The ReMIT project, a collaboration between Partners in Hope,
UCLA, and the Ministry of Health, tackles mobility-associated interruption in
HIV treatment—the leading cause of treatment interruption in Malawi. The study
pilots a co-created intervention package designed with clients, healthcare
workers, and stakeholders to support mobile people living with HIV. The project
combines enhanced counseling, a toll-free support hotline, and healthcare
worker training on multi-month dispensing to assess acceptability, feasibility,
and preliminary efficacy of interventions that help mobile clients maintain
continuous HIV care.
Additional elements
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Interruptions in HIV treatment (IIT) undermine
epidemic control in Southern & Eastern Africa by causing viremia, reduced
immune function, and increased transmission risk. With only 59-66% of adults
virally suppressed in the region, and mobility cited as the primary reason for
treatment interruption by 33-56% of affected clients, addressing
mobility-related barriers to continuous ART access is critical for achieving
sustained viral suppression and preventing onward HIV transmission.
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This intervention directly supports Malawi's HIV
epidemic control goals by targeting a key driver of treatment failure—temporary
mobility. By reducing IIT among mobile populations, the study addresses gaps in
the HIV care cascade and aligns with national efforts to improve viral
suppression rates and retain all people living with HIV in continuous care,
which are essential to achieving UNAIDS 95-95-95 targets.
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If proven effective, this low-cost intervention
package—comprising tailored counseling, a toll-free hotline, and enhanced
multi-month dispensing—offers a scalable, Ministry of Health-friendly solution
for nationwide implementation. The intervention can be integrated into existing
ART services with minimal infrastructure changes, providing evidence-based
strategies to improve retention among mobile clients and inform national
service delivery guidelines for differentiated care models.