PONE-D-22-35584The unmet mental health needs of adolescents living with HIV in Eastern Tanzania: Experience of healthcare providers, adolescents, and caregiversPLOS ONE

Dear Ms. Tasiana

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.

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Yared Abayneh Reta, MSC in ICCMH

Academic Editor

PLOS ONE

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Additional Editor Comments:

Dear Author, I would like to apologize for the delay in the review process. Finding reviewers has been quite difficult. Please read the review comments carefully and remember to respond to each remark and question point-by-point.

As part of your revised paper, kindly include the following:

- Include any set criteria's to include or exclude interviewees.

- Clearly put your objectives

- Specify which model of phenomenological qualitative study approach was employed

- Explain how you managed bias (did you use bracketing?)

- Since your research is qualitative, try replacing terms such as "high level of unmet..." with equivalent qualitative vocabulary.

Regards,

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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: I Don't Know

Reviewer #2: I Don't Know

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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?

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: No

Reviewer #2: Yes

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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 authors are to be congratulated for considering this important subject. Unmet mental health needs is the challenging problem not only in people living with HIV but also in the general population especially in low-income countries.

Please address the following issues regarding your manuscript.

1. The background of your manuscript needs rewriting. Because adolescents with HIV are not only risk for depression but they are also vulnerable for psychosis, mood spectrum disorder etc. Make it more inclusive.

2. You use purposive sampling approach to recruit the participants. Which type of purposive sampling you used? Specify it?

3. Since you have used human participants, instead of saying NA, you have to state the ethics statement from the online submission of your manuscript.

4. In your data availability statement, you have stated that all relevant data are with in the manuscript and its supporting information but your manuscript lacks supporting information. Please include the supporting information in your manuscript.

5. Please include a caption for table 1.

6. I note you have included a table to which you do not refer in the text of your manuscript. Please ensure that you refer to table 1 in your text.

7. Other problems are minor. The paper could be improved grammatically by using a native English speaker and lack of publication information for reference number 32.

Reviewer #2: 1. Why ethical review board of AAU needed? since the study was in Tanzania ? justify

2. It is interesting finding but would have sounded better if you had mixed with quantitative study design

3.Why only depression symptoms experienced ? why not psychotic symptoms ?or anxiety , how about substance use disorder

and related mental illness ??

4.samplze size did not look based on saturation , if so how did it happened to be equal among each participants ? by change ?justify

5.I believe that not having quantitative should be limitation of your study , you may do this as limitation

6.I recommend to to attach your questionnaires as annex ,others may refer it when needed.

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Reviewer #1: Yes: Agmas Wassie Abate

Reviewer #2: Yes: Yacob Abraham Borie

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The unmet mental health needs of adolescents with HIV in Eastern Tanzania: Experience of healthcare providers, adolescents, and caregivers

PONE-D-22-35584R1

Dear Mrs. Tasiana

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.

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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,

Yared Abayneh Reta, MSC in ICCMH

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Dear Authors,

As the Academic Editor, I apologize for the delay in the review of your manuscript. Finding suitable reviewers was quite challenging, and I appreciate your patience and understanding during this time. Please review the manuscript for any final comments before submission.

Thank you for your cooperation and patience.

Best regards,

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

Reviewer #3: All comments have been addressed

Reviewer #4: 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 #2: Yes

Reviewer #3: Yes

Reviewer #4: Yes

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

Reviewer #2: I Don't Know

Reviewer #3: Yes

Reviewer #4: Yes

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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

Reviewer #3: Yes

Reviewer #4: Yes

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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

Reviewer #3: Yes

Reviewer #4: Yes

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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: No comment , I am satisfied. This important for policy makers to focus on mental health issues.

It would be better if you could add quantitative parts to support your finding's figuratively. You may add or do it in future in accordance with current findings.

Reviewer #3: It would have been better if the writers change their title to “unmet mental health needs related to depression among AWHIV in eastern Tanzania:experience of adolescents, health care providers and caregivers”, to make it more specific and to avoid any confusion while reading the paper for the readers.

Reviewer #4: I would like to thank the authors for their nice work as well as for incorporating the feedback into the first version of the manuscript.

I would also like to appreciate the constructive comments of the previous reviewers.

For the authors:

It is not clear whether the study was conducted on all the adolescents attending the HIV care and treatment centers or focused on adolescents with both disorders only (HIV and mental illness). How adolescents with HIV and mental illness are identified and accessed is not clear (if that were the case).

Adolescents who experienced symptoms of mental illness and/or suicidal wishes were not referred for further intervention for their sufferings (not stated under the ethics section).

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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 #2: Yes: Yacob Abraham Borie

Reviewer #3: No

Reviewer #4: No

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