Ended up with the following which seems to do the trick
public void onRemoveButtonClick(View v) {
ListView listview = getListView();
ListAdapter listAdapter = listview.getAdapter();
int position = listview.getPositionForView(v);
MultiSelectListPreference mslp = (MultiSelectListPreference) listAdapter.getItem(position);
if (mslp != null) {
preferenceScreen.removePreference(mslp);
}
}