Factors influencing early sexual initiation among hill tribe youths in Chiang Rai Province, Northern Thailand: A community-based cross-sectional study

Ratipark Tamornpark; Tawatchai Apidechkul; Panupong Upala; Chalitar Chomchoei; Fartima Yeemard

doi:10.1371/journal.pone.0321083

Peer Review History

Original SubmissionOctober 31, 2023
31 Oct 2023 Author Response Attachments Attachment Submitted filename: Response to editor and reviewers_PONE-D-20-21332.docx https://doi.org/10.1371/journal.pone.0321083.r001
20 Mar 2024 Decision Letter - George Kuryan, Editor PONE-D-23-33898Influencing factors early sexual initiation among hill tribe youths in northern ThailandPLOS ONE %LAST_Dear Dr. Apidechkul, 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 submit your revised manuscript by May 04 2024 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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Please note that Supporting Information files do not need this step. Attachments Attachment Submitted filename: PLOS ONE_early sexual initiation.docx https://doi.org/10.1371/journal.pone.0321083.r002
Revision 1
20 Apr 2024 Author Response Repose to reviewers and editor comments Dear Editor of Ploseone, Thank you very much or the opportunity to improve our paper with excellent comments from reviewer. We have carefully revised by re-analysis in the whole process based in the conditions suggested by reviewers. TK PONE-D-23-33898 Influencing factors early sexual initiation among hill tribe youths in northern Thailand PLOS ONE Dear Editor, Thank you very much for opportunity to review the manuscript titled " Influencing factors early sexual initiation among hill tribe youths in northern Thailand" for PLOS ONE. I think that some aspects of this manuscript are interesting. I believe that some major changes are required. Below are my comments about this manuscript, which I hope are some assistances to the authors. 1.The title, author should be specific “in Chiang Rai province”? not representative in northern of Thailand, and may considering add approach “: community based cross sectional approach” : Thank you, it’s improved 2.An abstract - Author conclusions “A large proportion of the hill tribe youths have experienced early sexual initiation before the age of 15 years. A specific training program should be integrated into the high school study curriculum to protect early sexual initiation behaviors and safe sex, particularly in males. The curriculum should focus on the impact of alcohol and working in unskilled work sectors and potentially early sexual initiation. As the result based author may conclude in community or family based intervention, attitude come from socialization in family….etc. Thailand has a sexual education curriculum at all level in school. : Thank you for the comment. We know that Thailand has a curriculum at all school levels, but we intend to add an extra and special curriculum. You said that it exists at all levels, but according to the findings of our program, those people still lack skills and knowledge in safe sex. This is the reason that we put this statement together. We apologize if this makes you confused. : We also agree with you to add family and community levels, which we have added information in the section. 2. Methodology, - page 5 line 25-27 author mention that “In the section on knowledge of safe sex (10 items), there were classified into three categories; poor (0-5 scored), moderate (6-8 scored), and good (9-10 scored).” It is knowledge about HIV transmission (not safe sex). Please clearly how scoring and range of score and cutting point? Including reference? : This category is formed by the findings from our previous study in Ref. No.23 and also on our pilot phase. It’s improved. -Substance use question between Thai and English inconsistent. The answer means? Current use? Ever but quit? Never or ever tried? Please clearly explain at variable section. What yes? : Thank you for the comment. Based on our developed initial questionnaire, three answers to these questions were provided. However, after piloting, two options were found: better validity and reliability. Then, we used two options to answer these questions. We have revised the questionnaire. Thank you so much for the great comment, which is excellent for those who will apply our original questionnaire in the future. Our update/revised questionnaires (ENG and THAI) are attached. 3. Results - Table 3 Something error? Author present variable” Alcohol or drug use prior having sexual initiation with 3 answers <no, sometime, yes> but in questionnaire part 3 item 3.9 in English and Thai language the answer only <Yes, No> : Please see our response in your previous comment. - Table 1 and 2 author should present as below characteristics Total Early sexual initiation Never had sexual experience � 2 p-value Yes (<14) No (�15) n % n % n % n % : Thank you so much for your great comment, we agreed with you and have carefully revised tables, please see our new tables 1, 2, and 4 -Table 4 Author definition “Early sexual initiation” yes= age at first sexual initiation <14 and No= age at first sexual initiation �15 including never had sexual experience. Author should exclude never had sexual experience or use as reference. : We thank you so much for such great suggestion!. We have re-run the model by comparing those who had sexual before and after 15 years by excluding those who did not have sexual experience from the model. Please see detail in table 4. The new model really reflects the objective of the study. 4. Discussion Page 15-line 16-18 Author discuss that “The hill tribe youths have a younger age of their first sexual initiation than Thai youths which might be the culture of the hill tribe that needs to get married early to have a child for help in their family work.” Is it culture issue? Economic or occupational Issue? Author should explain how culture difference from hill tribe and general youths. : Thank you for your feedback. It’s added the culture issue on page 19-line 9-20. Thank you so much, TK Associate Prof. Dr. Tawatchai Apidechkul, MSc (Infectious Epidemiology), Dr.P.H. (Epidemiology) School of Health Science, Mae Fah Luang Univeristy, Thailand Director, Center of Excellence of Hill Tribe Health Research Former Hubert H Humphrey Fellow (2013-2014), Emory University Candidate MMSc-GHD, Harvard Medical School, Harvard University, United States Attachments Attachment Submitted filename: Point-by-point response.pdf https://doi.org/10.1371/journal.pone.0321083.r003
13 Aug 2024 Decision Letter - George Kuryan, Editor PONE-D-23-33898R1Influencing factors early sexual initiation among hill tribe youths in Chiang Rai Province, northern Thailand: A community-based cross-sectional studyPLOS ONE Dear Dr. Apidechkul, 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 submit your revised manuscript by Sep 27 2024 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. Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols . Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols . We look forward to receiving your revised manuscript. Kind regards, George Kuryan Academic Editor PLOS ONE Journal Requirements: Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. [Note: HTML markup is below. Please do not edit.] 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: Reviewers’ comments Title: Influencing factors early sexual initiation among hill tribe youths in Chiang Rai Province, northern Thailand: A community-based cross-sectional study The manuscript was well-prepared. I have a few comments as follows. Abstract -The conclusion did not come from the study findings. The authors can be more specific, like suggesting what to be include in the training program (what knowledge is lacking from the results). Methods -The authors mentioned that the questionnaires were piloted in Mae Chan district. Where did the study take place? Please add in the study setting. -Please clarify about the recruitment which should happen without coercion. The authors stated that they contacted village headmen for their permission to access the villages, but how those youth was reached? As most of them were studying, were they in the village or lived somewhere outside the village for their schooling? Could any youth deny participation? Did their parents, family members, and other villagers know about their entering the study? How many of them refused to join? Any compensation to youth, their family, or villager headmen? -Please describe how youth were instructed before completing the questionnaires. Were there any specific guide written in the questionnaire or mentioned verbally, like the time frame for alcohol, smoking, and substance use (lifetime, or any specific duration to be reported), definition of sexual intercourse, etc.) Results Table 1: The column “Early sexual initiation” can list only “yes” (and add the denominator somewhere). Similarly for variables with yes/no response, presentation in the table can be only yes which would make them easier to read and reduce the table size. Discussion Page 18 line 17-18. The study found that a larger proportion of male had early sex initiation than female youth. Was it a result of reporting bias? Males perceived power over females when they initiated sex, while females might have early sex without their willingness. Thus, males were more likely to report having early sex. It might be related to patriarchy in Thai society, which could be prominent in hill tribe cultures. Just a thought, I know the authors are experts on this issue. Could the authors provide any comments or discussion on this possibility. Page 19 line 32” the term “poor education” might not appropriate and too broad, given that most participants had attended school. The authors could consider changing to other words like “limited literacy”, or “low reading ability”. ****** 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: Linda Aurpibul ******** [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.0321083.r004
Revision 2
22 Aug 2024 Author Response Response to the reviewer comment PONE-D-23-33898R1 Influencing factors early sexual initiation among hill tribe youths in Chiang Rai Province, northern Thailand: A community-based cross-sectional study PLOS ONE Dear Editor and Reviewers, Thank you very much for the opportunity to revise that paper. We have carefully and completely revised your comments. The paper also double-checked the grammatical error before re-submitting. Please kindly the following our responses. Thank you, TK +++ 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: Reviewers’ comments Title: Influencing factors early sexual initiation among hill tribe youths in Chiang Rai Province, northern Thailand: A community-based cross-sectional study The manuscript was well-prepared. I have a few comments as follows. Abstract -The conclusion did not come from the study findings. The authors can be more specific, like suggesting what to be include in the training program (what knowledge is lacking from the results). Methods : It is a sexual education focused on safe sex and early sexual interaction protection. -The authors mentioned that the questionnaires were piloted in Mae Chan district. Where did the study take place? Please add in the study setting. : Thank you. It’s added which are Huan Hin Fon and Sun Ti Suk Villages -Please clarify about the recruitment which should happen without coercion. The authors stated that they contacted village headmen for their permission to access the villages, but how those youth was reached? As most of them were studying, were they in the village or lived somewhere outside the village for their schooling? Could any youth deny participation? Did their parents, family members, and other villagers know about their entering the study? How many of them refused to join? Any compensation to youth, their family, or villager headmen? : There was nobody to refuse the participants. In the process of recruitment, after providing them with information about the study, all participants were informed that they had the right to refuse or deny joining the project as the standard protocol for human research ethical procedure. All parents were also informed about the study, and only those who had children aged less than 17 and below were asked for their permission to gather the information from the participants (youths). All participants and parents agreed and were willing to join the project. During the study, we did not have any inclusion and exclusion criteria for whether the participants were in or out of the school. All participants were compensated 200 baht ($6), which is clearly declared in the ethical consideration process. -Please describe how youth were instructed before completing the questionnaires. Were there any specific guide written in the questionnaire or mentioned verbally, like the time frame for alcohol, smoking, and substance use (lifetime, or any specific duration to be reported), definition of sexual intercourse, etc.) : Each question provided complete and clear information. We did not have any specific guide for completing the questionnaire; however, all participants were told that if there was any confusion, they could contact the researcher. Nobody asked to clear any questions. : Since we worked a cross-sectional, then the questions were asked directly with the time frame, except for some question that we had a clear its frame in the questions. Results Table 1: The column “Early sexual initiation” can list only “yes” (and add the denominator somewhere). Similarly for variables with yes/no response, presentation in the table can be only yes which would make them easier to read and reduce the table size. : Thank you for the comments; however, after discussing with the team, we decided to maintain this column and information to make it easier and quicker for the readers to go through the details. Discussion Page 18 line 17-18. The study found that a larger proportion of male had early sex initiation than female youth. Was it a result of reporting bias? Males perceived power over females when they initiated sex, while females might have early sex without their willingness. Thus, males were more likely to report having early sex. It might be related to patriarchy in Thai society, which could be prominent in hill tribe cultures. Just a thought, I know the authors are experts on this issue. Could the authors provide any comments or discussion on this possibility. : Thank you for this great idea. We had discussed this point while making the conclusion; however, with the study design, we could not extend our thoughts outside of what we found in the results. One of our team is trained in medical anthropology and is trying to work on her project to understand some critical issues from our findings, particularly gender roles and sexual inequality in some tribes. We very much hope that we will be able to publish our findings soon. Page 19 line 32” the term “poor education” might not appropriate and too broad, given that most participants had attended school. The authors could consider changing to other words like “limited literacy”, or “low reading ability”. : Thank you very much for the suggestion; we agree. It’s changed it to limited literacy. Thank you very much, TK Assoc Prof. Dr. Tawatchai Apidechkul, MSc (Infectious Epidemiology), Dr. P. H (Epidemiology) Director, Center of Excellence of Hill Tribe Health Research, School of Health Science, Mae Fah Luang University, Thailand Former Hubert H Humphrey Fellow (2013-2014), Emory University Attachments Attachment Submitted filename: Response to reviewer comment_PAM paper.pdf https://doi.org/10.1371/journal.pone.0321083.r005
29 Jan 2025 Decision Letter - Ghulam Yaseen, Editor PONE-D-23-33898R2Influencing factors early sexual initiation among hill tribe youths in Chiang Rai Province, northern Thailand: A community-based cross-sectional studyPLOS ONE Dear Dr. Apidechkul, 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 submit your revised manuscript by Mar 15 2025 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. Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols . Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols . We look forward to receiving your revised manuscript. Kind regards, Ghulam Yaseen, Ph.D. Academic Editor PLOS ONE Journal Requirements: Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. [Note: HTML markup is below. Please do not edit.] 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 ******** 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 ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #2: Yes Reviewer #3: 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 Reviewer #3: 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: No Reviewer #3: No ****** 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: Reviewers’ comments Thank you for the revised manuscript. The authors have done a great job in improving it. I have only a few comments as follows. Abstract Page 2 line #3-4: males was compared to males (one should be females?) Page 2 line# 12: impact of substance use was mentioned in the conclusion, but no information in the results of abstract to explain how they were related. I understand it later when reading results part in the main text. Could the authors add a sentence about substance use in the results to guide the readers that the conclusion did not come from nowhere? Methods Page 4 line#15: “…, it needed 1293 samples in the study” What is it refer to? Should the author modify it to something like “we needed 1293 participants in the study” Page 4 line#29: “Those questions that scored less than 0.5 were excluded.” I think it should be “less than or equal to 0.50”, isn’t it? Please recheck. Results Page 7 line # 14: It seemed like the word “difference” is missing from the 3rd paragraph. What was statistically significant is the difference, isn’t it? Please check. Page 13 line#3-4.: the percentage was different from other place (13.6% had sexual initiation before 15 years of age”, it was 9.8% elsewhere). Please recheck. Page 13 line#13-17: P-value in the text should be written only “p”, usually small p with italic. Discussion Page 17 line#21: I think it should be “Males and younger age…” not females. Page 18 line # 31-33: The sentence is confusing, please revise the language. Page 19 line# 9: the phrase “, it was found that” could be removed as it has no meaning in the sentence. Page 19 line#17-18: Please add numbers from the study finding to support the statement as the authors did in other statements. Language quality Overall, the language in this article is difficult to read, not flow while reading. I would advise the article to be edited by native English speaker for quality improvement. Reviewer #3: I can see the authors have improved previous versions of the manuscript, based on reviewers' comments. The study is of importance because there are important results that should be known in the country and other countries with similar situations. However, despite improvements, there are several places where the descriptions and language used need to be revised in order to make it clear for the reader. I have made a number of suggestions to edit the document in the attached file. Please after carrying out corrections have the document checked by someone who speaks and writes English, so it is fully edited. Thanks. ****** 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: Linda Aurpibul Reviewer #3: Yes: Dr. Alfredo L. Fort ******** [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. Attachments Attachment Submitted filename: PONE-D-23-33898_R2_AFreviewer.pdf https://doi.org/10.1371/journal.pone.0321083.r006
Revision 3
27 Feb 2025 Author Response Response to reviewer comments Reviewer #2: Reviewers’ comments Thank you for the revised manuscript. The authors have done a great job in improving it. I have only a few comments as follows. Abstract Page 2 line #3-4: males was compared to males (one should be females?) : We apologize for this mistake; it should read female. Please see line 6, page 2. Page 2 line# 12: impact of substance use was mentioned in the conclusion, but no information in the results of abstract to explain how they were related. I understand it later when reading results part in the main text. Could the authors add a sentence about substance use in the results to guide the readers that the conclusion did not come from nowhere? Methods : Thank you for this helpful comment. This occurs because the statistics are significant in the univariate analysis and chi-square test. However, in the multivariable analysis, there were no associations with early sex. Thus, we slightly extended our thoughts in the Conclusion sections. We have also added a sentence to the Abstract (page 2, lines 2-3). Page 4 line#15: “…, it needed 1293 samples in the study” What is it refer to? Should the author modify it to something like “we needed 1293 participants in the study” : Thank you; it has been revised. Please see page 4, lines 12-13. Page 4 line#29: “Those questions that scored less than 0.5 were excluded.” I think it should be “less than or equal to 0.50”, isn’t it? Please recheck. : Sorry for the mistake, it is 0.5. We have revised the sentence in the text as follows: “Those questions that scored less than 0.5 were excluded, questions that scored 0.50-0.69 were revised as comments…” Results Page 7 line # 14: It seemed like the word “difference” is missing from the 3rd paragraph. What was statistically significant is the difference, isn’t it? Please check. : Thank you; this information was added. Please see page 7, line 14. Page 13 line#3-4.: the percentage was different from other place (13.6% had sexual initiation before 15 years of age”, it was 9.8% elsewhere). Please recheck. : Thank you so much. This small error prompted us to check the entire paper. Now, all the points are correct. Page 13 line#13-17: P-value in the text should be written only “p”, usually small p with italic. Discussion Thank you for the comment. We have discussed this point, and we have to maintain its original form because two of our statisticians inform us that there is a specific requirement for the journal. However, using the full term is also common, as used in our previous papers. We hope that you understand. Page 17 line#21: I think it should be “Males and younger age…” not females. : Thank you so much for calling this to our attention; we have corrected it accordingly. Page 18 line # 31-33: The sentence is confusing, please revise the language. : Thank you for the comment. These sentences were drafted by one of our coauthors during the manuscript development. However, we forgot to include the details of the reference. Once we read the whole paragraph, it still clearly presents the information we want to present. However, we deleted the sentences from the text. Thank you so much for pointing this out. Page 19 line# 9: the phrase “, it was found that” could be removed as it has no meaning in the sentence. : Thank you; this has been deleted. Page 19 line#17-18: Please add numbers from the study finding to support the statement as the authors did in other statements. : Thank you for this helpful comment. We have added this number to the paragraph. Please see page 19, lines 16-17. Language quality Overall, the language in this article is difficult to read, not flow while reading. I would advise the article to be edited by native English speaker for quality improvement. : Thank you; the paper has been double-checked by AJE (certificate no: 2012-7831-AE6C-33FF-026E) Reviewer #3: I can see the authors have improved previous versions of the manuscript, based on reviewers' comments. The study is of importance because there are important results that should be known in the country and other countries with similar situations. However, despite improvements, there are several places where the descriptions and language used need to be revised in order to make it clear for the reader. I have made a number of suggestions to edit the document in the attached file. Please after carrying out corrections have the document checked by someone who speaks and writes English, so it is fully edited. Thanks. : Thank you. The paper has been double-checked by AJE (certificate no: 2012-7831-AE6C-33FF-026E.). 1. Check the number/information in percentage of having had sexual experience. The text has been checked and corrected; see page 1, lines 33-35. 2. Page 2, lines 27-28, delete “old; these behaviors vary in different societies frequently occur among youths [13]” : This has been deleted per your suggestion. 3. Page 3, line 1, “lived”… “live” : This has been deleted per your suggestion. 4. Page 3, lines 10, delete “the hill tribe youths who have been clearly defined as” : This has been deleted per your suggestion. 5. Page 3, delete “then” in line18 6. Many points in the whole paper, in the PDF file, are asked to improved. : All the points have been improved by AJE. TK Assoc Prof. Dr. Tawatchai Apidechkul, MSc (Infectious Epidemiology), Dr. P. H (Epidemiology) Director, Center of Excellence of Hill Tribe Health Research, School of Health Science, Mae Fah Luang University, Thailand Former Hubert H Humphrey Fellow (2013-2014), Emory University Attachments Attachment Submitted filename: Response to reviwers comments.pdf https://doi.org/10.1371/journal.pone.0321083.r007
2 Mar 2025 Decision Letter - Ghulam Yaseen, Editor Factors influencing early sexual initiation among hill tribe youths in Chiang Rai Province, northern Thailand: A community-based cross-sectional study PONE-D-23-33898R3 Dear Dr. Apidechkul, 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 will be generated when your article is formally accepted. Please note, if your institution has a publishing partnership with PLOS and your article meets the relevant criteria, all or part of your publication costs will be covered. Please make sure your user information is up-to-date by logging into Editorial Manager at Editorial Manager® and clicking the ‘Update My Information' link at the top of the page. If you have any questions relating to publication charges, 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, Ghulam Yaseen, Ph.D. Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: https://doi.org/10.1371/journal.pone.0321083.r008
Formally Accepted
Acceptance Letter - Ghulam Yaseen, Editor PONE-D-23-33898R3 PLOS ONE Dear Dr. Apidechkul, I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now being handed over to our production team. At this stage, our production department will prepare your paper for publication. This includes ensuring the following: * All references, tables, and figures are properly cited * All relevant supporting information is included in the manuscript submission, * There are no issues that prevent the paper from being properly typeset If revisions are needed, the production department will contact you directly to resolve them. If no revisions are needed, you will receive an email when the publication date has been set. At this time, we do not offer pre-publication proofs to authors during production of the accepted work. Please keep in mind that we are working through a large volume of accepted articles, so please give us a few weeks to review your paper and let you know the next and final steps. Lastly, 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 customercare@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 Professor Ghulam Yaseen Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0321083.r009

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