The media is full of stories about famous people, not only having affairs, but living double lives. A double life is different from a brief affair because it is a twin existence. Arnold had a love child with the Latina housekeeper who worked for the family for many years, and nobody seemed to notice that he looked like Arnold. Herman Cain, it seems, not only grabbed, groped and harassed, but also had a long-term relationship while living with his wife. One of the most acclaimed movies of this season is The Descendants, in which George Clooney discovers that his comatose wife was in love with another man, who himself had a family.

There are definitely gay equivalents. Barney Frank’s then-boyfriend was running a hustler operation out of their basement years ago. Many, if not most of us, have something going on that we are not sharing with the people closest to us. We hide these secrets out of guilt, shame or just because whatever we are doing, we don’t want to stop. Secrets are sexy. Secrets make us feel independent and free. Secrets spice up our home lives. The danger of getting caught is itself a turn-on.

Double lives obviously come with multiple dangers. There are dangers to reputation, to relationships, to children and to our mental and physical health. A gay doctor I know was having an affair with a married man with two children. The married man also had a long-term relationship with another man. The doctor was in a long-term relationship. The married man contracted herpes, got into a fist fight with the other man and broke up with the doctor. Supposedly, the wife knows nothing. The stress on everyone is intense.

One of my oldest friends—a woman with three children—was having a long-term affair with a business associate. She would call me for advice. She wanted to confess to her husband what was going on. I made her swear to me that if she felt that impulse at any time of the day or night that she would call me so I could talk her out of it—sort of like an AA sponsor. I told her that no one would be helped by a guilty confession. Fast forward: confession led to an ugly divorce, financial ruin, the children going to multiple therapists and a lot of unhappiness for my friend.

Double lives often express a part of us that is otherwise repressed. We have so many responsibilities in our ‘normal life’ and often so little opportunity to express who we really feel we are. But these secrets screw with our heads, because they involve lying, covering up and betrayal. So we are in conflict within ourselves, and this creates other dangers, such as STDs, drug and alcohol abuse and screwing up at work.

There is no rulebook. You have a right to the things that satisfy you; however, there is likely to be a price to be paid at some point. Are you willing to pay it? You think you can manage it all, but the best-laid plans often get screwed up. Friends can help to a point. Think about what the true risks are, and whether or not you are willing to take them. Living a double life with the stresses that it represents does not mean you have to throw all caution to the wind and end up with an infection, an addiction or tremendous losses in your professional life. As with any risk, calibrate how far you are willing to go ahead of time and have the discipline to end it when you reach that point. And, if you have too much to hide, stay out of the spotlight.

Finally, have you ever wondered why all these smart guys in politics, business and entertainment when they were straying couldn’t at least have used a condom? It’s hard enough coping with complications—don’t add HIV to the mix.

president@aidshealth.org; aidshealth.org