More African health staff are being lost to HIV/AIDS than are being enticed to work abroad
The death rate in Zambia's Lusaka and Kasama districts is double the number who applied to work in the UK - the so-called brain-drain, the Lancet said.
Researchers from Boston University in the US found that the average age of death from Aids was just 38.
Experts said the major problem was that people with HIV struggled to get access to antiretroviral drugs.
Report author Frank Feeley, from the university's international health and development centre, said: "Policymakers might be tempted to focus on stopping emigration as the best strategy to strengthen the African civil service.
"Undoubtedly, the pay of health professionals is low and the burden of disease in the population makes the job difficult. But the dead do not complain about conditions of service.
"It is time to put more effort into keeping HIV-positive professionals alive and serving in national institutions."
His research showed that there was an annual death rate of 3.5% for nurses and 2.8% for clinical officers - medical assistants - in the Lusaka and Kasama districts.
If this was applied to all the nurses in the country it would mean the number of deaths in a year - 298 - would be nearly double the number applying for registration in the UK - 169.
He said the low average age of death suggested that "Aids rather than diseases of advancing age is responsible for most of the deaths".
Zambia: HIV in health sector 'worse than brain drain'
AIDS, not overseas recruitment, stripping Zambian hospitals