A hoist provides high mechanical advantage and accurate positioning, driven by hand or with a powered rotary implement such as a drill. The hoist includes flexible tension members, such as chains, cables or straps, for applying force and tension to a load. A load nut is connected to the tension members for high mechanical advantage from rotational drive input to a load screw threadedly connected to the load nut. Alongside the tension members are guides forming channel-like spaces within which the flexible tension members travel. The guides, or portions of the guides, pass through the load nut in most forms of the invention.