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.
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.
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.
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.
