PONE-D-20-23565

“I want to perform and succeed more than those who are HIV-seronegative ” Lived Experiences of youth who acquired HIV Perinetally and attend Zewditu Memorial Hospital ART clinic, Addis Ababa, Ethiopia.

PLOS ONE

Dear Dr. Solomon,

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 evaluated by two reviewers, and their comments are available below. You will see the reviewers have commented on the interest and relevance of your study. However, the reviewers have also raised critical concerns and the manuscript will need significant revision before it can be considered for publication – you should anticipate that the reviewers will be re-invited to assess the revised manuscript, so please ensure that your revision is thorough. I have outlined some of the key concerns noted by the reviewers below, but you should respond to all concerns mentioned by the reviewers in your response-to-reviewers document. 

The key concerns noted by the reviewers relate to the clarity of the reporting of the methods and results. Specifically, the reviewers requested additional information about participant recruitment and the interview procedures, including the semi-structured interview guide. Additionally, Reviewer 1 noted that the relationship between participant sociodemographic characteristics and the study findings should be discussed. 

Please submit your revised manuscript by Apr 24 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.

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We look forward to receiving your revised manuscript.

Kind regards,

Danielle Poole

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: Yes

Reviewer #2: Yes

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

Reviewer #1: N/A

Reviewer #2: N/A

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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

Reviewer #2: No

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

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Reviewer #1: Yes

Reviewer #2: 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: It is a study about a relevant theme, it is well developed and well elaborated.

It presents some absences in the methodology and inconsistencies in the results that need to be clarified, described below.

The object under study is clear and justified and the method chosen is appropriate to the objectives of the study.

The methodological path is lacking information that gives it more transparency. It is necessary to clarify better how the recruitment of participants was done. It is reported that the study was carried out with patients at a hospital specializing in HIV treatment. It is reported that 16 young people volunteered to take part in the study. How did this happen? How did they find out about the study and why did they volunteer? Was there prior knowledge between the interviewer and the participants? Were there refusals to participate?

It is said that the interviews followed a semi-structured script, however the content of that script was not presented. It is said initially that the interviews were collected by the principal investigator and then that the interviewer was young like the interviewees, which is inconsistent with the initial information. After all, is the principal investigator as young as the participants? Were all interviews conducted by the same investigator?

It is said that facial expressions and other non-verbal manifestations were noted, however, nothing is said in the results about this.

In the results, the sociodemographic data were not associated with any category, therefore, they do not contribute anything to the study. Also, nothing was informed about participants’ social and economic status. There was no questioning regarding the participant's gender, education, family composition or religion, data that were cited. For example, were there any differences between the experiences of boys and girls? And among those who had family support or not? Were there differences according to education?

In the discussion there is an excerpt on page 20, in the second line of the second paragraph, that young people acquired HIV from their parents or the community in general. So, can vertical transmission come from the community at large? On the same page 20, in the sixth and seventh lines of the third paragraph, an unsupported statement by the results is made: “The reasons for the girls who have unsafe sex with both seropositive and negative partners was mainly love and keeping the feelings of their partners ”.

Reviewer #2: Thank you for the opportunity to review this great work! I appreciated learning more about young people's experiences in Ethiopia.

Although I believe this work is important, there are several items which should be addressed, which prevented me from recommending it for publication.

I've provided my specific comments below:

Please review the spelling, grammar, and word choice in the manuscript. I acknowledge that this is a difficult ask, but some grammar issues interfered with the ability to understand the writing (e.g. the way perinatal was described, the use of don't rather than do not, the term "youth" inconsistently).

I would have appreciated understanding more about the semi-structured guide and the phenomenological approach was applied. This should be described in more detail in the methods. It would be useful to have some theory or frame work for this qualitative analysis.

Similarly, the organization of results should be summarized more concisely. I would recommend moving the quotes into a table and using the results to provide themes/major categories. The results of the study are not clear to me, because each section included only one quote and it wasn't clear to me if these quotes/themes showed up often in the interviews.

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Reviewer #1: No

Reviewer #2: No

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“I want to perform and succeed more than those who are HIV-seronegative ” Lived Experiences of youth who acquired HIV Perinetally and attend Zewditu Memorial Hospital ART clinic, Addis Ababa, Ethiopia.

PONE-D-20-23565R1

Dear Dr. Solomon

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.

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Kind regards,

STELLA REGINA STELLA TAQUETTE, Ph.D.

Guest Editor

PLOS ONE

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