Human resource shortages play a role in limited access to antiretroviral therapy in low- and middle-income countries. This occurs mostly where the burden of HIV disease is greatest and where access to trained doctors is limited. It is important to know if task shifting of care from doctors to non-doctors provides both high quality and safe care for all patients requiring antiretroviral treatment.
? There is moderate quality evidence from two trials that when doctors initiated therapy and nurses provided follow-up, there was probably no difference in death or number of patients lost to follow up at one year.
? There is low quality evidence from one cohort study showed that death as well as the number of patients lost to follow-up at one year may be lower in the group treated by nurses.
? Compared to doctor led care, there is moderate quality evidence from a single trial that when antiretroviral therapy was provided in the community, by trained field workers, there was probably no difference in death or losses to follow-up.