What about prevention of HIV and other sexually transmitted infections during the COVID-19 pandemic?

Prevention of sexually transmitted infections (STIs) continues to be important when having sex during the COVID-19 pandemic. Using pre-exposure prophylaxis (PrEP) or condoms or having an undetectable viral load will continue to help prevent HIV. Condoms will continue to prevent other STIs. Regular testing for STIs may also be important.

If someone is taking PrEP to prevent HIV and is no longer having in-person sex, they may choose to continue to take PrEP or to stop taking PrEP. If a person chooses to stop taking PrEP, chooses to take on-demand PrEP or wishes to restart PrEP, they should talk to their healthcare provider about how to do so safely. It is important that people are regularly tested for HIV and STIs if they continue to have sex while taking PrEP. PrEP is not an effective treatment against COVID-19.

The information on this page is based on available research related to the transmission and prevention of COVID-19. This resource will be updated as new evidence emerges. Last updated February 18, 2021.

Resources

Safer Sex Guide (CATIE)

PrEP Resources and Tools (CATIE)

Safer Sex and COVID-19 (NYC Department of Health)

COVID-19 and Sex (British Columbia Centre for Disease Control)

Sexual Health in the SARS-CoV-2 Era (Annals of Internal Medicine article)