Helen A Wei
Biographic Data
| ID | 1734887 |
|---|---|
| NAME | Helen A Wei |
| GIVEN NAMES | Helen A |
| FAMILY NAME | Wei |
| SIGNATURE | WEI H A |
| AFFILIATIONS | London School of Hygiene & Tropical Medicine |
| ORCID | 0000-0003-3547-7936 |
| VERIFIED | Yes |
| TOTAL WORKS | 71 |
| TOTAL CITATIONS | 33 |
| AUTHOR COUNT | 71 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2005 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 2 |
Longitudinal assessment of changes in hair cortisol levels and associations with violence, poor mental health and harmful substance use among female sex workers in Nairobi, Kenya
Female sex workers (FSWs) in sub-Saharan Africa commonly experience violence, mental health problems, and harmful substance use. Stressful life events can harm the functioning of the hypothalamic-pituitary-adrenal (HPA) axis, serving as a pathway to increased poor health, including HIV susceptibility through cortisol levels. In this paper, we examine changes in hair cortisol concentration (HCC) levels and associations with experiences of violence…
Forced vaginal sex and genital immune correlates of HIV risk
BACKGROUND: The likelihood of HIV acquisition is increased following forced vaginal sex. This relates in part to epidemiological and behavioural factors; however, the biological effects of forced vaginal sex, including impacts on immune parameters linked to HIV susceptibility, are poorly understood. Here, we examine biological mediators of HIV susceptibility among female sex workers (FSWs) in Nairobi, Kenya, who recently experienced forced vagina…
Cost-effectiveness of Zvandiri, a community-based support intervention to reduce virological failure in adolescents living with HIV in Zimbabwe
Improving antiretroviral therapy (ART) adherence among adolescents living with HIV (ALHIV) improves outcomes, but with resource implications. We conducted a cost-effectiveness analysis extrapolating the costs and benefits of a community-based peer-support intervention (Zvandiri) among ALHIV in Zimbabwe. We used a de-novo multistate Markov decision-analytic model that simulated Zvandiri lifetime costs and benefits on viral suppression, death rates…
Non-inclusive language in human subjects questionnaires
Adverse health outcomes disproportionately affect marginalized populations. Utilizing culturally and socially conscious research materials that are inclusive of various identities and experiences is necessary to help remediate these disparities. Our review finds compelling evidence of bias in many widely used data collection instruments. Recommendations for conducting more inclusive science are discussed
Acceptability and feasibility of CHANGE, a non-specialist worker delivered intervention to address alcohol use disorders and psychological distress among conflict-affected populations in Uganda
If proven to be effective, the acceptability and feasibility of CHANGE makes it a potentially scalable intervention in low resource settings with shortage of specialist healthcare professionals. The intervention may have the potential to be integrated with other programmes of care that can address additional adversities that the population may face in the setting
Factors Associated with Usage of Oral-PrEP among Female Sex Workers in Nairobi, Kenya, Assessed by Self-Report and a Point-of-Care Urine Tenofovir Immunoassay
Pre-exposure prophylaxis (PrEP) is highly effective at reducing HIV acquisition. We aimed to estimate usage of oral-PrEP, and factors associated with adherence among female sex workers (FSWs) in Nairobi, Kenya, using a novel point-of-care urine tenofovir lateral flow assay (LFA). The Maisha Fiti study randomly selected FSWs from Sex Worker Outreach Program clinics in Nairobi. Data were collected from 1003 FSWs from June-October 2019, including su…
Effect of a brief psychological intervention for common mental disorders on HIV viral suppression
Background For people living with co-morbid HIV and common mental disorders (CMD), it is not known whether a brief psychological intervention for CMD can improve HIV viral suppression. Methods We conducted a prospective cohort study in eight primary care clinics in Harare, Zimbabwe, enrolling adults with co-morbid HIV and CMD. Six clinics provided the Friendship Bench (FB), a brief psychological intervention for CMD based on problem-solving thera…
The epidemiology of HIV infection among female sex workers in Nairobi, Kenya
High HIV prevalence among female sex workers (FSWs) is heavily influenced by structural determinants (e.g. criminalisation of sex work; violence) and significant life events (e.g. orphanhood, teenage pregnancy). This study aims to understand the epidemiology of HIV among FSWs in Nairobi, Kenya using a structural determinants and life-course perspective. Baseline cross-sectional survey data were collected June–December 2019 for the Maisha Fiti stu…
Are violence, harmful alcohol/substance use and poor mental health associated with increased genital inflammation
Violence, alcohol use, substance use and poor mental health have been linked with increased HIV acquisition risk, and genital inflammation enhances HIV susceptibility. We examined whether past 6 month experience of these exposures was associated with increased genital inflammation, thereby providing a biological link between these exposures and HIV acquisition risk. The Maisha Fiti study was a longitudinal mixed-methods study of female sex worker…
Methodological issues of retrospective surveys for measuring mortality of highly clustered diseases
BACKGROUND: There is a lack of empirical data on design effects (DEFF) for mortality rate for highly clustered data such as with Ebola virus disease (EVD), along with a lack of documentation of methodological limitations and operational utility of mortality estimated from cluster-sampled studies when the DEFF is high. OBJECTIVES: The objectives of this paper are to report EVD mortality rate and DEFF estimates, and discuss the methodological limit…
Epidemiology of alcohol use and alcohol use disorders among people living with HIV on antiretroviral therapy in Northwest Tanzania
Alcohol use disorders (AUD) among people living with HIV (PLHIV) are associated with poor health outcomes. This cross-sectional study examined current alcohol use and AUD among 300 PLHIV on ART at four HIV care centres in Northwest Tanzania. Participants' data were collected using questionnaires. Alcohol use was assessed using Alcohol Use Disorders Identification Test (AUDIT). Logistic regression was used to examine associations between each outc…
Violence outcomes in later adolescence with the Good School Toolkit-Primary
Clinicaltrials.gov, NCT01678846, registration date 24 August 2012. Protocol for this paper: https://www.researchprotocols.org/2020/12/e20940
Bibliometric analysis of authorship patterns in publications from a research group at the London School of Hygiene & Tropical Medicine, 2016–2020
BACKGROUND: Authors from low and middle-income country (LMIC) institutions are under-represented in publications of research based in LMICs. This case study of publications from authors within the Medical Research Council International Statistics and Epidemiology Group (MRC-ISEG), a global health research group affiliated to the London School of Hygiene & Tropical Medicine in the UK, aims to describe patterns in authorship and factors associated …
Interventions to increase help-seeking for mental health care in low- and middle-income countries
Mental health problems are a significant and growing cause of morbidity worldwide. Despite the availability of evidence-based interventions, most people experiencing mental health problems remain untreated. This treatment gap is particularly large in low- and middle-income countries (LMIC) and is due to both supply-side and demand-side barriers. The aim of this systematic review is to identify and synthesise the evidence on interventions to impro…
Understanding the social and physical menstrual health environment of secondary schools in Uganda
Adolescent girls face social, psychological, and physical problems managing menstruation in schools in low-resource settings. This study aimed to evaluate the social and physical menstrual health environment of secondary schools in Wakiso and Kalungu districts, Uganda, in preparation for a subsequent menstrual health intervention trial to improve education, health and wellbeing. We conducted a qualitative rapid assessment in 75 secondary schools …
Developing knowledge-based psychotherapeutic competencies in non-specialist providers
We evaluated a digital learning programme for non-specialists to develop knowledge-based competencies in a problem-solving intervention for adolescents to examine the overall impact of training on knowledge-based competencies among learners; and to compare the effects of two training conditions (self-guided digital training with or without coaching) in a nested parallel, two-arm, individually randomised controlled trial. Eligible participants wer…
Community-based rehabilitation intervention for people with schizophrenia in Ethiopia (Rise) cluster-randomised controlled trial
We evaluated the effectiveness of community-based rehabilitation (CBR) in reducing depressive symptoms, alcohol use disorder, food insecurity and underweight in people with schizophrenia. This cluster-randomised controlled trial was conducted in a rural district of Ethiopia. Fifty-four sub-districts were allocated in a 1:1 ratio to the facility-based care [FBC] plus CBR arm and the FBC alone arm. Lay workers delivered CBR over 12 months. We asses…
Predictors of spontaneous remission and recovery among women with untreated perinatal depression in India and Pakistan
Women with low baseline severity may remit from perinatal depression with adequate social support from family and friends. These factors are important contributors to the management of perinatal depression and the prevention of clinical worsening, and should be considered when designing low-threshold psychological interventions
Conducting Violence and Mental Health Research with Female Sex Workers during the Covid-19 Pandemic
Conducting violence and mental health research during the COVID-19 pandemic with vulnerable groups such as female sex workers (FSWs) required care to ensure that participants and the research team were not harmed. Potential risks and harm avoidance needed to be considered as well as ensuring data reliability. In March 2020, COVID-19 restrictions were imposed in Kenya during follow-up data collection for the Maisha Fiti study ( n = 1003); hence da…
Violence across the Life Course and Implications for Intervention Design
We examined violence experiences among Female Sex Workers (FSWs) in Nairobi, Kenya, and how these relate to HIV risk using a life course perspective. Baseline behavioural-biological surveys were conducted with 1003 FSWs June-December 2019. Multivariable logistic regression models were used to estimate the adjusted odds ratio (AOR) and 95% confidence intervals (CI) for associations of life course factors with reported experience of physical or sex…
Managing motherhood – the experiences of female sex workers in Nairobi, Kenya
Women selling sex often face challenges in raising their children in the context of significant socio-economic difficulties and the social stigma inherent in sex work. This paper is based on a cross-sectional qualitative study that explored the dual roles of motherhood and sex work among female sex workers enrolled for ongoing HIV prevention and treatment services in the Sex Workers Outreach Programme (SWOP) clinics in Nairobi, Kenya. We examined…
Longitudinal experiences and risk factors for common mental health problems and suicidal behaviours among female sex workers in Nairobi, Kenya
Our study found a decline in mental health problems but high levels of persistent suicidal behaviours among FSWs. Syndemic risk factors including food insecurity and violence were longitudinally associated with mental health problems and recent suicidal behaviours. There is a need for accessible mental health services for FSWs, alongside structural interventions addressing poverty and violence
Harmful Alcohol and Drug Use Is Associated with Syndemic Risk Factors among Female Sex Workers in Nairobi, Kenya
Background: Female Sex Workers (FSWs) are at high risk of harmful alcohol and other drug use. We use quantitative data to describe the prevalence of alcohol and other drug use and identify associated occupational and socio-economic risk factors, and aim to elucidate patterns of alcohol and drug use through information drawn from qualitative data. Methods: Maisha Fiti was a mixed-method longitudinal study conducted in 2019 among a random sample of…
The potential effect of pre-exposure prophylaxis (PrEP) roll-out on sexual-risk behaviour among adolescents and young people in East and southern Africa
Pre-exposure prophylaxis (PrEP) is an HIV-prevention strategy recommended for those at high-risk of infection, including adolescents and young people (AYP). We explored how PrEP roll-out could influence sexual risk behaviour among AYP in East and southern Africa. Twenty-four group discussions and 60 in-depth interviews were conducted with AYP between 13 and 24 years old, recruited from community settings in Uganda, Zimbabwe and South Africa, from…
Beaten but not down! Exploring resilience among female sex workers (FSWs) in Nairobi, Kenya
Despite the adverse experiences throughout the lives of FSWs, resilience was a key theme that emerged from this study. A holistic approach is needed in addressing the health needs of female sex workers. Encouraging FSWs to come together and advocating together for their needs is a key resource from which resilience and forbearance can grow. Upstream prevention through strengthening of education systems and supporting girls to stay in school and c…
Experiences of stigma and discrimination of people with schizophrenia in India
Experiences of stigma and discrimination faced by family caregivers of people with schizophrenia in India
Stigma associated with schizophrenia significantly affects family caregivers, yet few studies have examined the nature and determinants of family stigma and its relationship to their knowledge about the condition. This paper describes the experiences and determinants of stigma reported by the primary caregivers of people living with schizophrenia (PLS) in India. The study used mixed methods and was nested in a randomised controlled trial of commu…
Exploring Perceived Barriers and Facilitators of PrEP Uptake among Young People in Uganda, Zimbabwe, and South Africa
Pre-exposure prophylaxis (PrEP) is an effective HIV prevention strategy. Few studies have explored adolescents and young people’s perspectives toward PrEP. We conducted 24 group discussions and 60 in-depth interviews with males and females aged 13–24 years in Uganda, Zimbabwe, and South Africa between September 2018 and February 2019. We used the framework approach to generate themes and key concepts for analysis following the social ecological m…
OP35 Sexual Risk Behaviour Among Young People in Rural Tanzania
Background Being in full-time education is associated with lower risk of HIV and other STIs. We describe sexual partnership histories reported by youth in rural Tanzania, and investigate the association between current attendance at post-primary education, and sexual behaviour and antibody responses to Herpes Simplex Virus Type 2 (HSV-2) infection. Methods In 2007/8, sexual partnership histories were collected through a face-to-face questionnaire…
The acceptability of male circumcision as an HIV intervention among a rural Zulu population, KwaZulu-Natal, South Africa
Epidemiological and biological studies provide compelling evidence for the protective effect of male circumcision against the acquisition of HIV. Three randomized controlled trials are currently underway to assess the impact of male circumcision as an HIV intervention in traditionally non-circumcising areas with high levels of heterosexually-transmitted infection. This study explores the acceptability of male circumcision among the rural Zulu aro…
Gender Disadvantage and Reproductive Health Risk Factors for Common Mental Disorders in Women
BACKGROUND: Gender disadvantage and reproductive health are major determinants of women's health in developing countries. OBJECTIVE: To determine the association of factors indicative of gender disadvantage and reproductive health with the risk of common mental disorders (CMDs) in women. DESIGN: Cross-sectional survey from November 1, 2001, to June 15, 2003. PARTICIPANTS: A total of 3000 women randomly selected from a sampling frame of women aged…
Detecting common mental disorders in primary care in India
Background Screening of patients for common mental disorders (CMDs) is needed in primary-care management programmes. This study aimed to compare the screening properties of five widely used questionnaires. Method Adult attenders in five primary-care settings in India were recruited through systematic sampling. Four questionnaires were administered, in pairs, in random order to participants: the General Health Questionnaire (GHQ, 12 items); the Pr…
Effectiveness of an intervention led by lay health counsellors for depressive and anxiety disorders in primary care in Goa, India (Manas)
A qualitative study of participant adherence in a randomized controlled trial of herpes suppressive therapy for HIV prevention in Tanzania
Poor participant adherence to treatment may contribute to lack of impact in some biomedical HIV prevention trials. This qualitative study explored adherence in a randomized controlled trial of herpes suppressive therapy to reduce HIV acquisition and infectivity among 1305 Tanzanian women. The trial found participants completed 72% of visits on treatment; 52-56% of women on treatment had > or = 90% adherence by pill count estimate; and between six…
Psychiatric disorders and psychosocial correlates of high HIV risk sexual behaviour in war-affected Eastern Uganda
This article sets out to investigate the psychiatric and psychosocial risk factors for high risk sexual behaviour in a war-affected population in Eastern Uganda. A cross-sectional survey was carried out in four sub-counties in two districts in Eastern Uganda where 1560 randomly selected respondents (15 years and above) were interviewed. The primary outcome was a derived variable "high risk sexual behaviour" defined as reporting at least one of ei…
Non-consensual Sex and Association with Incident HIV Infection Among Women
Non-consensual sex is associated with HIV infection in Africa, but there is little longitudinal data on this association. We describe reported non-consensual sex among women over two decades in southwest Uganda, including associations with incident HIV infection. Between 1990 and 2008, individuals in a population cohort who recently seroconverted to HIV were enrolled into a clinical cohort, along with randomly selected HIV-negative controls. Part…
Frequency and correlates of anxiety and mood disorders among TB- and HIV-infected Zambians
We determined the frequency and correlates of current common mental disorders (CMDs) in a consecutive series of 649 adult patients with human immunodeficiency virus (HIV), tuberculosis (TB) or both receiving treatment at 16 primary health care centres across Zambia. Data on socio-demographic variables, clinical disease features, anxiety and mood disorders were collected. The frequency of any anxiety disorder (AD) was 30.8% and major depressive di…
Condom use among female sex workers in Uganda
Consistent condom use can prevent HIV infection, yet levels of condom use are low in many settings. This paper examines determinants of inconsistent condom use among 905 women enrolled in a high-risk cohort in Kampala, Uganda, who reported sexual intercourse with paying clients in the last month. Among these, 40% participants reported using condoms inconsistently with paying clients in the past month. The most common reason for inconsistent condo…
Older HIV-infected individuals present late and have a higher mortality
Older adults were more likely to present late and had a higher mortality. Initiatives to expand HIV testing in clinical and community setting should not neglect individuals aged over 50
OP35 Sexual Risk Behaviour Among Young People in Rural Tanzania
Background Being in full-time education is associated with lower risk of HIV and other STIs. We describe sexual partnership histories reported by youth in rural Tanzania, and investigate the association between current attendance at post-primary education, and sexual behaviour and antibody responses to Herpes Simplex Virus Type 2 (HSV-2) infection. Methods In 2007/8, sexual partnership histories were collected through a face-to-face questionnaire…
Alcohol consumption and high risk sexual behaviour among female sex workers in Uganda
Alcohol consumption has been associated with high risk sexual behaviour among key populations such as female sex workers. We explored the drivers of alcohol consumption and its relationship to high risk sexual behaviour. Participants were drawn from a cohort of 1027 women selected from 'hot spots' in the suburbs of Kampala city. We conducted 3 in-depth interviews with 40 female sex workers between 2010 and 2011. Data were analysed thematically, f…
Sexual Risk Behavior, Alcohol Use, and Social Media Use Among Secondary School Students in Informal Settlements in Cape Town and Port Elizabeth, South Africa
Factors Associated with HIV-Testing and Acceptance of an Offer of Home-Based Testing by Men in Rural Zambia
Experiences of stigma and discrimination of people with schizophrenia in India
Validation of the Mini (DSM IV) Tool for the Assessment of Alcohol Dependence among Young People in Northern Tanzania Using the Alcohol Biomarker Phosphatidylethanol (PEth)
The alcohol dependence section of the Mini International Neuropsychiatric Interview questionnaire (MINI) has not been evaluated in young Africans. We applied the MINI in a cross-sectional study of 202 alcohol users from northern-Tanzania, aged 18-24 years (103 male casual workers and 99 students), and validated it against phophatidylethanol (PEth) at a cut-off suggesting heavy chronic alcohol use (≥0.30 μmol/L). Blood was assayed for PEth (16:0/1…
Frequency of HIV-testing and factors associated with multiple lifetime HIV-testing among a rural population of Zambian men
Although men's levels of ever-testing for HIV have increased, strategies need to increase the lifetime frequency of HIV-testing among men at continued risk of HIV-infection
Effect of a Primary Care–Based Psychological Intervention on Symptoms of Common Mental Disorders in Zimbabwe
Importance: Depression and anxiety are common mental disorders globally but are rarely recognized or treated in low-income settings. Task-shifting of mental health care to lay health workers (LHWs) might decrease the treatment gap. Objective: To evaluate the effectiveness of a culturally adapted psychological intervention for common mental disorders delivered by LHWs in primary care. Design, Setting, and Participants: Cluster randomized clinical …
Intimate partner violence as seen in post-conflict eastern Uganda
BACKGROUND: Conflict and post-conflict communities in sub-Saharan Africa have a high under recognised problem of intimate partner violence (IPV). Part of the reason for this has been the limited data on IPV from conflict affected sub-Saharan Africa. This paper reports on the prevalence, risk factors and mental health consequences of IPV victimisation in both gender as seen in post-conflict eastern Uganda. METHODS: A cross-sectional survey was car…
The 12-item WHO Disability Assessment Schedule II as an outcome measure for treatment of common mental disorders
Further research is recommended on a CMD-specific WHODAS subscale comprised of the six WHODAS items found to be most strongly associated with CMD severity and recovery. This shorter, CMD-specific disability subscale would critically serve as a common metric to compare intervention impact on patient-centered outcomes and, in turn, to allocate global mental health resources efficiently
High Levels of Persistent Problem Drinking in Women at High Risk for HIV in Kampala, Uganda
The aim of this study was to describe the epidemiology of problem drinking in a cohort of women at high-risk of HIV in Kampala, Uganda. Overall, 1027 women at high risk of HIV infection were followed from 2008 to 2013. The CAGE and AUDIT questionnaires were used to identify problem drinkers in the cohort. Interviewer-administered questionnaires were used to ascertain socio-demographic and behavioural factors. Blood and genital samples were tested…
Voluntary medical male circumcision for HIV prevention in fishing communities in Uganda
Local beliefs and practices about voluntary medical male circumcision (VMMC) may influence uptake and effectiveness. Data were gathered through interviews with 40 people from four ethnically mixed fishing communities in Uganda. Some men believed that wound healing could be promoted by contact with vaginal fluids while sex with non-regular partners could chase away spirits - practices which encouraged unsafe sexual practices. Information given by …
HCV prevalence can predict HIV epidemic potential among people who inject drugs
Our results show that HCV prevalence can be used as a proxy biomarker of HIV epidemic potential among PWID, and that the scale and evolution of HIV epidemic expansion can be predicted with sufficient precision to inform HIV policy, programming, and resource allocation
Incidence and Persistence of Major Depressive Disorder Among People Living with HIV in Uganda
Data on the course of major depressive disorder (MDD) among people living with HIV (PLWH) are needed to inform refinement of screening and interventions for MDD. This paper describes the incidence and persistence rate of MDD in PLWH in Uganda. 1099 ART-naïve PLWH attending HIV clinics in Uganda were followed up for 12 months. MDD was assessed using the DSM IV based Mini-International Neuropsychiatric Interview with a prevalence for MDD at baselin…
The Healthy Activity Program (HAP), a lay counsellor-delivered brief psychological treatment for severe depression, in primary care in India
BACKGROUND: Although structured psychological treatments are recommended as first-line interventions for depression, only a small fraction of people globally receive these treatments because of poor access in routine primary care. We assessed the effectiveness and cost-effectiveness of a brief psychological treatment (Healthy Activity Program [HAP]) for delivery by lay counsellors to patients with moderately severe to severe depression in primary…
Medicine (64 works) · Environmental health (36 works) · Psychiatry (34 works) · HIV/AIDS Research and Interventions (29 works) · Family medicine (27 works) · Public health (23 works) · Adolescent Sexual and Reproductive Health (22 works) · Demography (22 works) · Internal Medicine (22 works) · Nursing (21 works)