Sexual behaviour, changes in sexual behaviour and associated factors among women at high risk of HIV participating in feasibility studies for prevention trials in Tanzania

Diana Faini; Claudia Hanson; Kathy Baisley; Saidi Kapiga; Richard Hayes

doi:10.1371/journal.pone.0231766

Peer Review History

Original SubmissionSeptember 20, 2019
3 Feb 2020 Decision Letter - Iratxe Puebla, Editor PONE-D-19-26501 Sexual behaviour, changes in sexual behaviour and associated factors among women at high risk of HIV participating in feasibility studies for prevention trials in Tanzania PLOS ONE Dear Dr Faini, 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. The manuscript has been assessed by two reviewers, their comments are available below. The reviewers find the work of relevance but have raised some items that need attention in a revision. The reviewers request clarifications about the analyses undertaken, recommend some further analyses and request additional discussion of limitations of the study. Could you please revise the manuscript to address the items raised. We would appreciate receiving your revised manuscript by Mar 17 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. 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, Iratxe Puebla Deputy Editor-in-Chief, 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. 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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: Partly ******** 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: No ****** 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’s an interesting study that needs minor revision The authors used a random intercept logistic regression model to estimate odds ratios for the change in prevalence of certain risky behaviours. However, the justification for this multilevel modeling is not clearly stated. For example, is it to cater for variance between visits and correlation between individual repeated measurements? It would have been appropriate to specify the random intercept logistic regression model used for clarity. The authors said “since few women were categorized as having risky sexual behavior at 12months, no attempt was made to build a full multivariable model to avoid problems with data sparsity” but it’s not clear how factors associated with risky behavior at 12 months were identified (table4 of results). Lastly, self-reported changes in risky behavior is such a highly subjective matter prone to bias especially where the respondent is aware of the purpose of the study. This may have overestimated the effect Reviewer #2: The grammar is largely correct ecxept in a few places where minor corrections are needed. The authors need to make some corrections to the few typos. Statistical analysis is clear except in Poisson regression. ****** 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: 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. Attachments Attachment Submitted filename: PLOS One review.docx https://doi.org/10.1371/journal.pone.0231766.r001
Revision 1
19 Mar 2020 Author Response Reviewer #1, Comment 1: It’s an interesting study that needs minor revision The authors used a random intercept logistic regression model to estimate odds ratios for the change in prevalence of certain risky behaviours. However, the justification for this multilevel modelling is not clearly stated. For example, is it to cater for variance between visits and correlation between individual repeated measurements? It would have been appropriate to specify the random intercept logistic regression model used for clarity. Response: We thank the reviewer for this important question. Yes, as the reviewer points out, the justification for using Logistic regression with random effect intercepts was to account for correlations between repeated measurements at the multiple visits. A sentence has been added to the manuscript to clarify this as suggested by the reviewer . (Page 6, lines 132-133). Reviewer #1,Comment 2: The authors said “since few women were categorized as having risky sexual behaviour at 12 months, no attempt was made to build a full multivariable model to avoid problems with data sparsity” but it’s not clear how factors associated with risky behaviour at 12 months were identified (table 4 of results). Response: We thank the reviewer for this comment. The Table four (4) of results presents the outcome of the Logistic regression model which examines each covariate with its association with the “having risky behaviour at 12 months” (outcome of interest). Following the univariate association, each covariate was adjusted for the effect of the “baseline behaviour”. While this is not a full multivariable model, each covariate was only adjusted for the effect of the baseline behaviour. Therefore, the presented adjusted odds ratios are “partially” adjusted as they do not take into account the effect of the other behaviours. (Page 7,line 162-166). We have revised the manuscript in the section quoted by the reviewer so as to improve clarity of the analyses performed. A footnote in Table 4 explains that the estimated odds ratio are adjusted only for the baseline sexual behaviour risk score. Reviewer #1, Comment 3: Lastly, self-reported changes in risky behaviour is such a highly subjective matter prone to bias especially where the respondent is aware of the purpose of the study. This may have overestimated the effect. Response: We agree with the reviewer that self-reported behaviours are prone to reporting bias i.e the social desirability bias. It is for this reasons that we have acknowledge and discussed this as a study limitation and how it may have overestimated the reported reduction of risky behaviour. In the discussion section, we have also highlighted the several attempts made to minimize this bias during study design and data collection. To underscore the effect of this bias on our study findings, we have reviewed and made necessary additions to this section in the manuscript. (Page 20, line 311-317). Reviewer #2 comment 1: The grammar is largely correct except in a few places where minor corrections are needed. The authors need to make some corrections to the few typos. Response: We thank the reviewer for pointing this. We have reviewed the entire manuscript and take note of the grammar and typographical errors. We have corrected the errors and proof-read the final version of the manuscript. Reviewer #2 comment 2: Statistical analysis is clear except in Poisson regression. Response: We take note of the reviewer’s concern on the clarity of the Poisson regression analysis performed. We have reviewed this section in detail and revised the paragraph to improve clarity. (Page 7, line 138-154). Attachments Attachment Submitted filename: Responses to Reviewers .docx https://doi.org/10.1371/journal.pone.0231766.r002
1 Apr 2020 Decision Letter - Ethan Morgan, Editor Sexual behaviour, changes in sexual behaviour and associated factors among women at high risk of HIV participating in feasibility studies for prevention trials in Tanzania PONE-D-19-26501R1 Dear Dr. Faini, 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, Ethan Morgan Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: https://doi.org/10.1371/journal.pone.0231766.r003
Formally Accepted
6 Apr 2020 Acceptance Letter - Ethan Morgan, Editor PONE-D-19-26501R1 Sexual behaviour, changes in sexual behaviour and associated factors among women at high risk of HIV participating in feasibility studies for prevention trials in Tanzania Dear Dr. Faini: 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. Ethan Morgan Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0231766.r004

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