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.

Crowdsourced lists of warnings about abusive or non-paying clients -- known as "bad date lists" -- offer chilling examples of the danger.

A 2019 list compiled by St. James Infirmary, a health center for sex workers in San Francisco, ranges from a stripper who accuses a local deputy sheriff of pressuring her to do more than dance, to a woman who describes being burned with cigarettes, adding "Do not report this please I'm scared."

One self-described sugar baby who offers relationships for pay in California told CNN that she felt that the clients who continued to come forward despite social distancing guidelines were greater risk-takers -- a potential red flag.

"The in-person client pool is much more dangerous right now and much more shady because they are already willing to violate societal norms," the 34-year-old said.

Even for those who stop working, she notes, the economic crunch could expose women to more domestic violence -- an epidemic of its own in America under lockdown.

"Women go into relationships to avoid homelessness. And when people know that we have histories of sex work, or histories of drug use, then we're seen as desperate and very easy to take advantage of, we're expected to provide services in exchange," she says.

She herself doesn't have a home of her own, and is currently quarantining in a client's house -- a situation of dependence that she doesn't always feel comfortable with. "Having all your eggs in one basket is dangerous for a sex worker. Sometimes I just wake up feeling panicked and trapped," she said."Then again, who doesn't feel that way right now?"

The remote work challenge

As in other industries across the US, some sex workers have been able to turn to remote work, salvaging their income by offering provocative live stream shows, pictures and chats.

Many are on subscription site Only Fans, where adult content creators make up a large portion of the offerings. The company tells CNN that since the start of the pandemic in early March, new sign-ups have increased 75%.

The platform is now adding about 200,000 new users every 24 hours. (It's not all sex -- the platform says "influencers and celebrities" of all kinds have taken to the site to offer subscribers photos and videos since the shutdown.)

Creating a digital brand requires the same communications and tech savvy that makes great influencers -- which is to say, it isn't easy. And the basic ingredients to start building a following aren't cheap. A computer, high-speed internet for live streaming, webcam and mic are the minimum, sex workers told CNN -- not to mention robust cellphone data plans to stay in constant contact with clients and privacy to get it all done.

All of that can raise an insurmountable barrier to entry for the poorest sex workers.Maya, a New York-based full-service sex worker who has successfully transitioned to online work, says she used to make $8,000 to $10,000 a month. Since the coronavirus swept through the city, she makes half of that, all from digital performances.

"Okay, so I'm a little more privileged than most sex workers," the 26-year-old says.Born in Trujillo, Honduras, she says she crossed the Mexican desert into the United States when she was six years old in the arms of a smuggler. She vividly remembers her first encounter with US law enforcement: the border guard who intercepted them.

"He asked me, 'Oh, that guy over there says he's your dad. Is that true?" "And I was like, 'No,'" she recalls. "Then he smirked at me and walked away and I realized he was going to basically ruin this guy's life.

That haunted me for a while."A recipient of the Obama-era program known as DACA, which allows undocumented children raised in the US to stay and work legally, Morena says the 2016 presidential campaign played a part in her career path.

"I started to embrace sex work more as I realized that Trump's campaign promise was to eliminate DACA. If I didn't have working rights, then I needed to have an underground job, so that I could still survive.

"To those who have left sex work and now face a cratering economy and fierce competition for few jobs, the underground may also beckon. Rachel Lloyd, a former sex worker and founder of GEMS, a New York City-based organization that helps exploited and trafficked young people exit the sex trade, worries that they'll be drawn back into it.

"I've worked really hard to build a program that had options," she says. "We were able to say, look, you can leave this life, and here are the options. They may not be amazing options initially, but we know we can help you build on them, and we can support you through college. Then, there were jobs available. Now it's like none of that stuff means anything."

Asking for help

For Americans with tax records and bank accounts, ID cards and Social Security numbers, there are options.

The US government has expanded federal funds to cushion the blow from the pandemic, and added a generous number of new acronyms to the national lexicon: UI for employees, SBA or PPP loans for businesses, PUA for independent contractors.

It's a lot to navigate for anyone. And for sex workers who already view the government as an antagonist, it's not always clear if they can or should ask for help.

Just to set the tone: In contrast to Japan, where the government was forced to include legal sex workers in its April emergency financial aid package, a morality clause in the US CARES acts means that even legal sex-adjacent US businesses, like strip clubs, cannot qualify for the billions of dollars set aside in federal loans, along with casinos and lobbyists.

An individual sex worker could theoretically receive a stimulus check or even collect unemployment insurance, but many don't have the income tax history or even bank accounts necessary to claim those benefits.

Several described overwhelming shame and anxiety around filing taxes on their earnings, and worried that the US government would use unemployment applications to identify and prosecute them as sex workers.

"I always knew it was a good idea to file taxes and I always knew it was going to bite me in the ass if I didn't -- but didn't, but it was just so daunting.

The very idea of it, you know. And I'd always just operated so totally outside the legit market in many ways," said one sex worker. "I don't know how US bureaucracies intertwine.

I don't know what I'm risking if I try to get any benefit," she said.Asking for help can also seem particularly unthinkable for non-citizens. According to multiple activists and lawyers, sex workers who are immigrants are keenly aware of the Trump administration's "public charge" rule, which makes it more difficult for immigrants to obtain green cards if they are caught using public benefits like food stamps and housing vouchers.

"We tried to help apply for unemployment for several people and they're like, please don't do that. Just don't hit send," said Elena Shih, an assistant professor of American Studies at Brown University and one of the co-founders of Red Canary Song, an outreach group for massage parlor workers in New York City.

Some workers are even afraid to accept food from food pantries, she says "because they're worried it's going to be counted against them in some way, shape or form."

What happens next

Since the coronavirus swept through, the US is hardly recognizable anymore as a land of opportunity -- according to a recent Census Bureau survey, 10% of adults say they aren't getting enough of the food they need.

And as unemployment rates reach record levels in all but seven states, the "above ground" economy is now wrestling with an urgent question that sex workers know all too well: How to work in safety?

It's a dilemma that groups like the Sex Workers Outreach Project (SWOP), the Black Sex Worker's Collective and Red Canary Song -- all part of a global flourishing of sex worker self-organizing -- have been working on for a long time, focusing on policy changes that would empower sex workers seek police and governmental help, before the immediate crisis of the coronavirus emerged.

"When you have to rely on yourself, you come up with all sorts of things," says Monica Jones, an activist whose organization, the Outlaw Project, now offers financial aid to sex workers who have stopped working, and masks and gloves to those who haven't. SWOP Behind Bars, a SWOP sub-group that supports incarcerated sex workers, is preparing to ship 3,000 face masks around the country for distribution to streetwalkers, says co-founder Alex Andrews.

But in this industry, every client is an X-factor in the delicate balance of risk vs. need.Kyli and Jinx, two members of the Salt Lake City SWOP chapter, estimate that they've delivered about 300 N95 masks to street-based workers in the city -- whom they say are often homeless -- in addition to cash assistance, food and other supplies. Jinx herself wears a mask when she performs at a local strip club, which recently re-opened, and says she hopes that the sex workers receiving donations wear them -- but she's not sure.As with hand-washing and other safety practices, unless you can afford to walk away from work, it's really up to the client. "It's not like you get to choose," she says.

"Your client directs things because they're the client."Simon, who in ordinary times makes a couple hundred dollars per week and receives food stamps, has sought to set her own rules. The 38-year-old is has been staying home and following Massachusetts' social distancing guidelines for months. But it is hard, she says.

"The regulars who have texted me, there's all this paternalistic, benevolent concern about staying safe, but then once I offer them sexting, or if I offer them phone sex, they say, 'Oh you know well, it's nothing compared to your touch and blah blah blah and suddenly they're trying to schedule an appointment," Simon says.

"I don't judge anyone out there who is working right now," she says, but a note of frustration with her clients is audible."I've told them that I'm trying not to work and they're pressuring me to do so," she says."My bank account is at zero from day to day. I'm still trying not to go back to sex work, but I don't know how long I'm going to be able to."