Myself and my girlfriend are both positive for the last few years. We both are on Atripla. My questions are, is there any precaustion or side effect having unprotected sex. My other question is if we want to have a baby what is the chance of transimiting the virus to the baby. My CD4 is above 400 and my VL is undetectable for the last 8 years. She is also undetectable.

It is certainly possible to have an HIV negative child when both partners are HIV+. Your partner is on Atripla, and efavirenz, a component of Atripla is best avoided in pregnancy. Once you are clear you wish to conceive together, talk to your doctor about her modifying treatment to a regimen suitable for conceiving. Once the efavirenz is out of her body (say 1 month) you can start trying. Transmission between partners of different strains of HIV is a further issue. Some authorities, most notably the Swiss, have suggested that if the viral load is undetectable <50, then tansmission risk is eliminated. Your doctor will be able to further guide you on the safest way to conceive Best Wishes Dr Moyle