The role of depression in secondary HIV transmission among people who inject drugs in Vietnam: A mathematical modeling analysis

Sara N. Levintow; Brian W. Pence; Teerada Sripaipan; Tran Viet Ha; Viet Anh Chu; Vu Minh Quan; Carl A. Latkin; Vivian F. Go; Kimberly A. Powers

doi:10.1371/journal.pone.0275995

Peer Review History

Original SubmissionApril 1, 2022
19 Jul 2022 Decision Letter - Hamid Sharifi, Editor PONE-D-22-09164The role of depression in HIV transmission among people who inject drugs in Vietnam: A mathematical modeling analysisPLOS ONE Dear Dr. Levintow, 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. ============================== Please revise the manuscript based on the reviewers' comments. ============================== Please submit your revised manuscript by Sep 02 2022 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. 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Additional Editor Comments: Major Revision [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 Reviewer #2: Yes Reviewer #3: Partly ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: Yes Reviewer #3: 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 Reviewer #3: 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: Yes Reviewer #3: 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: Date: June 18, 2022 Study title The role of depression in HIV transmission among people who inject drugs in Vietnam: A mathematical modeling analysis General comments This is one of the relevant literatures that presented the mathematical modelling of Bernoulli process to describe and explain the depression and secondary HIV transmission. The manuscript is well structured, narrated and put in logical order, the flow of which is easy to go through to the end. The introduction section has clearly put the gray area or the problem statement. The result section is detailed, with relevant finding addressing the objective of the study. The authors have summarized the finding, showed the relevance of the finding to HIV prevention and control policy suggestions. The persisted gray area and the study limitations were also well explained and justified for the future investigation. The Specific comments The authors might consider the following items to further improve the manuscript 1. It seems that the mainstay of HIV transmission in Vietnam is among people who inject drugs. However, the main ways of HIV transmission could be presented in introduction/method section objectively, so that the reader could easily understand which section of population are at risk for HIV, and then the significant of the modelling could be justified. 2. The key modelling finding, and discussion was about depression and secondary HIV transmission which might be reflected in the title and objective of the study. 3. There seem old references (older than 2005). The authors are advised to look for recent references and replace with the recent relevant evidence. Reviewer #2: This is an interesting article with very important implications. It is important to evaluate the psychosocial factors influencing behavior and this was very clear as to the conclusions and implications. I am not sophisticated to judge the modeling but will assume it was done properly. Reviewer #3: This paper is on an important subject that correlates PWID, depression and HIV infection risk. The association of PWID and the risk for secondary transmission of HIV seem adequately addressed by modelling. However, the role of depression as a variable was not thoroughly investigated to answer the following questions: 1. What is the prevalence of depression in PWID compared with the other drug users and general population? 2. Were robust measurement parameters used to ascertain the depression status of the recruited participants? 3. Were confounders/effect modifiers considered in associating depression among PWID with the risk of secondary HIV transmission Following these responses, bring out a clear take home message from the study, that address how the limitations of the model affect the conclusions ****** 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: Yes: Richard Elion Reviewer #3: Yes: dumiwaboka@gmail.com ******** [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. https://doi.org/10.1371/journal.pone.0275995.r001
Revision 1
23 Aug 2022 Author Response Response to Reviewers Reviewer 1 This is one of the relevant literatures that presented the mathematical modelling of Bernoulli process to describe and explain the depression and secondary HIV transmission. The manuscript is well structured, narrated and put in logical order, the flow of which is easy to go through to the end. The introduction section has clearly put the gray area or the problem statement. The result section is detailed, with relevant finding addressing the objective of the study. The authors have summarized the finding, showed the relevance of the finding to HIV prevention and control policy suggestions. The persisted gray area and the study limitations were also well explained and justified for the future investigation. The specific comments the authors might consider the following items to further improve the manuscript. 1. It seems that the mainstay of HIV transmission in Vietnam is among people who inject drugs. However, the main ways of HIV transmission could be presented in introduction/method section objectively, so that the reader could easily understand which section of population are at risk for HIV, and then the significant of the modelling could be justified. Response: We appreciate this suggestion from the reviewer and have revised the first paragraph of the Introduction to provide greater context for the modes of HIV transmission. This text now states: “Sharing drug preparation and injection equipment is one of the most efficient means of HIV transmission, enabling bodily fluids from a person with HIV to directly enter an injecting partner’s bloodstream (1,2). Globally, the estimated prevalence of HIV among people who inject drugs (PWID) is 18% (3), and injection drug use accounts for nearly one-third of incident HIV infections outside of sub-Saharan Africa (4,5).” 2. The key modelling finding, and discussion was about depression and secondary HIV transmission which might be reflected in the title and objective of the study. Response: We updated the title to specify “secondary” HIV transmission, and we revised the objective statement in the abstract: “Using mathematical modeling, we sought to estimate secondary HIV transmissions and identify differences by depression among PWID.” We also clarified this objective in the first sentence of the last paragraph of the Introduction: “In this study, we use mathematical modeling to: 1) estimate secondary HIV transmission events from PWID living with HIV to their potentially susceptible injecting partners, and 2) examine differences in transmissions by depression status.” 3. There seem old references (older than 2005). The authors are advised to look for recent references and replace with the recent relevant evidence. Response: We closely reviewed the references but found that the majority represent recent evidence on the HIV epidemic among PWID from the last 5-10 years. Only 4 of 60 references are older than 2005, and all 4 correspond to foundational work for the development of the methods used in this study. Radloff 1977 evaluated the psychometric properties of the CES-D for depression screening, and we include citations to more recent studies validating and applying the CES-D in Vietnamese populations (Thai et al. 2016, Huynh et al. 2017). Pinkerton & Abramson 1993 and Rottingen et al. 2002 developed the Bernoulli modeling methodology, and we also cite more recent studies using these models (Pearson et al. 2007, Fox et al. 2011, Adams et al. 2013, Kroon et al. 2017). Rubin 1987 developed the multiple imputation methodology, and we include a citation to more recent work programming these methods into statistical software (van Buuren & Groothuis-Oudshoorn 2011). Reviewer 2 This is an interesting article with very important implications. It is important to evaluate the psychosocial factors influencing behavior and this was very clear as to the conclusions and implications. I am not sophisticated to judge the modeling but will assume it was done properly. Response: We thank the reviewer for positive feedback on our manuscript. Reviewer 3 This paper is on an important subject that correlates PWID, depression and HIV infection risk. The association of PWID and the risk for secondary transmission of HIV seem adequately addressed by modelling. However, the role of depression as a variable was not thoroughly investigated to answer the following questions: 1. What is the prevalence of depression in PWID compared with the other drug users and general population? Response: We added greater background to the second paragraph of the Introduction on the prevalence of depression among PWID and in other populations. This text reads: “Depression prevalence estimates among PWID range from 29% to 75% (14–18), considerably higher than pooled prevalence estimates of 13%-24% in other populations with HIV (19) and global estimates that 4.4% of the world’s population experiences depression (20).” 2. Were robust measurement parameters used to ascertain the depression status of the recruited participants? Response: We expanded on the description of the psychometric properties of Center for Epidemiologic Studies Depression Scale (CES-D) in the Measures subsection of the Methods: “The questionnaire also assessed depressive symptoms in the past week with the Center for Epidemiologic Studies Depression Scale (CES-D), a measurement tool that has been widely used in populations with drug use (15,33–35) and shown to have strong reliability and validity in a similar study population in Vietnam (36). Although not a clinical diagnostic, the CES-D has good sensitivity and specificity for detecting depression in the general population and among patients with comorbid chronic illness, such as HIV (18,36–38).” 3. Were confounders/effect modifiers considered in associating depression among PWID with the risk of secondary HIV transmission? Response: We appreciate the reviewer bringing up these methodological considerations, which we have now described as a limitation of our study in the Discussion: “Our mathematical modeling approach enabled the integration of behavioral and biological mechanisms to estimate HIV transmissions according to depression status, but we did not conduct a formal causal analysis with consideration of potential confounders or effect measure modifiers.” Given this study limitation, we also toned down some of the language in the Discussion paragraph on future research directions. Modeled interventions on depression would be hypothetical and could potentially reduce expected transmissions under certain assumptions, now described in the text: “Future mathematical models could investigate the extent to which successful depression treatment might reduce continued HIV incidence, assuming that decreasing the severity of symptoms to mild or none through treatment would translate to the lower transmissions predicted for those groups in our study.” Attachments Attachment Submitted filename: Response to Reviewers.docx https://doi.org/10.1371/journal.pone.0275995.r002
27 Sep 2022 Decision Letter - Hamid Sharifi, Editor The role of depression in secondary HIV transmission among people who inject drugs in Vietnam: A mathematical modeling analysis PONE-D-22-09164R1 Dear Dr. Levintow 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, Hamid Sharifi 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 #2: All comments have been addressed ******** 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 #2: Yes ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #2: 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 #2: 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 #2: 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 #2: excellent work, i have no further comments. This work raises an excellent point of the syndemic of psychological state and risk management. ****** 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 #2: No ******** https://doi.org/10.1371/journal.pone.0275995.r003
Formally Accepted
4 Oct 2022 Acceptance Letter - Hamid Sharifi, Editor PONE-D-22-09164R1 The role of depression in secondary HIV transmission among people who inject drugs in Vietnam: A mathematical modeling analysis Dear Dr. Levintow: 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. Hamid Sharifi Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0275995.r004

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