My wife and I have been having unprotected sex for just over ten years now - at the time my viral load was very high. we have had two healthy children 9 & 5. all this time my wife has tested negative whilst i remain positive.why should we worry about protection particularly since my viral load is undetected and at some stage she was exposed a very high viral load? should we see this as an indication that my wife is resistance to the HIV virus? E

Hi, E:

Thanks for writing in. While there is a lot of debate over this issue at the moment, I would have to encourage you and your wife to use condoms for penetrative sex.

It is very fortunate for you, your wife, and your children that you did not pass on the virus during unprotected sex. While having unprotected penetrative sex is a risk, that does not mean that an infection will absolutely occur. That being said, while we know that a reduced viral load reduces the risk of transmission, it does not eliminate the risk. "Blips" or random spikes in your viral load can bring your undetectable viral load up and therefore increase the risk of transmission.

Again, my suggestion is that you consider the use of condoms. To date, the proper use of condoms remains one of our best defenses against the spread of HIV.

I hope this helps.

In health, Richard