Programmatic mapping and size estimation of key populations to inform HIV programming in Tanzania

Mwita Wambura; Daniel Josiah Nyato; Neema Makyao; Mary Drake; Evodius Kuringe; Caterina Casalini; Jacqueline Materu; Soori Nnko; Gasper Mbita; Amani Shao; Albert Komba; John Changalucha; Tobi Saidel

doi:10.1371/journal.pone.0228618

Peer Review History

Original SubmissionAugust 28, 2019
10 Dec 2019 Decision Letter - Kwasi Torpey, Editor PONE-D-19-24277 Programmatic mapping and size estimation of key populations to inform HIV programming in Tanzania PLOS ONE Dear Dr Wambura, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. We would appreciate receiving your revised manuscript by 9th January 2020. When you are ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. 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Thank you for including your ethics statement: "The geographical mapping study was granted ethics approval by the Medical Research Coordinating Committee (MRCC) of the National Institute for Medical Research (NIMR) in Tanzania (NIMR/HQ/R.8a/Vol.IX/2086), and Institutional Review Board of the Johns Hopkins University (IRB 00006668). Approval to work in the study communities was obtained through official permission from respective local government offices and leaders after authorisation from the regional and district government authorities. No personal identifying information was collected from respondents as part of the study. Interviewees provided verbal consent because sex work and same-sex relationships are illegal in Tanzania. The interviewers signed the consent form to confirm that they had obtained informed consent from the participant before conducting the interview." a. Please amend your current ethics statement to include the full name of the ethics committee/institutional review board(s) that approved your specific study (the latter named approval for community interviews, specifically). b. Once you have amended this/these statement(s) in the Methods section of the manuscript, please add the same text to the “Ethics Statement” field of the submission form (via “Edit Submission”). For additional information about PLOS ONE ethical requirements for human subjects research, please refer to http://journals.plos.org/plosone/s/submission-guidelines#loc-human-subjects-research 3. Please include additional information regarding the pretesting of the structured interviews used in the study, i.e. did pretesting take place and, if so, upon whom. 4. Please include captions for your Supporting Information files at the end of your manuscript, and update any in-text citations to match accordingly. Please see our Supporting Information guidelines for more information: http://journals.plos.org/plosone/s/supporting-information. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes Reviewer #2: Yes ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: Yes ****** 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes Reviewer #2: Yes ****** 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes ****** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: This study, which sets out to map and estimate the number of female sex workers, men who have sex with men for the purpose of informing efforts directed at reducing HIV transmission in these hard to reach populations, is ambitious and in the main successful in identifying the places where these people can be accessed. Tanzania is large country geographically with diverse sociocultural populations. Tanga region, for example, is bordering Mombasa, a big seaport. It is not clear how it has influenced Tanga and might alter the picture that would emerge if it was included. There is therefore need to reflect this in the conclusions when discussing prevalence figures for Tanzania. The design, methodology and conduct of the study has been technically and scientifically sound as well as of very high standard Reviewer #2: The study addresses an important data and information need for effective HIV prevention programming in Tanzania. The study uses a methodology that has been applied in other countries in Africa and Asia for similar purposes. The methodology’s strengths and weaknesses are now well established. Overall, the study is described and presented well. The overall findings are also consistent with those from studies using a similar methodology in different parts of Africa. The authors identify their three-step approach to adjust for potential double counting as the key strength of their study. However, I would advise that they provide further details on the adjustment factors, especially for double counting and frequency of visiting a venue. Reliable correction factors for key population (KP) size estimates from this methodology should be based on data on behaviours of KPs reached directly through the study itself, especially at Level 2 of the data collection process. The authors present on Table 1 (page 9) a set of questions that were used to derive adjustment factors for FSW estimates. The questions as phrased are not asking the FSWs about their own behaviour, but rather their views on other FSWs’ client solicitation practices, including client solicitation at multiple venues. Such an approach is prone to response biases, which could affect the associated assumptions built into the extrapolation models. Can the authors clarify if they asked the same set of questions to the KPs they interviewed focusing on the KP’s own behaviour and how the findings compared to the responses the KPs gave on their impressions of the practices of fellow/other KPs (as indicated on Table 1)? If not, can the authors comment on how not using data on actual behaviours of the sample of FSWs reached directly by the study could affect the assumptions for their population size estimation and extrapolation models? ****** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review?** For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No Reviewer #2: Yes: Willis Omondi Odek [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files to be viewed.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email us at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0228618.r001
Revision 1
15 Jan 2020 Author Response Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes Reviewer #2: Yes ________________________________________ 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: Yes ________________________________________ 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes Reviewer #2: Yes ________________________________________ 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes ________________________________________ 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: This study, which sets out to map and estimate the number of female sex workers, men who have sex with men for the purpose of informing efforts directed at reducing HIV transmission in these hard to reach populations, is ambitious and in the main successful in identifying the places where these people can be accessed. Tanzania is large country geographically with diverse sociocultural populations. Tanga region, for example, is bordering Mombasa, a big seaport. It is not clear how it has influenced Tanga and might alter the picture that would emerge if it was included. There is therefore need to reflect this in the conclusions when discussing prevalence figures for Tanzania. The design, methodology and conduct of the study has been technically and scientifically sound as well as of very high standard Response: Thanks for the comment. The study was conducted in regions supported by Sauti project to provide programmatic data for local program planning, target setting and monitoring of program coverage. Please see the last paragraph on page 4, line number 89-96. Extrapolation was used for estimating the size of FSWs/MSM in the wards without direct estimates within the study regions. This study was not able to generate national FSW/MSM estimates because only 5 regions were mapped. Extrapolating estimates in non-mapped regions using estimates in the five mapped regions may have generated imprecise estimates because of the lack of useful data to group regions into strata that are more likely to have similar population proportions of MSM/FSWs. Reviewer #2: The study addresses an important data and information need for effective HIV prevention programming in Tanzania. The study uses a methodology that has been applied in other countries in Africa and Asia for similar purposes. The methodology’s strengths and weaknesses are now well established. Overall, the study is described and presented well. The overall findings are also consistent with those from studies using a similar methodology in different parts of Africa. The authors identify their three-step approach to adjust for potential double counting as the key strength of their study. However, I would advise that they provide further details on the adjustment factors, especially for double counting and frequency of visiting a venue. Reliable correction factors for key population (KP) size estimates from this methodology should be based on data on behaviours of KPs reached directly through the study itself, especially at Level 2 of the data collection process. The authors present on Table 1 (page 9) a set of questions that were used to derive adjustment factors for FSW estimates. The questions as phrased are not asking the FSWs about their own behaviour, but rather their views on other FSWs’ client solicitation practices, including client solicitation at multiple venues. Such an approach is prone to response biases, which could affect the associated assumptions built into the extrapolation models. Can the authors clarify if they asked the same set of questions to the KPs they interviewed focusing on the KP’s own behaviour and how the findings compared to the responses the KPs gave on their impressions of the practices of fellow/other KPs (as indicated on Table 1)? If not, can the authors comment on how not using data on actual behaviours of the sample of FSWs reached directly by the study could affect the assumptions for their population size estimation and extrapolation models? Response: Thanks for this comment. Only one of the three adjustments was for double-counting. The other two adjustments (frequency of visiting sites and non-visibility) were making assumptions about people who may not have been at any venue during the mapping process. Therefore, the study was collecting information about people who may have been “absent” from people who were “present” because they would be in a better position to inform those assumptions than if we just made assumptions randomly. Regarding double-counting, the study did not ask the FSWs/MSM about their behaviour, but rather their views on other FSWs’/MSM client solicitation practices, including client solicitation at multiple venues. We agree that such an approach may be prone to response bias, which could affect the associated double-counting assumption built into the extrapolation models. We have, therefore, acknowledged this as a weakness. Please see the last sentence on page 33, line number 639-649. ________________________________________ Attachments Attachment Submitted filename: Mapping comments Revised 15jan2020.pdf https://doi.org/10.1371/journal.pone.0228618.r002
22 Jan 2020 Decision Letter - Kwasi Torpey, Editor Programmatic mapping and size estimation of key populations to inform HIV programming in Tanzania PONE-D-19-24277R1 Dear Dr. Wambura We are pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it complies with all outstanding technical requirements. Within one week, you will receive an e-mail containing information on the amendments required prior to publication. When all required modifications have been addressed, you will receive a formal acceptance letter and your manuscript will proceed to our production department and be scheduled for publication. Shortly after the formal acceptance letter is sent, an invoice for payment will follow. To ensure an efficient production and billing process, please log into Editorial Manager at https://www.editorialmanager.com/pone/, click the "Update My Information" link at the top of the page, and update your user information. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to enable them to help maximize its impact. If they will be preparing press materials for this manuscript, you must inform our press team as soon as possible and no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. With kind regards, Kwasi Torpey, MD PhD MPH Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: https://doi.org/10.1371/journal.pone.0228618.r003
Formally Accepted
24 Jan 2020 Acceptance Letter - Kwasi Torpey, Editor PONE-D-19-24277R1 Programmatic mapping and size estimation of key populations to inform HIV programming in Tanzania Dear Dr. Wambura: I am pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please notify them about your upcoming paper at this point, to enable them to help maximize its impact. If they will be preparing press materials for this manuscript, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. For any other questions or concerns, please email plosone@plos.org. Thank you for submitting your work to PLOS ONE. With kind regards, PLOS ONE Editorial Office Staff on behalf of Professor Kwasi Torpey Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0228618.r004

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