Help during COVID-19

Sexual assault care is classified as essential and you should receive care as a matter of priority. The place you normally access sexual and reproductive health care is a good place to start. You can also call the police, your local sexual assault referral centre or sexual health service for advice. If you’re unsure where to go use the sexual health service finder on NHS.UK. Your healthcare provider won’t tell anyone that you’ve accessed this care, unless you want them to. Other domestic abuse support services are available.

• If you have had unprotected sex you may be at risk of pregnancy.
• If you do not want to be pregnant you may need emergency contraception so contact your local pharmacy, or phone your GP or your local contraception clinic.
• Consultations usually take place by telephone or by video call.
• Your emergency contraceptive options will include a copper intrauterine device (the most effective form of emergency contraception) and services are trying to maintain fitting these devices where possible.
• Oral emergency hormonal contraception will only help protect you against one episode of unprotected sex so it’s important to use other contraception such as condoms for the rest of your cycle. until you can start a more effective method.
• If you haven’t had a normal period within 3 weeks of taking emergency hormonal contraception, do a pregnancy test.
• To check whether you are at risk and for more information about emergency contraception visit Sexwise.  

What’s different from usual during COVID-19?

• You are unlikely to have a face to face consultation but should be able to access free emergency hormonal contraception (the “morning after” pill) from:
  • Your GP or a local sexual and reproductive health service via a telephone or online consultation. They will be able to issue an electronic prescription for collection in the pharmacy or post it by mail.
  • Your local pharmacy if they already have arrangements to provide free emergency hormonal contraception – contact them to check.
  • Where possible, you might still be able to get an emergency intrauterine device (IUD). Check with your GP and/or local sexual and reproductive healthcare clinic
• You can also buy both types of emergency pill from:
  • Most pharmacies. You'll need to be 16 years old or over to buy oral emergency contraception
  • Some fee-paying clinics

Think you might be pregnant and don’t know what to do?

There are many reasons that your period may be irregular or late, particularly in times of stress. However, if you think you may be pregnant, you can purchase a pregnancy test from your pharmacy to check.

If you want to continue with the pregnancy, then you should contact your GP in the usual way.

For information about your options if your test is positive visit Sexwise.

Abortion

Abortion services remain open. If you are seeking an abortion, then you will need to have an initial appointment with your local abortion provider, which will probably be on the phone or via video.  Visit NHS.UK to find your local service.

What’s different from usual?

If you are less than 10 weeks pregnant you may be able to have a medical abortion at home without the need to first attend a hospital or clinic. After you have made contact with an abortion provider, you will have a consultation with a clinician on the phone or via a video link. Following the consultation, if you are eligible, and you wish to proceed, the medication will be delivered to your home with clear instructions on how to manage the process. A 24-hour helpline will be available to provide support.

If you are more than 10 weeks pregnant, you should contact your abortion provider by telephone who will discuss options with you.

Living with HIV during COVID-19

If you have no other underlying conditions and an undetectable viral load, there is no current evidence that people living with HIV are at increased risk from COVID-19.

However, those people with a weakened immune system and/or other underlying conditions may be at increased risk from COVID-19, and this could include some people living with HIV. The British Association for HIV has provided detailed recommendations.

If you have any concerns over whether you fall into the clinically vulnerable group or not, you should speak to your HIV physician or GP.

Do you think you have been exposed to HIV in the last 72 hours?

You may have been exposed to HIV if you've:

• had unprotected sex (without using a condom)
• had sex with someone with HIV with a detectable viral load and the condom broke
• used or been injured with an HIV-infected needle

If any of the above are true for you, by taking PEP (Post Exposure Prophylaxis), ideally within 24 hours of the risk, and no later than 72 hours, you may be able to prevent HIV infection. PEP is not always appropriate, and a doctor can advise if PEP is suitable for you based on the level of risk.

The best place to get PEP is a sexual health or HIV clinic. If you need PEP over the weekend or outside of office hours, when clinics will often be closed, the best place to go is an Accident and Emergency (A&E) service.

THT has more information on PEP.

Do you need PrEP?

Public health advice on social distancing means that you shouldn’t have sex with anyone outside your household. Therefore, many people will choose to stop taking PrEP, unless there is a specific need – for example, if you live with a partner with a detectable HIV viral load.

If you are getting your PrEP via the NHS or the Impact Trial you should still be able to get your PrEP pills, but some services may have had to ‘pause' some activities during the COVID-19 outbreak. Some clinics will be issuing PrEP users with a six-month (six pack) supply so you don't need to come to the clinic as often. If you need another pack or have questions do not attend your clinic in person, check your clinic’s website and contact them by email or phone.

For more information:

• About getting PrEP through the Impact Trial
• About safely stopping and starting PrEP and seeking help in deciding if you need to continue PrEP

If you are worried about an STI you can still seek advice and treatment by contacting a local sexual and reproductive health service get more information here. Do not attend in person unless advised to do so by your service. The service will tell you what you should do, particularly if you need testing or treatment.

To reduce risk of STI and HIV transmission it’s important to use protection, such as a condom, during sex. Not everyone who has an STI has signs or symptoms, but you can still have the infection and pass it on to someone else.

The following symptoms may mean you have an STI that needs treatment:

• pain when peeing
• unusual discharge from the vagina, penis or anus
• lumps or skin growths around the genitals or anus
• a rash
• unusual vaginal bleeding
• itchy genitals or anus
• blisters and sores around the genitals or anus

Make sure you tell the service about any symptoms when you call them. The service will tell you what you should do, particularly if you need testing or treatment.

For more information about STIs visit:

• Sexwise
• NHS.UK

Contraception

If you want to start contraception, or are having problems with your contraceptive method, contact your GP or local contraception service by phone. You should still be able to get supplies of contraception when you run out or start taking contraception, but some of the usual arrangements are likely to be different.

What’s different from usual?

Because of potential delays, it’s best to try and sort this out as early as possible. You may not be able to get a routine face to face appointment as easily as usual. It may not be possible to start or continue your chosen contraceptive method at this time, but you will be provided with an effective temporary method in the meantime. The Faculty of Sexual and Reproductive Healthcare has published advice for women seeking contraception, abortion and other sexual and reproductive healthcare during COVID-19. You can also read a Q&A on extended use of long acting reversible contraception on our blog post

Repeat combined pill, patch or vaginal ring

• If you have had your blood pressure and height/ weight measured in the last year, you should be able to get repeat supplies via an online or telephone consultation with your usual pharmacy, GP or sexual health service.
• If you have not had a blood pressure or a height/ weight check or you have new health issues the doctor or nurse may recommend a progestogen only pill or condoms until you can be properly assessed.
• Let your doctor or nurse know if there are particular reasons why you are taking the combined pill, for example very heavy periods or endometriosis.

Progestogen only pill

• You will be able to get repeat supplies of the progestogen only pill.
• You may be offered a progestogen only pill in place of your usual combined pill for the time being.
• You will be able to do this via an online or telephone consultation with your GP or sexual health service. Because of potential delays, it’s best to try and sort this out as early as possible.

Injection is due

• It is important that you do not have a gap of more than 14 weeks between injections.
• It is unlikely that you will be offered a face-to-face appointment for a repeat injection, so you may be offered the progestogen-only pill in the short term to protect against pregnancy.
• If you already use Sayana Press® and inject this yourself at home, it should be possible for you to be issued an electronic prescription for a further 12-month supply that can be collected at your pharmacy.
• You will be able to do this via an online or telephone consultation with your GP or sexual health service.
• Because of potential delays, it’s best to try and sort this out as early as possible.

Implant is about to run out

• Contraceptive implants are usually changed after 3 years, but don’t cause health problems if used for longer.  You can continue to use your implant for another year (4 years in total).

• If you have already had your implant for 3 years, your risk of becoming pregnant in the 4th year is very low but if you are worried about this, use condoms or ask for the progestogen only pill as additional protection.

Copper IUD or hormonal IUS is about to run out

• Most copper IUDs such as T-Safe, are licensed for 10 years but don’t cause health problems if left in place for longer.  They are likely to be effective at preventing pregnancy for up to 12 years, but additional contraception, such as condoms, should be used.
• If you have a 5-year copper IUD which has expired, it may not continue to be effective. There’s no need to remove the IUD quickly, but it is important to use other contraception, such as condoms, for additional protection.
• Hormonal IUSs such as Mirena and Levosert, which are licensed for 5 years don’t cause health problems if used for longer and are likely to be effective at preventing pregnancy for 6 years.