Question: Is there any information about transmission risk and sexual behavior?

Answer: Thanks for asking! We don’t have direct evidence about the risk of virus transmission and sexual activity. Here’s what we do know and what doctors and public health experts suggest.

In terms of what we know. First, because SARS-CoV-2 is spread through respiratory droplets and may spread from contaminated surfaces, any in-person activity carries risk, including and especially sex. Second, it’s still unclear whether the virus can be transmitted through semen, vaginal fluids, fecal matter, or urine. Two small studies of infected people found no evidence of the virus in semen or vaginal secretions. Another small study of 38 infected men detected the virus in 6 patients (16%). SARS-CoV-2 has also been detected in urine and anal swabs as well as fecal matter. Now, virus detection does not equate to transmission risk, but until it is proven otherwise, it would be prudent to consider exposure to semen, urine, and feces as potential avenues for transmission.

When it comes to advice from doctors and public health experts, there is widespread agreement that abstinence-only approach is not sustainable for most folks. A recently published comment in the Annals of Internal Medicine, “Sexual Health in the SARS-CoV-2 Era”. offers a lot of advice to clinicians counseling their patients. I’ve copied their table below, which synthesizes current recommendations for safer sex (Table 1). The DC Health Department also offers a bulleted list of suggestions (Table 2) and the NYC Department of Health offers a fact sheet.

Table 1. Sexual Approach and Recommendations (ordered by increasing risk)

Table 2. Sex During the COVID-19 Public Health Emergency (DC DoH)