PONE-D-20-10185

Quality of sleep and associated factors among people living with HIV/AIDS attending ART clinic at Hawassa University comprehensive specialized Hospital, Hawassa, SNNPR, Ethiopia

PLOS ONE

Dear Mr. Bedaso,

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Amir H. Pakpour, Ph.D.

Academic Editor

PLOS ONE

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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: No

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

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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

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

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Reviewer #1: No

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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: The study entitled “Quality of sleep and associated factors among people living with HIV/AIDS attending ART clinic at Hawassa University comprehensive specialized Hospital, Hawassa, SNNPR, Ethiopia” assessed an important topic of sleep on people with HIV/AIDS attending ART clinic. I am impressed by the high response rate for the study and I do think that the study adds something to the current literature; especially the study investigated understudied population. However, grammatical errors and editing errors can be found in the manuscript. For example, in the Abstract sentence: Data was entered and analyzed using SPSS version 22, Adjusted odds ratio (AOR) with 95% CI, was estimated to assess the strength of associations and variables with p-value <0.05 were considered statistically significant. Several errors are easily observed: “Data were”; “SPSS version 22, adjusted odds ratio”. It is not the reviewer’s responsibility to point out all the errors and the authors may consider asking help from a native English speaker to improve the quality. Moreover, some uncommonly used abbreviations are directly used without explanation (e.g., HTN, ETB). The authors should provide a full spell-out for these abbreviations when they are firstly mentioned. I have additionally specific comments below.

1. The following two references are talking about the sleep among people with HIV/AIDS. The authors should incorporate them in the Introduction.

https://www.ncbi.nlm.nih.gov/pubmed/28735919

https://www.ncbi.nlm.nih.gov/pubmed/31739231

2. In the sentence “Among the total ART clients currently being enrolled in ART service, 422 study participants were selected using a systematic random sampling technique (K=6).” I cannot understand what K=6 means here.

3. Please incorporate the Variables section into the Data process and analysis section.

4. What is the meaning of “Daily base supervision was conducted by one mental health professional specialist”? Do the authors mean the psychiatry nurses were under supervision by mental health professional specialist to collect data? If so, what kind of supervision is it?

5. As the instruments are all self-report nature, I wonder what exactly the psychiatry nurses administer the survey.

6. Please provide the internal consistency information of the instruments (PSQI, HADS, and OSS-3) for the present study sample.

7. I wonder whether the PSQI and the OSS-3 have an Ethiopia version. The authors have explicitly mentioned that Ethiopia version of HADS, but not for the PSIQ and OSS-3.

8. In Data processing and analysis section, please define what a possible confounder variable is.

9. In the first paragraph of the Discussion section, I wonder whether all the compared countries used the same instrument with the same cutoff point (i.e., using PSQI with a cutoff at 5) to indicate the poor sleep quality. Also, it is unclear whether all the mentioned studies assessing people with HIV/AIDS. Please clarify.

10. Avoid using “besides” throughout the manuscript.

11. Please comment on how the study results can be generalized to other population with HIV/AIDS. Specifically, the sample was relatively healthy in the HIV stages; therefore, the results may not be applicable to people with severe HIV stage.

12. Please comment on how the prevalence rate of poor sleep quality found in the present study can be generalized to the Ethiopia. Also, please revise the sentence “Also, it is better if HUCSH ART staffs carefully assess the sleeping pattern of PLWHA and special consideration has to be given to those with age >55 years, having poor social support, having depression and anxiety and those living below the poverty line.” I think that the authors should not narrow down their implications to only one hospital. I understand that the authors may not want to overgeneralize their results; however, implication for a hospital only does not provide impact to the healthcare field.

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Reviewer #1: No

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Quality of sleep and associated factors among people living with HIV/AIDS attending ART clinic at Hawassa University comprehensive specialized Hospital, Hawassa, SNNPR, Ethiopia

PONE-D-20-10185R1

Dear Dr. Bedaso,

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.

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With kind regards,

Amir H. Pakpour, Ph.D.

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

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 #1: All comments have been addressed

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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 #1: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: 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 #1: Yes

**********

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 #1: 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 #1: The authors have well addressed all my previous comments. I am satisfied with the revision and glad to recommend publication.

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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 #1: No