Long-term dynamic-choice program to reduce HIV treatment interruptions in Malawi
Ongoing Dynamic Choice to Address HIV Treatment Interruption in Malawi (CHOICE)
This project will test whether giving people who stopped HIV treatment long-term, flexible choices about services helps them stay on ART in Malawi.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 800 (estimated) |
| Ages | 15 Years and up |
| Sex | All |
| Sponsor | University of California, Los Angeles Academic / other |
| Locations | 1 site (Lilongwe) |
| Trial ID | NCT07220278 on ClinicalTrials.gov |
What this trial studies
This interventional project enrolls ART clients in Malawi who are more than 28 days late for their last appointment and are at least 15 years old and not pregnant. Participants will be offered a long-term, dynamic choice package that repackages existing clinic services and lets clients change which services they receive over time based on their needs. Study staff will provide ongoing follow-up and support during re-initiation and beyond to track retention, viral suppression, and repeat treatment interruption. The approach builds on prior short-term counseling and home-based ART interventions but extends choice and duration to try to prevent repeat interruptions.
Who should consider this trial
Good fit: Ideal candidates are people living with HIV in Malawi who started ART more than 3 months ago, are at least 15 years old, non-pregnant, and currently more than 28 days late for their last ART appointment.
Not a fit: Pregnant women, new ART initiates (≤3 months), or patients who are already consistently retained in care are unlikely to benefit from this intervention as implemented.
Why it matters
Potential benefit: If successful, this could help people who stop ART reinitiate and stay on treatment long-term, reducing viral rebound and new HIV transmissions.
How similar studies have performed: Prior trials in Malawi (ENGAGE and IDEAL) showed short-term person-centered counseling and home-based ART greatly improved re-initiation (about 96% re-initiated vs 67% with standard care) but did not sustain high engagement at six months, so long-term dynamic approaches remain untested.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * 15 years of age or older * living with HIV; * initiated ART for the first time\>3-months ago (i.e., not a new initiate); * non-pregnant; * experienced Treatment Interuptions during their most recent ARTappointment (\>28 days late). Exclusion Criteria: * pregnant women because the ART/antenatal care (ANC) programs are integrated and require additional considerations and linkages with antenatal services.
Where this trial is running
Lilongwe
- Partners in Hope — Lilongwe, Malawi (Recruiting)
Study contacts
- Principal investigator: Kathryn L Dovel, PhD — University of California, Los Angeles
- Study coordinator: Kathryn L Dovel, PhD
- Email: kdovel@mednet.ucla.edu
- Phone: 310-267-5844
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.