We've all heard the expression "sex and love aren't the same thing." In this poem, though, they sort of are the same thing. The love in this poem is "dark and secret" (7) and is associated with a destructive or violent act of sexual intercourse, bordering on but not quite synonymous with rape. The poem refuses to give us an image or symbol of love that isn't complicated by something more sinister. The rose, an almost universal symbol of love, is sick, and the worm's "love" is as far from a Valentine's Day card as one could get.