South Africa: Nurse-Centered HIV Care as Effective as Doctor's Care

A new study carried out in South Africa suggests that nurse-centered care of patients with HIV can be as effective as doctor-provided care, and it offers some particular benefits.

Researchers from the University of East Anglia (UEA) in the United Kingdom and the University of Cape Town in South Africa coordinated with other universities on the project -- a two-year randomized controlled trial involving 15,000 patients in Free State, South Africa.

The study marked the first time scientists have investigated doctor-to-nurse task-shifting on such a large scale. The results indicated a number of benefits for patients in nurse-centered care. These included significantly improved TB detection, increased white blood-cell counts, weight gain and better treatment compliance. In addition: When nurses, rather than doctors, administered antiretrovirals, survival rates were not negatively affected.

"Our findings show that with very little extra training and support, nurses can deliver HIV care that is just as safe and effective as that provided by doctors," said Professor Max Bachmann, joint lead author, of UEA's Norwich Medical School.

[PNU editor's note: The study, "Task Shifting of Antiretroviral Treatment from Doctors to Primary-Care Nurses in South Africa (STRETCH): A Pragmatic, Parallel, Cluster-Randomized Trial," was published online in the Lancet (2012;doi:10.1016/S01040-6736(12)60730-2).]

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