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Where did the sex go in our relationship?

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I have been with my boyfriend for a year and a half. The sex was only consistent the first month of our relationship. He is a great guy and I love him. Our relationship has had it's ups and downs in other aspects. Now it seems like only if I say something about us not having sex or messing around we don't do anything. Then when he does make a move after we have fought about it I feel like he doesn't really want it he is just doing it to get me off his back. He tells me that I can initiate it too but he always says he is tired and doesn't feel good. After he says stuff like that I would feel bad for initiating it. I feel like I get rejected before I have even made a move. We went on a vacation for six nights and didn't have sex or mess around once. I have encouraged him to see a doctor and he hasn't. I am to the point where I told him I am scared that this will lead to cheating or us breaking up and I don't want that. I don't know what to do. I love him.