How does population viral load vary with the evolution of a large HIV epidemic in sub-Saharan Africa?

Using mathematical modelling, we describe the temporal evolution of population HIV-1 viral load in Tanzania throughout the epidemic. Population log(10) viral load was found to be stable and not sensitive to epidemic dynamics. However, even modest increases in antiretroviral therapy (ART) coverage were reflected as appreciable reductions in population log(10) viral load. As ART coverage expands in sub-Saharan Africa, population log(10) viral load will increasingly become a powerful proxy for monitoring ART implementation and HIV incidence trends.