Editor’s Note: Several sex workers interviewed for this story spoke on condition of anonymity due to fear of legal repercussion and social stigma.

CNN  — 

Don’t kiss. Tell clients to wash their hands before they touch you. Wear a mask. Avoid face-to-face positions. And even: Put on a nurse costume and pull out a thermometer – if his temperature is normal, make it part of the game. If he has a fever, end the session.

These are real tips that advocacy groups and health authorities around the world are sharing in the age of coronavirus, hoping to protect workers in the vast and often overlooked sex trade. Armchair advice would be to stop all so-called “full service” sex work altogether, but as UNAIDS warned in April, many sex workers are being forced to weigh what’s safe against what will put food on the table.

An old economics axiom claims that investments in “vice” and “sin” like gambling, alcohol, drugs and sex trades weather economic downturns well, because people turn to them whether they’re sad or happy. Some vices are even thought to be countercyclical, rising when economy takes a nosedive.

Whether that’s true for America’s estimated millions of full-service sex workers is hard to definitively disprove – sex for pay is illegal in most of the country, so large-scale data is scant. But sex workers, aid organizations and the lawyers who work with them say that the pandemic has been devastating.

“Prostitution is supposed to be inelastic and recession-proof,” says Caty Simon, a self-described “cheap escort,” writer and activist in a small town in Western Massachusetts. “But there’s never been a recession where in-person contact with people was dangerous before.”

Less work, more risk

Lockdown orders might seem redundant for an already forbidden business, but several sex workers told CNN that they had chosen to stop working due to fear of the coronavirus.

Demand from clients has chilled too, and as unemployment in the US reaches Great Depression-levels, many Americans have less to spend on services of all kinds. Nevertheless, every sex worker interviewed said they were still receiving requests to meet in person – if not as frequently as before.

“It’s my ethical duty to not work on anyone’s body because of the virus,” said one San Francisco-based sex worker and massage therapist, who said they’d gone from seeing more than 30 clients per week to zero.

“I’ve lived in my apartment for 16 years, like, I’ve never paid rent late or ever. This is the first time I’m ever having to struggle with money while I’ve been in San Francisco,” they said. In March, they reached out to advocacy group Black Sex Workers’ Collective for financial help, receiving an emergency $400 grant to fund basic living expenses.

Yet this worker says they continue to be contacted by prospective clients – including from doctors and nurses at the hospital down the street. “They’re like begging you to work with them,” they said. “They’re throwing up all this money at you, like I’ll give you $300 to work for me for an hour. It’s a dilemma for me, because I need the money.”

Broadly, there two kinds of markets in the sex industry, says Scott Cunningham, a Baylor University economist who studies the sex trade in America. “There’s the lower-end, lower-wage work where clients seem to be primarily interested in the sexual experience,” he says. “Then there’s like a higher wage rate that is sort of companionship bundled with sexual services and a lot of times those clients will become regulars, they’ll be steady work.”

While high-end workers may have been able to build a financial cushion before the crisis, many lower-end workers were already living day-to-day – and now their customers are more likely to be laid off, he says. “As you move down the wage distribution for sex workers, there’s really, really a lot of suffering that’s kind of going undetected right now,” he says.

A sex worker who has continued to work out of her home in Arizona told CNN that several regulars who lost their own jobs as landscapers and drivers had stopped visiting. “I can tell what day everybody got an economic stimulus check, because that’s when I see clients again. Then for three days, I might see no one,” she says.

At the beginning of the pandemic’s spread through the US, she took clients’ temperatures with a thermometer when they arrived, and tried to make it sexy by playing “nurse.” While she no longer does that consistently, she says she still wears a mask and gloves with new clients.

Some are frustrated after months of lockdown and have offered premiums to be seen in the age of Covid-19, she says. Others are asking for a discount. “There are clients who might want to lowball you because they know times are tough,” she says. “Others might lowball you because, hey, they’re not working either.”

Weighing risk vs. need

When it comes to contagious diseases, strangers sharing fluids is pretty much an epidemiologist’s nightmare – and clients asking sex workers to shoulder the risk is nothing new.

Akynos, a 42-year-old sex worker based in New York and Berlin, runs the Black Sex Workers Collective. While she is not currently working, Akynos says she has observed a regular stream of inquiries for full-service sex work, with specific requests for interactions more likely to spread a respiratory disease – like kissing. “They want it despite the heightened risk,” she says. “They don’t seem to care. They’re like, “Yeah I know what’s happening but I still want to kiss.”

“It’s typical client behavior,” she adds. “They always want to go have sex workers do something that they wouldn’t normally do with anyone else.”

What worries experts more than the virus itself is a rising potential for violence and abuse: With fewer clients and no end to the economic downturn in sight, sex workers who are still active now might be less selective about clients and less firm about their own boundaries.

“People are really desperate out there right now. Unfortunately, what happens in a recession like this is people have to take more calculated risks than they usually do. They are going against their gut and doing things that they otherwise wouldn’t. They’re seeing clients that they know are dangerous,” says Simon.

“It’s just like after FOSTA-SESTA, but worse,” she adds, referring to a 2018 law that made digital platforms legally liable for hosting sexual service advertisements. The bipartisan legislation sought to fight human trafficking, and was heralded by some human rights advocates. But advocates of decriminalizing the sex trade say the resulting closures of advertising websites erased a safe means of meeting, negotiating with, and vetting clients for non-trafficked sex workers and created financial pressure to take additional risks.