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In the U.S., quality of care and likelihood of survival for HIV-infected patients correlate with the HIV experience of their providers. But in areas with insufficient HIV specialist support — for example, in sub-Saharan Africa, where there are 1.7 HIV care providers per 10,000 HIV-infected patients — alternative models of care must be considered.
To that end, investigators conducted an unblinded, randomized trial among 812 patients initiating antiretroviral therapy (ART) in South Africa. Each patient had his or her initial regimen selected and prescribed by a physician; half were then monitored by physicians (doctor group), and half by nurses (nurse group).
During a median follow-up of 120 weeks, 46% of the patients experienced treatment fail…