Project Summary/Abstract Project: Despite advances in HIV treatment programs, marginalized groups, including mobile men, continue to struggle to remain in care. Mobility is associated with worse antiretroviral treatment (ART) retention and viral suppression throughout sub-Saharan Africa. However, mobility is an essential livelihood strategy for many men living with HIV (MLHIV). In the ReMIT study (“Reducing Mobility-associated Interruption in Treatment among Men in Malawi”), we will refine and pilot an intervention to improve ART outcomes among mobile MLHIV in Malawi. In Aim 1, we will use qualitative data from MLHIV, healthcare workers, and a community advisory board to refine an intervention including multi-month dispensing, a hotline for mobile MLHIV, and mobility- specific counseling. In Aim 2, we will conduct a pilot cluster randomized control trial at 6 health facilities with 240 mobile male ART clients (n=120 per arm) to test the intervention refined in Aim 1. Outcomes include a preliminary estimate of the intervention’s effectiveness on ART retention (6-month retention - primary outcome) and acceptability and feasibility of the intervention. Results of the pilot will inform a future, definitive trial. Candidate background: I am trained as a physician and board certified in Internal Medicine & Pediatrics and am transitioning to a career in global health research. In addition to my medical degree, I have a master’s in public administration in international development (MPA/ID) and have worked in Malawi, Mozambique, and Kenya. Career goals: My long-term career goal is to become an independent investigator with expertise in health system interventions to improve access to care among vulnerable populations in sub-Saharan Africa. Career development plan: The proposed K01 award will provide protected time, practical experience, and training resources to develop my skills in (1) health systems interventions, (2) mobile populations, (3) trial design and analysis, and (4) ethics in global health research and decolonizing global health. Environment: The study will be conducted as part of an ongoing collaboration between the University of California Los Angeles (UCLA) and Partners in Hope (PIH), a medical and research organization, based in Malawi. PIH is the prime awardee on a US President’s Emergency Plan for AIDS Relief (PEPFAR) grant to support 123 health facilities throughout Malawi, providing staff mentorship and capacity building, treatment and care, and monitoring and evaluation of HIV and TB services. PIH and UCLA have a 15-year relationship using a Multiple PI model that has resulted in completion of 20 clinical trials and implementation science studies.