Simplified ART delivery models are needed for the next phase of scale up

1001055 Lawrence Long and colleagues report that "down-referring" stable HIV patients from a doctor-managed, hospital-based ART clinic to a nurse-managed primary health facility provides good health outcomes and cost-effective treatment for patients. Future research on ART delivery should build on these findings in order to help develop the elements that promote early HIV diagnosis, ensuring rapid enrollment into care, and support continuous adherence to an effective treatment regimen such that HIV care is largely a self-managed chronic disease, with the role of hospitals limited to providing care for a sick minority.