Nurses May Take Load Off Doctors in Certain Areas of AIDs Care

by Alex A. Kecskes

HIV/AIDS takes the lives of nearly 1,000 people daily in South Africa. The area has the world's largest national program that treats patients with antiretroviral drugs. Yet only 17.4 medical practitioners are available for every 100,000 people. A partial solution may be at hand.

Nurses monitoring treatment for AIDS patients have been found to be just as effective as doctors. Taking the load of physicians could ease the burden of health workers. A "task-shifting" study in HIV care in South Africa uncovered little difference in patient outcomes for patients undergoing AIDS drug therapy under the supervision and care of a physician or nurse.

The United Nations estimates that 33 million people worldwide are infected with the human immunodeficiency virus (HIV) that causes AIDS. And half of the 9.5 million people who need AIDS drugs have no access to them. To make matters worse, there is a global shortage of 4.3 million healthcare workers. To help alleviate the problem, the World Health Organization recently proposed task-shifting, allowing certain aspects of physician duties to be performed by other qualified healthcare workers.

To test this strategy, a team from the Comprehensive International Program for Research in AIDS in South Africa compared the outcomes of nurse versus doctor management for patients in two clinics between 2005 and 2007. The study revealed that 48 percent of patients encountered treatment failures in the nurse group, while 44 percent encountered similar failures in the doctor group. After two years, deaths and outcomes due to drug toxicity side effects or dropout varied only slightly.

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