SF health dept. publishes new 'risk reduction' guidance for sex during COVID

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Dr. Stephanie Cohen, shown here in a remodeled room at City Clinic last year, said the health department issued new guidance for sex during the pandemic. Photo: Rick Gerharter
Dr. Stephanie Cohen, shown here in a remodeled room at City Clinic last year, said the health department issued new guidance for sex during the pandemic. Photo: Rick Gerharter  

The San Francisco Department of Public Health has published updated guidance on how to have sex while mitigating the risk of contracting the COVID-19 virus.

The guidance is effective September 5. It is being updated because "SFDPH is learning more about COVID-19 and how it may be spread," according to the six-page document titled "Tip Sheet for Safer Sex During the COVID-19 Pandemic."

The document recommends "avoiding close contact — including sex — with anyone outside your household or a small, stable social group."

With sometimes racy subheads — such as "Suck it - or not?" and "Quicker can be better" — the document helps individuals to negotiate risk.

"Breathing, panting, shouts and groans, mouths, lips, eyes, spit, semen, anal play, and shared toys are all ways that COVID-19 can spread," the document states, going on to give some facts for the reader to consider, such as that individuals who are asymptomatic may be carrying the COVID-19 virus; that the virus has not been found in vaginal fluid; that heavy breathing increases risk of transmission; that masturbation at a distance of six feet is safer than penetrative intercourse; that the amount of time in close contact increases the chance of catching the virus; that outdoor space is safer than indoor space; that virtual sex obviously carries zero risk; that more sexual partners heightens risk; and that "cleaning sex toys, sheets, rings, masks, collars and other items is important."

"The virus can also spread through direct contact with saliva or mucus," the document states. "Which means through licking, tasting, rubbing lips or eyes or face together, or on mouthed or spit-covered toys, or even through letting someone suck on your fingers and then putting them in your own mouth, just to name a few G-rated examples."

The document notes that its purpose is risk reduction.

"It's important to remember that risk is a spectrum for most people," the document states, before reiterating its main points. "It is very important to remember that your risk for COVID-19 is also determined by actions you take in all areas of your life. Your risk is also affected by the risks that your partner(s) may take in the non-sexual parts of their lives, too. Talking to your partners and potential partners about how they manage COVID-19 risk in other parts of their lives is important."

Dr. Stephanie Cohen, the medical director of DPH's City Clinic in the South of Market neighborhood, told the B.A.R. September 4 that the guidance was crafted by sexual health experts at the department.

"The way to minimize coronavirus exposure to the greatest extent is to avoid close contact sex," Cohen said. "This pandemic is ongoing and sex is an important part of people's lives and so expecting complete abstinence as a long-term option for folks is not realistic. We continue to advise minimizing the number of sexual partners."

The document states that people should not be stigmatized for their COVID status, and encourages people to comply with DPH contact tracers.

"People are not positive or negative. Tests are," the document states. "We know from other pandemics that it is important not to stigmatize people who are infected, or who test positive. When it comes to COVID-19, we are all in this together."

As the Bay Area Reporter previously reported, DPH issued guidelines in March that did not specifically relate to sexual health. A link to the previous DPH sexual health guidance published in April, returns a '404 Not Found' webpage.

(Jenna Lane, a DPH communications liaison, said that guidance is typically removed from City Clinic's website when updated versions are published, unlike public health orders which remain online in perpetuity.)

The guidance was updated due to new information on which sexual fluids the COVID-19 virus can be found in, Cohen said.

In March, the New York City Department of Public Health issued issue sex-specific guidance that advised people only have sexual contact with those who live in their households if they do so at all. New York's guidelines made headlines because they encouraged individuals seeking a sexual liaison to "be creative with sexual positions and physical barriers, like walls that allow sexual contact while preventing close face to face contact."

Cohen said that information on glory holes may be published in supplemental guidance.

"Barriers, walls and holes are ways to mitigate risk," Cohen said. "It's hard to include all that in a single guidance. Supplemental guidance will be available on our website as well. If people are wondering if barriers are a way to mitigate risk, the answer is yes."

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