Q: I’ve met a guy who I’m in love with, and he’s HIV positive. I’m trying really hard to overlook that, but I can’t stop thinking about it. When we have sex I really can’t let myself go. I worry about his health too. Any advice?

A:. There may be two issues you’re dealing with. One is your fear of becoming infected with HIV. The other is the knowledge that you are in love with a man infected with a virus long seen as fatal. Let’s start with the first. The good news is there’s next to no chance that you will become infected with HIV if you, and your partner, take some simple steps. The most important of those steps is using a condom if you have anal sex. A condom provides a latex barrier that the HIV virus cannot cross (reports that condom use isn’t 100 percent safe include situations where a condom breaks or slips off). The second important step if for your partner to take his HIV medication. That medicine is designed to reduce the amount of virus in his body (make him “undetectable.”) That doesn’t mean that there is no virus in his body. But it means the chance that his sperm could infect you is radically reduced.

Your partner may be one of those men who is unable to get his HIV to an “undetectable” level. That’s more common among older gay men who were infected well before the introduction of “triple-therapy,” which is the use of three different drugs (often in one pill.) Triple-therapy reduces the chance that the sneaky HIV virus, always mutating to find a way around a drug meant to kill it, will become resistant to treatment. Here again, the condom is the answer. There’s next to no risk of contracting HIV from oral sex so long as the guy performing oral sex doesn’t have an open sore or cut in his mouth. To be even more on the safe sex, agree with your partner that neither of you with ejaculate in one another’s mouth.

What may also be an issue (it is for some HIV negative men who aren’t even conscious of it) is the realization that HIV is incurable and long has been considered fatal. In the 1980s and 1990s there were many HIV negative men who wouldn’t let themselves fall in love with someone who was HIV positive because of the pain they knew they would feel when he died before his time. There’s good news here as well. HIV, while still incurable, isn’t necessarily fatal — if your partner follows his doctor’s orders and takes his medicine, he likely will live to a ripe old age.

We humans have a hard time accepting the inevitability of death. The reality is that we all will die one day. You may well die before he does. It may be from the complications of old age, or it may be from a traffic accident this afternoon. The only thing in your power, and his, is making sure you make the most of every day that you are alive.

Finally, if you haven’t already, talk with the man you love about your worries. Nothing causes fear to vaporize more than discussing it. If the two of you find that conversation difficult, consider visiting a counselor who can guide you. There is a list of such services on our LA Health Resources page.

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