{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T06:45:12Z","timestamp":1788245112984,"version":"build-2803163510"},"reference-count":43,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2021,2,10]],"date-time":"2021-02-10T00:00:00Z","timestamp":1612915200000},"content-version":"vor","delay-in-days":40,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["grant numbers R01-GM125440, R01-AI108490, R21-HD075662, R01-HD068395"],"award-info":[{"award-number":["grant numbers R01-GM125440, R01-AI108490, R21-HD075662, R01-HD068395"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development research infrastructure","award":["grant number R24 HD042828"],"award-info":[{"award-number":["grant number R24 HD042828"]}]},{"name":"Hyak supercomputer system"},{"name":"STF at the University of Washington"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,1,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>HIV set point viral load (SPVL), the viral load established shortly after initial infection, is a proxy for HIV virulence: higher SPVLs lead to higher risk of transmission and faster disease progression. Three models of test-and-treat scenarios, mainly in heterosexual populations, found that increasing treatment coverage selected for more virulent viruses. We modeled virulence evolution in a population of men who have sex with men (MSM) with increasing test-and-treat coverage. We extended a stochastic, dynamic network model (EvoNetHIV). We varied relationship patterns (MSM vs. heterosexual), HIV transmission models (increasing vs. plateauing probability of transmission at very high viral loads), and treatment roll-out (with explicit testing or fixed intervals between infection and treatment). In scenarios most similar to previous models (longer relational durations and the plateauing transmission function), we replicated trends previously found: increasing treatment coverage led to increased virulence (0.12 log10 increase in mean population SPVL between 20% and 100% treatment coverage). In scenarios reflecting MSM behavioral data using the increasing transmission function, increasing treatment coverage selected for viruses with lower virulence (0.16 log10 decrease in mean population SPVL between 20% and 100% treatment coverage). These findings emphasize the impact of sexual network conditions and transmission function details on predicted epidemiological and evolutionary outcomes. Varying these features creates very different evolutionary environments, which in turn lead to opposite effects in mean population SPVL evolution. Our results suggest that, under some realistic conditions, effective test-and-treat strategies may not face the previously reported tradeoff in which increasing coverage leads to evolution of greater virulence. This suggests instead that a virtuous cycle of increasing treatment coverage and diminishing virulence is possible.<\/jats:p>","DOI":"10.1093\/ve\/veab011","type":"journal-article","created":{"date-parts":[[2021,2,8]],"date-time":"2021-02-08T20:14:08Z","timestamp":1612815248000},"source":"Crossref","is-referenced-by-count":5,"title":["Test-and-treat coverage and HIV virulence evolution among men who have sex with men"],"prefix":"10.1093","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3251-8501","authenticated-orcid":false,"given":"Sarah E","family":"Stansfield","sequence":"first","affiliation":[{"name":"Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, WA 98195, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua T","family":"Herbeck","sequence":"additional","affiliation":[{"name":"Department of Global Health, University of Washington, Seattle, WA 98195, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffrey S","family":"Gottlieb","sequence":"additional","affiliation":[{"name":"Departments of Medicine & Global Health, University of Washington, Seattle, WA 98195, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil F","family":"Abernethy","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, WA 98195, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James T","family":"Murphy","sequence":"additional","affiliation":[{"name":"Department of Microbiology, University of Washington, Seattle, WA 98195, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John E","family":"Mittler","sequence":"additional","affiliation":[{"name":"Department of Microbiology, University of Washington, Seattle, WA 98195, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4577-7406","authenticated-orcid":false,"given":"Steven M","family":"Goodreau","sequence":"additional","affiliation":[{"name":"Department of Anthropology, University of Washington, Seattle, WA 98195, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,2,10]]},"reference":[{"key":"2021021908075806300_veab011-B1","doi-asserted-by":"crossref","first-page":"e1001123","DOI":"10.1371\/journal.ppat.1001123","article-title":"Phylogenetic Approach Reveals That Virus Genotype Largely Determines HIV Set-Point Viral Load","volume":"6","author":"Alizon","year":"2010","journal-title":"PLOS Pathogens"},{"key":"2021021908075806300_veab011-B2","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1017\/S0031182000055360","article-title":"Coevolution of Hosts and Parasites","volume":"85","author":"Anderson","year":"1982","journal-title":"Parasitology"},{"key":"2021021908075806300_veab011-B3","doi-asserted-by":"crossref","first-page":"1131","DOI":"10.1016\/S0140-6736(00)02061-4","article-title":"Time from HIV-1 Seroconversion to AIDS and Death before Widespread Use of Highly-Active Antiretroviral Therapy: A Collaborative Re-analysis. 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