Ikuo Sato knows he will be in trouble if he becomes infected with COVID-19.

“I’m over 60, I’ve got diabetes, I’m HIV-positive and I’m on artificial dialysis,” says the 61-year-old, who works for a nonprofit organization that supports HIV-positive people in Japan. “I began feeling very uncomfortable when the number of cases in Tokyo started rising, but I still had to go to the office every day because I couldn’t work from home.”

Sato has another reason for wanting to avoid the virus. For the past 16 years, he has lived with his same-sex partner, Yoshi. Sato’s two younger sisters know about the relationship and are understanding, but Yoshi — who spoke on condition that his surname would not be published because he has yet to publicly come out — is estranged from his own family.