PONE-D-21-30256Sexual health behavior, health status, and knowledge among queer womxn and trans men in Kenya: an online cross-sectional studyPLOS ONE

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Reviewer #1: Yes

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Reviewer #1: Yes

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Reviewer #1: Haase and colleagues reported on sexual health behavior, health status, and knowledge among queer womxn and trans men in Kenya (n=335), through an online survey shared by whatsapp by influencers of the community. The manuscript is overall clear and well written. Methods are sufficiently sound. The topic is interesting, especially considering the inclusion of an understudied population in Africa and the fact that Kenya's Penal Code still criminalizes consensual same-sex activities. I only have some minor comments to the authors.

In the introduction, when referring to the healthcare impact of queer womxn and trans men, authors might want to refer to queer womxn and trans men, showing that sexual orientation actually affects healthcare resource utilization and health status also in countries not criminalizing consensual same-sex activities. As such, this study is also relevant in terms of cultural change.

Table 3. Could you please add percent of participants in the new grouping column?

By any chance, have authors investigated race/ethnicity of participants?

“The majority, 69.3% (n=232), had never used any form of contraception”. Do you have any corresponding figure from the general population in Kenya?

I really liked the use of community influencers for sharing the survey in a country that criminalizes consensual same-sex activities. While I agree influencers play a very important part in communities for sharing reliable information (e.g., 10.1016/j.msard.2018.07.046), I also believe this should be discussed among limitations with the inclusion of a subset of the queer womxn and trans men community (e.g., in-closeted people do not belonging to the community were not reached).

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Reviewer #1: No

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Sexual health behavior, health status, and knowledge among queer womxn and trans men in Kenya: an online cross-sectional study

PONE-D-21-30256R1

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Kind regards,

Luigi Lavorgna

Academic Editor

PLOS ONE

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