In the time of coronavirus disease (COVID-19), sex and drug use will continue, regardless of physical distancing orders and policies. People who previously met in community gathering venues such as bars and clubs may now meet in different sites, ones that are “hidden” or less accessible. This, in turn, may hinder efforts to reach them with prevention interventions, such as condoms, lubricants, and needle–syringe programmes. With the widespread loss of livelihood and fewer employment opportunities, transactional sex, sex work and sexual exploitation may increase. Anxiety about the pandemic and personal vulnerability also may lead to some disruption in community cohesion, and to changes in the social and sexual norms that influence behaviour.