Your Sexual Health during the COVID-19 Outbreak
As COVID-19 cases increase across Ireland, we are learning lots about washing our hands, dealing with symptoms, self-isolation and social distancing. We’re also coming to terms with the closure of our pubs, clubs and saunas – places where many members of the gbMSM community meet to socialise, have fun and feel safe. What we’re hearing less about is how to look after our sexual health and wellbeing during this emergency. So, our MPOWER Programme team have compiled some advice and tips to help during the COVID-19 crisis.
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First, let’s take a moment to recognise that HIV Ireland, and the MPOWER Programme at HIV Ireland, works from a place of sex-positivity and we encourage everyone to enjoy sex without shame or fear. For many gay and bi men, it’s a matter of principle not to associate sex with fear and to enjoy as much sex as we want, whenever we want, without being shamed for it. We want you to know that we agree. However, due to this public health emergency, normality has been suspended and like so many other things in society right now, we must reconsider our actions in favour of the common good.
While COVID-19 is not sexually transmitted, sex itself is a contact sport. Touching, kissing and manoeuvring in your favourite sexual positions are ways to pass on the coronavirus. In addition, we are all being asked to maintain social distancing – keeping at least 2 meters (6ft) away from each other, making any kind of sex difficult.
It’s not an easy transition to make, but instead of sex you could use this time as an opportunity to explore other things that can satisfy your needs such as phone sex, cam-sex, reading erotica, watching porn or just plain old masturbation. (Remember, if you’re sharing pictures or videos of yourself online – do so carefully and be conscious of where they could end up.)
If you continue to hook-up, consider reducing the number of guys you have sex with. Remember that while you might think that COVID-19 is not much of a risk to you, it may be a much bigger risk to the health of the people you have sex with and anyone you and those sexual partners come into contact with. In fact, there is an increasing number of young, fit and otherwise healthy people acquiring the virus and becoming very ill. Consider taking a break from hooking-up until things return to normal.
It is very important that you avoid sex and especially kissing if you or your partner is not feeling well and is experiencing symptoms of COVID-19 e.g. fever, cough or shortness of breath. If you develop the symptoms of COVID-19 you should self-isolate and phone your doctor for further advice.
The HSE has published guidance on Sex and COVID-19 which can be accessed here.
STI Testing and Treatment
Many of the clinic staff that operate sexual health services in Ireland are responding to the COVID-19 crisis which means most clinics have been scaled back or closed completely. We are maintaining a list of what’s open and what’s not and are updating it as things change.
And things will change. The ‘surge’ of COVID-19 diagnoses, which is on its way, will mean that the services which have been able to continue offering testing and treatment are likely to close completely too. That adds extra risk if you continue to have sex during the COVID-19 emergency.
If you do continue to have sex, stock up and use condoms and lube. No matter your opinion on condoms, they’re your best bet in preventing STIs in a time where treatment options are limited.
For people living with HIV, your treatment will continue. If you have an upcoming appointment you will be contacted and informed when to pick up your medication. This is true too for people who are in treatment for hepatitis. We have developed a special section on our website to give the most up-to-date information on COVID-19 for people living with HIV.
HIV Prevention – PrEP & PEP
As with STI testing and treatment, PrEP is accessed through our sexual health services so it will become increasingly more difficult to access in the coming weeks. Check the clinic closure list – if you are due to attend a PrEP appointment and the clinic that you go to is closed – do not attend! Services with restrictions will get in touch with you before the appointment to let you know if you should attend or not. You can attend an appointment in a service marked normal unless you have been told otherwise.
We know that GMHS users that have an upcoming PrEP appointment are being contacted individually and told not to attend but they are also offering to send you a PrEP prescription in the post if you need one. Other PrEP services are considering this but may be limited in doing so as more staff get redeployed into the COVID-19 response.
If you are a cis man and you decide that you’re going to maintain social distancing and not have sex until things go back to normal, you can safely stop daily dosing after you have taken PrEP for at least two sex-free days. For everyone else, (including vaginal/frontal sex) continue taking it for seven sex-free days and then stop.
If an unexpected sex opportunity happens, then you could use ‘Event-Based’ PrEP – that doesn’t work for everyone and you must follow a specific regimen. You can learn more about that here. It’s also a good way to save your PrEP supply during the COVID-19 outbreak if you’re running low and can’t get more.
You may have read or heard people talking about PrEP or PEP being effective in preventing COVID-19. This is not true. There is currently no evidence to suggest that PrEP or PEP is effective against COVID-19. These are only effective in preventing HIV.
If you decide to have sex and you didn’t use condoms or PrEP, you might want to consider accessing PEP. However, as with all of the points above, this might be difficult considering services are closing. PEP continues to be available at some Accident and Emergency Departments at a cost of €100 for EU citizens and considerably more for non-EU citizens. Remember, you need to access it within 72 hours of the sex you had. Also keep in mind that our Emergency Departments are going to experience really high demand in the coming weeks.
Drugs & Alcohol
We know that our community experiences high levels of drug and alcohol use during normal times. With a possible sudden increase in free time, uncertainty, anxiety and stress, some may want to rely more heavily on drugs and alcohol. This, for some, can tip the scales from managed and recreational use into problematic use and addiction. As we face into a considerable reduction in access to healthcare, it is a good time to consider a planned break or reduction in your drug and alcohol use. If you want to take a break, check out this care plan which can help you plan the break and manage cravings and triggers.
Of course, everyone has different relationships to drugs and alcohol and choosing to take a break is not always possible. If you find that this relates to your use, try to reduce the possible negative effects as much as possible. There’s lots of harm reduction advice available at this link.
So, what now?
As no doubt you have heard many times already – we are living through an unprecedented situation. We’re learning and adapting to something that is having a huge impact on society as a whole. We all have a role in doing what we can in reducing the impact of COVID-19 and when it comes to sex and sexual health the best thing we can do, and remember we are only suggesting it in the context of this unique circumstance, is to consider a break from hooking-up. That said, we acknowledge that not all of us will be able or want to do so. In that situation consider all of the harm reduction tips above.
Regardless of the decisions you or others in our community choose to make, we need to be kind, understanding and empathetic with one another. We’re all in this together.
If you have any questions or need more information or support, you can contact the MPOWER Outreach team by phone, whatsapp, or email.