Examination of multilevel domains of minority stress: Implications for drug use and mental and physical health among Latina women who have sex with women and men

Alice Cepeda; Kathryn M. Nowotny; Jessica Frankeberger; Esmeralda Ramirez; Victoria E. Rodriguez; Tasha Perdue; Avelardo Valdez

doi:10.1371/journal.pone.0230437

Peer Review History

Original SubmissionJuly 26, 2019
5 Dec 2019 Decision Letter - Geilson Lima Santana, Editor Transfer Alert This paper was transferred from another journal. As a result, its full editorial history (including decision letters, peer reviews and author responses) may not be present. PONE-D-19-19530 Documenting disparities in drug use, physical health, and mental health for women who have sex with women and men using a cohort of Mexican-American women living in a disadvantaged community PLOS ONE Dear Dr. Cepeda, 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 Jan 19 2020 11:59PM. 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. To enhance the reproducibility of your results, we recommend that if applicable you deposit your laboratory protocols in protocols.io, where a protocol can be assigned its own identifier (DOI) such that it can be cited independently in the future. For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). This letter should be uploaded as separate file and labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. This file should be uploaded as separate file and labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. This file should be uploaded as separate file and labeled 'Manuscript'. Please note while forming your response, if your article is accepted, you may have the opportunity to make the peer review history publicly available. The record will include editor decision letters (with reviews) and your responses to reviewer comments. If eligible, we will contact you to opt in or out. We look forward to receiving your revised manuscript. Kind regards, Geilson Lima Santana, M.D., Ph.D. Academic Editor PLOS ONE Journal Requirements: When submitting your revision, we need you to address these additional requirements. 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at http://www.journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and http://www.journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf 2. PLOS requires an ORCID iD for the corresponding author in Editorial Manager on papers submitted after December 6th, 2016. Please ensure that you have an ORCID iD and that it is validated in Editorial Manager. To do this, go to ‘Update my Information’ (in the upper left-hand corner of the main menu), and click on the Fetch/Validate link next to the ORCID field. This will take you to the ORCID site and allow you to create a new iD or authenticate a pre-existing iD in Editorial Manager. Please see the following video for instructions on linking an ORCID iD to your Editorial Manager account: https://www.youtube.com/watch?v=_xcclfuvtxQ Additional Editor Comments (if provided): Congratulations for the article. Please, take into consideration the reviewers´ comments. They will enrich your article for sure. It is important also to elaborate on the data availability statement. In my opinion, data is not fully present in the text and supplementary material. You can add the databank to your submission. Alternatively, you can make it available in a public repository. If you don´t have permission to allow public access to it, it is important to state one of the two sentences below: Data cannot be shared publicly because of [XXX]. Data are available from the XXX Institutional Data Access / Ethics Committee (contact via XXX) for researchers who meet the criteria for access to confidential data. The data underlying the results presented in the study are available from (include the name of the third party and contact information or URL). [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: I Don't Know 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: No ****** 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: It seems understandable the incomplete availability of data, as this work is part of a larger ongoing project. All that was left was to better conceptualize, at the beginning of the work, what would be WSWM?, that is, how many episodes of sex with women would count to be classified as WSWM? As small details: 1. the title is not clear enough 2. reference 5 has some errors 3. DSM IV reference missing I would like to congratulate the authors, it is an interesting and important work. Both, the structure of the article, including the technical aspects, as well as the content are very good. Reviewer #2: This is a very interesting and needed article that calls for attention to several key factors that are associated to drug use, physical health and mental health among a sexual minority population - in this case, women who have sex with women and men (WSWM). Despite being a very specific and vulnerable population, the study results are very interesting and shed light for a poorly understood question. In my opinion, the article could be easily improved if the points listed below are answered/tackled: 1. Would it be possible to adjust the title, possibly making it more attractive? The data shown cover so many different aspects that should not to be simplified as just the "documentation of disparities". Moreover, the socioeconomic vulnerability to which they are exposed (e.g., violence and incarceration) should be another point to be highlighted, instead of just being the context of "living in a disadvantaged community". 2. Include the explanation for not assessing data of women who have sex with women/lesbians in the abstract. It is actually a little bit confusing in the article itself (last paragraph of page 6 and first one of page 7) - since 3.8% answered about their sexual identity as being lesbians, it would not be expected that absolutely 'all women in the cohort reported having sex with men'. Would it be specific of such a population? Moreover, this issue ends up getting more complicated when the results for the sexual identification are observed (lines 251-257) - could you please try to simplify or improve the intelligibility of these excerpts? 3. Please verify the name for 'substance dependence severity scale (SDS)' vs. 'Severity of Dependence Scale (SDS)' (line 188). It would be interesting if authors could explain the reason why they used more conservative cut-off scores as suggested by other researchers - e.g., were the populations similar to the one assessed? 4. In the discussion section, since it is a very particular population, it would be nice to have national rates of the individual-level, interpersonal-level, structural-level and health outcomes that are assessed, or at least identifying those that are rather different from the national level and actually citing the literature rate. For example, line 328 of the article states that the reported rates of childhood trauma, IPV, and incarceration history, overall, far exceed national rates - which are.... I believe this would further show the importance of the present findings and also of how relevant it is to study minority populations like these. ****** 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: Yes: Patricia B Hochgraf Reviewer #2: No [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.0230437.r001
Revision 1
21 Jan 2020 Author Response Reviewer #1: It seems understandable the incomplete availability of data, as this work is part of a larger ongoing project. We have a no-cost extension for the study so technically it has not ended.. Per NIH policy and PLOS ONE’s data policy, the data that support the findings will be made openly available but is not yet ready to be released. All that was left was to better conceptualize, at the beginning of the work, what would be WSWM?, that is, how many episodes of sex with women would count to be classified as WSWM? For participants in our study, being labeled a “WSWM” is based on lifetime reports (so having sex with one man and one women at least one time). We believed that this is well clarified in the methods section but have made it more explicit in the final paragraph of the introduction. As small details: 1. the title is not clear enough Reviewer 2 made a similar comment. Please see our response below. 2. reference 5 has some errors Thanks for noticing this. We added the sponsor agency of the report to the citation (National Health Statistics Reports, Centers for Disease Control and Prevention). 3. DSM IV reference missing The reference has been added to the citation list and the in-text citation has been updated. I would like to congratulate the authors, it is an interesting and important work. Both, the structure of the article, including the technical aspects, as well as the content are very good. Thank you for these kind words. We are excited to share these findings! Reviewer #2: This is a very interesting and needed article that calls for attention to several key factors that are associated to drug use, physical health and mental health among a sexual minority population - in this case, women who have sex with women and men (WSWM). Despite being a very specific and vulnerable population, the study results are very interesting and shed light for a poorly understood question. In my opinion, the article could be easily improved if the points listed below are answered/tackled: 1. Would it be possible to adjust the title, possibly making it more attractive? The data shown cover so many different aspects that should not to be simplified as just the "documentation of disparities". Moreover, the socioeconomic vulnerability to which they are exposed (e.g., violence and incarceration) should be another point to be highlighted, instead of just being the context of "living in a disadvantaged community". Both Reviewers 1 and 2 commented on the title. Following Reviewer 2’s suggestion, we have simplified it to the following: “Documentation of Disparities for Women Who Have Sex With Women and Men Using a Cohort of Mexican-American Women.” 2. Include the explanation for not assessing data of women who have sex with women/lesbians in the abstract. It is actually a little bit confusing in the article itself (last paragraph of page 6 and first one of page 7) - since 3.8% answered about their sexual identity as being lesbians, it would not be expected that absolutely 'all women in the cohort reported having sex with men'. Would it be specific of such a population? Moreover, this issue ends up getting more complicated when the results for the sexual identification are observed (lines 251-257) - could you please try to simplify or improve the intelligibility of these excerpts? We agree that this is very complex. In our sample, it is correct that all women reported having sex with men independent of their sexual identity. So all of the women in our sample that are lesbian reported having sex with a man at least once. We do not know from our data the context in which these sexual encounters took place: did it occur during sex work? out of social pressure to “fit in”? is their sexual identity fluid? This context is very important and it is missing from our data. The same is true for women who report being heterosexual yet have had sex with women. We were recently awarded a pilot grant to follow up with the WSWM subsample and ask them these kinds of questions. For the current paper, we see identity and behavior as separate, yet related, factors that may contribute to minority stress and negative health outcomes in different ways (similar to studies of the health of men who have sex with men (MSM) regardless of their sexual identity). We have added clarifying statements beginning in the Measures: Individual-level section to make this clearer for the reader. 3. Please verify the name for 'substance dependence severity scale (SDS)' vs. 'Severity of Dependence Scale (SDS)' (line 188). It would be interesting if authors could explain the reason why they used more conservative cut-off scores as suggested by other researchers - e.g., were the populations similar to the one assessed? We fixed the error with the scale title in the text and made some edits to the description of the measure. The scale as originally developed by the WHO uses the same items and cut-off scores for all types of drugs (e.g., cocaine, heroin, meth, marijuana, etc.). Other researchers have developed drug-specific cut-off scores by examining the scale properties specifically for meth users, heroin users, etc. We chose to use these more refined scores in order to be more precise and cautious in our analysis. 4. In the discussion section, since it is a very particular population, it would be nice to have national rates of the individual-level, interpersonal-level, structural-level and health outcomes that are assessed, or at least identifying those that are rather different from the national level and actually citing the literature rate. For example, line 328 of the article states that the reported rates of childhood trauma, IPV, and incarceration history, overall, far exceed national rates - which are.... I believe this would further show the importance of the present findings and also of how relevant it is to study minority populations like these. This is a great suggestion and we have done this. Attachments Attachment Submitted filename: Response to Reviewers.docx https://doi.org/10.1371/journal.pone.0230437.r002
21 Feb 2020 Decision Letter - Geilson Lima Santana, Editor PONE-D-19-19530R1 Documentation of disparities for women who have sex with women and men using a cohort of Mexican-American Women PLOS ONE Dear Dr. Cepeda, 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. Provide specific feedback from your evaluation of the manuscript We would appreciate receiving your revised manuscript by Apr 06 2020 11:59PM. 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. To enhance the reproducibility of your results, we recommend that if applicable you deposit your laboratory protocols in protocols.io, where a protocol can be assigned its own identifier (DOI) such that it can be cited independently in the future. For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). This letter should be uploaded as separate file and labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. This file should be uploaded as separate file and labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. This file should be uploaded as separate file and labeled 'Manuscript'. Please note while forming your response, if your article is accepted, you may have the opportunity to make the peer review history publicly available. The record will include editor decision letters (with reviews) and your responses to reviewer comments. If eligible, we will contact you to opt in or out. We look forward to receiving your revised manuscript. Kind regards, Geilson Lima Santana, M.D., Ph.D. Academic Editor PLOS ONE Additional Editor Comments (if provided): Dear authors, I will be glad to accept your submission for publication after some small changes suggested by one the reviewers: "The authors have addressed all comments and the article has improved, but they have misunderstood my first comment regarding the title. While I wrote "The data shown cover so many different aspects that should NOT to be simplified as just the "documentation of disparities", they understood as if I was suggesting to actually use the terms "documentation of disparities". Besides this minor correction and provided a new title that encompasses the range of multi-level risk factors that were assessed in the present study". Best wishes, Geilson. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation. Reviewer #2: All comments have been addressed ******** 2. 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 #2: No ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #2: Yes ****** 4. 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 #2: No ****** 5. 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 #2: Yes ****** 6. 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 #2: The authors have addressed all comments and the article has improved, but they have misunderstood my first comment regarding the title. While I wrote "The data shown cover so many different aspects that should NOT to be simplified as just the "documentation of disparities", they understood as if I was suggesting to actually use the terms "documentation of disparities". Besides this minor correction and provided a new title that encompasses the range of multi-level risk factors that were assessed in the present study. ****** 7. 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 #2: No [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.0230437.r003
Revision 2
25 Feb 2020 Author Response Additional Editor Comments (if provided): Dear authors, I will be glad to accept your submission for publication after some small changes suggested by one the reviewers: "The authors have addressed all comments and the article has improved, but they have misunderstood my first comment regarding the title. While I wrote "The data shown cover so many different aspects that should NOT to be simplified as just the "documentation of disparities", they understood as if I was suggesting to actually use the terms "documentation of disparities". Besides this minor correction and provided a new title that encompasses the range of multi-level risk factors that were assessed in the present study". Best wishes, Geilson. I see how this was a misunderstanding and am glad to have the opportunity to revise the title. The new title is, “Examination of Multilevel Domains of Minority Stress among Latina Women who have Sex with Women and Men.” Attachments Attachment Submitted filename: Repsonse to Reviewers.docx https://doi.org/10.1371/journal.pone.0230437.r004
2 Mar 2020 Decision Letter - Geilson Lima Santana, Editor Examination of Multilevel Domains of Minority Stress: Implications for Drug Use and Mental and Physical Health among Latina Women who have sex with Women and Men PONE-D-19-19530R2 Dear Dr. Cepeda, 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, Geilson Lima Santana, M.D., Ph.D. Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0230437.r005
Formally Accepted
9 Mar 2020 Acceptance Letter - Geilson Lima Santana, Editor PONE-D-19-19530R2 Examination of Multilevel Domains of Minority Stress: Implications for Drug Use and Mental and Physical Health among Latina Women who have sex with Women and Men Dear Dr. Cepeda: 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 Dr. Geilson Lima Santana Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0230437.r006

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