The challenge: streamlining HIV treatment and care while improving outcomes

Area of Science:

• Public Health
• Global Health
• Health Services Research

Background:

• Antiretroviral Therapy (ART) coverage for people with HIV varies significantly worldwide, impacting mortality and new infections.
• Healthcare worker shortages and resource limitations pose challenges to expanding HIV treatment and care globally.
• Task shifting, the delegation of tasks from doctors to less-trained healthcare workers, is a recognized strategy to improve healthcare delivery.

Purpose of the Study:

• To explore the implementation and optimization of task shifting in HIV services.
• To identify strategies for sustainable and effective task shifting to improve ART coverage.
• To address key questions regarding the organization, preconditions, and country-specific factors for successful task shifting.

Main Methods:

• Literature review on task shifting in HIV service delivery.
• Analysis of existing evidence supporting task shifting for HIV testing, counseling, and ART treatment.
• Examination of World Health Organization (WHO) recommendations on strengthening healthcare workforces.

Main Results:

• Task shifting is a literature-supported strategy for delivering HIV services, including ART.
• It can be an effective approach to address healthcare worker shortages and resource constraints.
• Successful implementation requires careful planning regarding sustainability, safety, efficiency, and effectiveness.

Conclusions:

• Task shifting is a viable strategy to expand ART coverage and improve HIV care, especially in resource-limited settings.
• Sustainable implementation necessitates addressing organizational factors, preconditions, and country-specific contexts.
• Task shifting should complement efforts to increase skilled health workers and be supported by quality assurance mechanisms.