PONE-D-24-43908Health worker acceptability of an HIV testing mobile health application within a rural Zambian HIV treatment programmePLOS ONE

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Reviewers' comments:

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Comments to the Author

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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

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

Reviewer #1: Yes

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Reviewer #1: Yes

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Reviewer #1: 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: Congratulations to the authors for this important piece of work. This innovation/research is very much needed to intensify HIV case finding, close the treatment gap for PLHIV and achieve epidemic control of HIV/AIDS in Zambia and other countries in sub-Saharan Africa. The mHealth application can potentially increase HIV testing coverage in Zambia and improve the efficiency of HIV testing services through hotspot mapping, real-time data collection and reporting, and HCW's performance measurement. Findings will support the design, adaptation, and scale-up of mHealth interventions in Zambia.

Comments

Abstract

- Nil

Introduction

- Line 95: UNAIDS write in full, first mention

Materials and Methods

• Since the list of study participants was first sent to facility heads for confirmation and approval to participate in surveys, IDI and FGDs, how did you address the possibility of selection and confirmation bias in your study? Facility heads may have selected ‘’best staff’’ to respond to survey and participate in interviews or FGDs

• What is the survey response rate among participants? What proportion of HIV testing healthcare workers using the mHealth application responded to the survey?

• What informed the minimum number of participants for IDI? How did you ensure data saturation?

• Considering that only participants from high-volume facilities were invited to partake in the FGDs and HIV testing managers for IDI, how did you ensure maximum variation to account for perspectives from the small facilities, probably in rural communities where there is little or no internet

o How will this intervention work in rural communities with junior healthcare workers who have less experience/education and limited internet access?

Findings

• Line 265: elaborate on the type of or unpack the resources statement 11 is referring to:’’ I have the resources necessary to use Lynx’’

• In-text table citations are incorrect for tables two to seven in the manuscript. Review all in-text citations and labelling for tables in the manuscript and ensure correct reference.

Discussion

• The authors acknowledged the capability of GIS while emphasising the usefulness of real-time data-capturing and reporting. Can authors elaborate on the production of local GIS HIV testing maps (GIS hotspots) as one of the healthcare uses, probably in their description of the intervention? Authors should elaborate on the type of geocordinates (residential or point of care/testing) collected that made GIS hotspots possible (pls note that this is optional). If only POC testing geocordinates are collected, discuss this implication for your programming from HCWs perspectives.

• Lines 423-427 and Lines 423 – 427 discuss the same theme. Understanding the different actors (for whom) and in what contextual conditions did the intervention (mHealth) work? Authors should expatiate to clarify or summarise the two paragraphs into one.

• Considering the concern about patient's negative perceptions and feelings of discomfort, future research that assesses the perception of clients/patients is needed

• Line 428 – 436: In a setting constrained by limited resources, providing mobile phones, maintaining and updating mobile applications, and building staff capacity can be challenging. Can you discuss the future of mobile health applications in Zambia in terms of scale-up and sustainability?

• What are the strengths and limitations of this study? discuss

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Reviewer #1: No

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Health worker acceptability of an HIV testing mobile health application within a rural Zambian HIV treatment programme

PONE-D-24-43908R1

Dear Dr. Montaner,

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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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 #1: 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 #1: Yes

**********

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

Reviewer #1: 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 #1: 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 #1: 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 #1: (No Response)

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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 #1: No

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