In the world of HIV, physician assistants and nurse practitioners often carry the heaviest burden when it comes to providing medical care. Particularly at public clinics and hospitals, they can manage the care of more patients than physicians do -- and since the virus disproportionately impacts people with a low income, public clinics and hospitals are exactly where most people with HIV go for their care.

Physician assistants (PAs) are licensed to practice medicine, just like doctors are -- although technically, PAs must work under the supervision of a doctor. Nurse practitioners (NPs) are registered nurses with advanced academic and clinical experience.

Both PAs and NPs are qualified to give HIV-positive people a full range of medical care, be it performing physical exams, ordering lab tests, diagnosing illnesses, prescribing medications or coordinating important research studies. Their actual responsibilities differ depending on their training, experience and their work setting, but most of them work independently, and are often the people who are primarily responsible for the health of HIV-positive patients.

Barbara Lewis, for instance, is a physician assistant at the Whitman-Walker Clinic in Washington, D.C., one of the largest HIV clinics in the country. She manages a caseload of 400 patients who are seen exclusively by her. A supervising physician reviews her charts on a regular basis, but otherwise she works autonomously. Similarly, Jeanne Dumestre is a nurse practitioner who is the primary care provider to about 400 women in New Orleans, most of whom are African American, and all of whom are poor.

Their jobs may not provide the same paycheck that doctors get, but in every way that matters, physician assistants and nurse practitioners are the care providers for many of America’s HIV-positive people.