Editor’s note: This article was originally posted on March 27, 2020, and is being updated as new information becomes available.

As increasing numbers of cities and states are issuing stay-at-home orders and otherwise encouraging social distancing, the ever-progressive New York City Department of Health and Mental Hygiene has issued pointers on navigating sex during this new pandemic. The latest update was June 8, 2020.

General social distancing guidelines stipulate that people should remain six feet apart from one another to prevent transmission of the new coronavirus, which can cause the potentially fatal respiratory illness known as COVID-19. Scientists know that the virus can spread through direct contact with an infected individual’s saliva or mucus.

Thus far, the coronavirus has been found in the semen and feces of infected individuals. Researchers have found that other coronaviruses do not transmit well through sexual acts.

The New York City guidelines state that masturbation is the safest sexual activity with regard to coronavirus transmission. The next safest is sex with a partner you already live with. The city advises against sex with anyone outside your household; if you do engage in sex with people who don’t live with you, the guidance is to minimize your number of partners as much as possible.

For those who meet partners online or through apps or who engage in sex work, the city advises putting in-person meetups on hold for now and exploring video dates, sexting or chat rooms.

The health department also recommends wearing a face mask as a way to add an extra layer of protection. “Make it a little kinky,” states the guidance. “Be creative with sexual positions and physical barriers, like walls, that allow sexual contact while preventing close face-to-face contact.”

To minimize the risk of transmitting coronavirus during sex, should you have sex, the health department notes that kissing can easily pass the virus and advises against kissing anyone not in your small circle of close contacts. Rimming could be a source of transmission as well. Condoms and dental dams can reduce contact with saliva or feces.

It’s very important to wash up before and after sex. Remember, when it comes to washing your hands, a minimum of 20 seconds is the golden rule.

If you or your partner isn’t feeling well, avoid sex, especially kissing. And talk about COVID-19 before you hook up.

The city health department notes that people who have been diagnosed with COVID-19 and have recovered from symptoms for 10 days and who have not had a fever for at least three days are not likely to be infectious. However, just because you have tested positive for COVID-19 antibodies—meaning you have had the disease—it does not mean you are immune from re-infection, warns the guidance, adding: “We don’t know how strong that protection is or how long it lasts.”

People at higher risk of developing complications related to coronavirus infection are also advised to avoid sex. This includes people with lung or heart disease, diabetes, cancer or a weakened immune system, including those with a detectable HIV viral load and a low CD4 count. People older than 60 years old are also at higher risk.

For related articles, see “Sex—and PrEP—During the Pandemic” and “How Coronavirus Shutdowns Could Cause an Uptick in HIV and STI Cases.”

To read the New York City safe sex and COVID-19 recommendations, which were updated June 8, 2020, click here.