Experiences of oral pre-exposure prophylaxis (PrEP) use disclosure among South African adolescent girls and young women and its perceived impact on adherence

Danielle Giovenco; Katherine Gill; Lauren Fynn; Menna Duyver; Shannon O’Rourke; Ariane van der Straten; Jennifer F. Morton; Connie L. Celum; Linda-Gail Bekker

doi:10.1371/journal.pone.0248307

Peer Review History

Original SubmissionOctober 26, 2020
11 Dec 2020 Decision Letter - Webster Mavhu, Editor PONE-D-20-33614 Experiences of PrEP use disclosure among South African adolescent girls and young women and its perceived impact on adherence PLOS ONE Dear Dr. Giovenco, Thank you for submitting your manuscript to PLOS ONE. Before we accept the manuscript for publication, there are a few issues we would like you to address - see comments/suggestions including in attached document. Please submit your revised manuscript by Jan 25 2021 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're 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. 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). 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For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols We look forward to receiving your revised manuscript. Kind regards, Webster Mavhu 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 https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf 2. Please include additional information regarding the survey or questionnaire used in the study and ensure that you have provided sufficient details that others could replicate the analyses. 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We will update your Data Availability statement on your behalf to reflect the information you provide. 5. Please amend your list of authors on the manuscript to ensure that each author is linked to an affiliation. Authors’ affiliations should reflect the institution where the work was done (if authors moved subsequently, you can also list the new affiliation stating “current affiliation:….” as necessary). Additional Editor Comments (if provided): This is a well-written paper on an important topic. I would largely ignore the reviewer's comments on Discussion and limitations. Given the recently-released amazing HPTN 084 study results, paper needs to refer even in passing - see suggestion in attached document. See additional comments/suggestions in attached paper. I would say qualitative respondents (not participants) throughout. Line 77 refers to just oral PrEP, needs to be revised. Include interview guide as supporting file and reference it as S1 file. See reviewer's comment on where interviews took place. Data processing section needs to say how accuracy of translation from isiXhosa to English was ensured. Reading the quotes, it looks like some of the grammar is due to inaccurate translations? Check lines 302-3. Results section on other family members could be more nuanced – Was there a pattern looking at male vs. female or younger vs. older? [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 ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: N/A ****** 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 ****** 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 ****** 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: Data collection section- can you please add the venue where the interviews were conducted as this has a potential effect on AGYW's responses line 221 not very clear the discuss section reads more like a repetition of the findings section and requires improvement. the discussion should outline the implication of the findings on the promotion of PrEP uptake. What the key message to clinicians or PrEP interventions based on these finding what are the key areas to look out for, What should be the main focus of PrEp messaging going forward. line 348 on limitations Qualitative study design findings are never meant to be generalized this is know and this cant be a limitation because that is how qualitative findings are designed. Before one conduct a qualitative result they know what it can and cannot do and this cant be a limitation just like you can not mention the generalizability of quantitative findings as a limitation. Same with the subjective nature of the qualitative studies. The limitations you have cited challenges the whole idea of qualitative research having a distinct epistemological standpoint which is different from a quantitative research. ****** 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 [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.] 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 PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. Attachments Attachment Submitted filename: Experiences of PrEP use - S. Africa WM.docx https://doi.org/10.1371/journal.pone.0248307.r001
Revision 1
29 Jan 2021 Author Response EDITOR COMMENTS: This is a well-written paper on an important topic. I would largely ignore the reviewer's comments on Discussion and limitations. Given the recently-released amazing HPTN 084 study results, paper needs to refer even in passing - see suggestion in attached document. Response: This has been added to the Discussion where suggested and the HPTN press release was cited in the References. Please let me know if the citation is acceptable. See additional comments/suggestions in attached paper. Response: Comments throughout the paper have been incorporated. I would say qualitative respondents (not participants) throughout. Response: This has been changed Line 77 refers to just oral PrEP, needs to be revised. Response: The citation referenced in this line references a review on the effectiveness and safety of oral HIV preexposure prophylaxis. Since this paper is about adherence to oral PrEP, which is likely to be very different than other PrEP formulations, we have focused the Introduction section on oral PrEP. Include interview guide as supporting file and reference it as S1 file. Response: The qualitative IDI guide has been included as a supporting file. Because the guide was long and was designed to explore several aspects of PrEP use, we have only included the relevant section which included disclosure and relationship questions. See reviewer's comment on where interviews took place. Response: This has been added to the “Data collection and processing” section. Participants could choose to have interviews conducted at their homes or the research site. Data processing section needs to say how accuracy of translation from isiXhosa to English was ensured. Reading the quotes, it looks like some of the grammar is due to inaccurate translations? Response: All sessions were audio recorded, transcribed verbatim in English by a staff member proficient in both isiXhosa and English, and reviewed for quality control by a second staff member. This detail has been added to the methods. We acknowledge there are a few grammar issues in the quotes, possibly due to translations or the casual nature of the interviews, but we preferred to leave the quotes as unchanged as possible. Check lines 302-3. Results section on other family members could be more nuanced – Was there a pattern looking at male vs. female or younger vs. older? Response: For disclosure to family members, AGYW seemed to be most likely to disclose to those who they perceived would be supportive. Therefore, we did not find any notable differences in supportive disclosures across family member age and gender. We have, however, added that disclosure to aunts, uncles, and cousins was more commonly discussed than disclosure to grandparents. This may be because AGYW perceived this older generation would be less supportive. REVIEWER #1 COMMENTS: Data collection section- can you please add the venue where the interviews were conducted as this has a potential effect on AGYW's responses Response: See response above line 221 not very clear Response: We apologize for the typo in this sentence. The revised sentence now reads: Lastly, another respondent who disclosed to a sibling outside the household explained: “[My sisters] were not supportive because I was not staying with them” (24yrs, M12). the discuss section reads more like a repetition of the findings section and requires improvement. the discussion should outline the implication of the findings on the promotion of PrEP uptake. What the key message to clinicians or PrEP interventions based on these finding what are the key areas to look out for, What should be the main focus of PrEp messaging going forward. Response: Given the qualitative nature of the data and small sample size, this analysis is intended to provide support for future investigations into this topic prior to recommendations. line 348 on limitations Qualitative study design findings are never meant to be generalized this is know and this cant be a limitation because that is how qualitative findings are designed. Before one conduct a qualitative result they know what it can and cannot do and this cant be a limitation just like you can not mention the generalizability of quantitative findings as a limitation. Same with the subjective nature of the qualitative studies. The limitations you have cited challenges the whole idea of qualitative research having a distinct epistemological standpoint which is different from a quantitative research. Response: We present both qualitative and descriptive quantitative data. Therefore, we feel there is no harm in mentioning this important limitation, despite its potential redundancy. https://doi.org/10.1371/journal.pone.0248307.r002
22 Feb 2021 Decision Letter - Webster Mavhu, Editor PONE-D-20-33614R1 Experiences of pre-exposure prophylaxis (PrEP) use disclosure among South African adolescent girls and young women and its perceived impact on adherence PLOS ONE Dear Dr. Giovenco, Thank you for submitting your manuscript to PLOS ONE. A few more edits or suggestions in attached. Please submit your revised manuscript by Apr 08 2021 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're 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. 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). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols We look forward to receiving your revised manuscript. Kind regards, Webster Mavhu Academic Editor PLOS ONE Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. [Note: HTML markup is below. Please do not edit.] [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.] 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 PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. Attachments Attachment Submitted filename: Experiences of PrEP use - S. Africa_WM.docx https://doi.org/10.1371/journal.pone.0248307.r003
Revision 2
22 Feb 2021 Author Response Dear Dr. Webster Mavhu, We appreciate the opportunity to provide additional revisions on our manuscript. No papers listed in the references have been retracted. We have replaced one citation that was previously listed as “forthcoming” with the citation for the recently published manuscript. In addition, we have replaced the citation for a conference abstract with the citation of another recently published manuscript. No other changes to the references have been made. Please let us know if there are any other specific changes to this section you would like us to make. Only one qualitative coder has been included as a co-author (SO). Therefore, for consistency, we have not included any staff initials in the qualitative analysis section. All in-text edits made by the editor have been accepted with the exception of line 206, where the sentence remains: “Disclosure to partners often initially raised concerns that respondents would be unfaithful or have multiple partners because they would no longer be concerned about acquiring HIV while taking PrEP” to keep the verb tense consistent throughout sentence. We appreciate your thorough edits. Please let us know if there are any additional edits. Sincerely, Danielle Giovenco https://doi.org/10.1371/journal.pone.0248307.r004
24 Feb 2021 Decision Letter - Webster Mavhu, Editor Experiences of oral pre-exposure prophylaxis (PrEP) use disclosure among South African adolescent girls and young women and its perceived impact on adherence PONE-D-20-33614R2 Dear Dr. Giovenco, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. 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 help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- 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. Kind regards, Webster Mavhu Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: https://doi.org/10.1371/journal.pone.0248307.r005
Formally Accepted
26 Feb 2021 Acceptance Letter - Webster Mavhu, Editor PONE-D-20-33614R2 Experiences of oral pre-exposure prophylaxis (PrEP) use disclosure among South African adolescent girls and young women and its perceived impact on adherence Dear Dr. Giovenco: I'm 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 let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, 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. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Webster Mavhu Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0248307.r006

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