Trends, and patterns, of premarital sexual intercourse and its associated factors among never-married young women aged 15–24 in Sierra Leone

Augustus Osborne; Castro Ayebeng; Peter Bai James; Camilla Bangura; Richard Gyan Aboagye; Bright Opoku Ahinkorah

doi:10.1371/journal.pone.0309200

Peer Review History

Original SubmissionMarch 20, 2024
4 Jul 2024 Decision Letter - Matt A Price, Editor PONE-D-24-11274Trends, patterns, and associations of premarital sexual intercourse among never-married young women aged 15-24 in Sierra Leone.PLOS ONE Dear Dr. Osborne, 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. The comments from the reviewers, one of which was me, are below. Please submit your revised manuscript by Aug 18 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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The PLOS ONE style templates can be found at https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf 2. Your ethics statement should only appear in the Methods section of your manuscript. If your ethics statement is written in any section besides the Methods, please move it to the Methods section and delete it from any other section. Please ensure that your ethics statement is included in your manuscript, as the ethics statement entered into the online submission form will not be published alongside your manuscript. 3. 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 If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references.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 If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. Additional Editor Comments: Abstract, conclusion: I’m not sure how “Implementing collaborative endeavours to enhance young women's financial empowerment is imperative.” Follows from your results. Please clarify, or consider removing or modifying this statement Lines 118+: You’re very explicit about how you create this variable, which is good – but please confirm that those who report sex, reported it before marriage (premarital, right?). Do you have date of marriage, or some other means to confirm they report sex prior to marriage? I imagine some report having had sex, but also after they got married Line 168: you note that the prevalence of PSI increased “significantly”. How do you define “significantly”? This is typically accompanied by some statistical test result, but perhaps you could clarify. Line 321: I don’t think “mitigate” is the right word here, I think you mean to say something along the lines of making PSI as safe and fulfilling as possible. Mitigate implies PSI is a problem, which I don’t think is your point. [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 ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: 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 ****** 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 ****** 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: Overall, this paper is well written and well organized with appropriate statistical analyses. My main critique is that more should be said about why repeated cross-sectional analyses are important to examine PSI rates, from a conceptual perspective. Do the authors believe that there are some societal drivers that influence change over time in these rates? I am also curious to understand why rates differ by District. Are these differences constant over time? In the Discussion, the authors state that more research is needed to understand these differences, but can you provide a speculation? For example, might cultural differences explain some of this variation? Otherwise this is a solid study. More minor recommendations are as follows: Line 100 - are there more recent population estimates for the country than 2015? Line 103 - I believe "Creole" should be "Krio". Lines 184-188 - What is the comparison group for media exposure? Line 224 - In Table 2, the ordering of the model results is not what I expected. It would make more sense to include all covariates in Model 1 into Model 2, and then likewise into Model 3. This is my understanding of how hierarchical models are presented. ****** 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 ******** [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. 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Revision 1
16 Jul 2024 Author Response The Editor PLOS ONE 15th July 2024 Ref: PONE-D-24-11274 Title: Trends, patterns, and associations of premarital sexual intercourse among never-married young women aged 15-24 in Sierra Leone. Response to Reviewers' comments Dear Sir/Madam, We want to express our sincere thanks for painstakingly reviewing our manuscript and providing valuable comments and suggestions. Please see our point-by-point response to the reviewers' comments and suggestions. Revisions are highlighted in blue in the revised manuscript. RESPONSE TO REVIEWERS Reviewer Comments: 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf Response: Thank you. We have done so. 2. Your ethics statement should only appear in the Methods section of your manuscript. If your ethics statement is written in any section besides the Methods, please move it to the Methods section and delete it from any other section. Please ensure that your ethics statement is included in your manuscript, as the ethics statement entered into the online submission form will not be published alongside your manuscript. Response: Thank you. We have done so in the manuscript. 3. 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. Response: Thank you. We have checked our references and are complete and there are no retracted references on the list. Additional Editor Comments: Abstract, conclusion: I’m not sure how “Implementing collaborative endeavours to enhance young women's financial empowerment is imperative.” Follows from your results. Please clarify, or consider removing or modifying this statement Response: Thank you. We have removed it from our manuscript. Lines 118+: You’re very explicit about how you create this variable, which is good – but please confirm that those who report sex, reported it before marriage (premarital, right?). Do you have date of marriage, or some other means to confirm they report sex prior to marriage? I imagine some report having had sex, but also after they got married Response: Please, be informed that the analytical sample was restricted to never-married young women. Kindly refer to the topic. Line 168: you note that the prevalence of PSI increased “significantly”. How do you define “significantly”? This is typically accompanied by some statistical test result, but perhaps you could clarify. Response: Thank you. We have removed significantly from that sentence in our manuscript. Line 321: I don’t think “mitigate” is the right word here, I think you mean to say something along the lines of making PSI as safe and fulfilling as possible. Mitigate implies PSI is a problem, which I don’t think is your point. Response: Thank you. It now reads as therefore, programs to make PSI safe and fulfilling as possible among young women should carefully consider these factors. Reviewer #1: Overall, this paper is well written and well organized with appropriate statistical analyses. My main critique is that more should be said about why repeated cross-sectional analyses are important to examine PSI rates, from a conceptual perspective. Do the authors believe that there are some societal drivers that influence change over time in these rates? Response: Thank you for your comment. By comparing data across multiple periods, we aimed to discern whether observed changes in PSI are consistent or transient, thus providing more robust insights into the dynamics of premarital sexual intercourse. Additionally, repeated cross-sectional studies help account for variations in demographic factors, ensuring that findings are representative and generalizable to the broader population. I am also curious to understand why rates differ by District. Are these differences constant over time? In the Discussion, the authors state that more research is needed to understand these differences, but can you provide a speculation? For example, might cultural differences explain some of this variation? Otherwise this is a solid study. More minor recommendations are as follows: Response: Thank you. We have now added that cultural attitudes towards sex, relationships, and gender roles can vary significantly across regions. Some regions might be more conservative, leading to less open communication about sex and sexuality, potentially affecting PSI rates[42]. Regional disparities in poverty, education levels, access to healthcare and family planning services could all influence PSI rates. Lower socioeconomic status might be linked to higher rates of PSI due to limited access to contraception or education[43]. Line 100 - are there more recent population estimates for the country than 2015? Response: Thank you. We have provided a more recent population estimate in the manuscript. In 2024, Sierra Leone's population stands at 8,977,972, reflecting a 2.13% growth compared to the previous year[21]. Line 103 - I believe "Creole" should be "Krio". Response: Thank you. Both is fine but we have changed it to Krio. Lines 184-188 - What is the comparison group for media exposure? Response: The comparison group is “those who were not exposed” as highlighted in line_187. Thank you. Line 224 - In Table 2, the ordering of the model results is not what I expected. It would make more sense to include all covariates in Model 1 into Model 2, and then likewise into Model 3. This is my understanding of how hierarchical models are presented. Response: We acknowledge your concern; however, this step-by-step approach allows for a comprehensive understanding of how different sets of variables (individual-level and contextual level factors) impact the outcome, leading to a robust and well-validated final model. Kindly refer to a similar approach in other publications below: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0297021 https://www.tandfonline.com/doi/abs/10.1080/23251042.2016.1197355 Etc. We hope that we have adequately addressed the reviewers' comments, and we look forward to receiving a favorable outcome on our paper. Yours Sincerely, Augustus Osborne Corresponding Author Attachments Attachment Submitted filename: Response to Reviewers.docx https://doi.org/10.1371/journal.pone.0309200.r002
8 Aug 2024 Decision Letter - Matt A Price, Editor Trends, patterns, and associations of premarital sexual intercourse among never-married young women aged 15-24 in Sierra Leone PONE-D-24-11274R1 Dear Dr. Osborne, 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, Matt A Price Academic Editor PLOS ONE Additional Editor Comments (optional): The reviewers' concerns have been addressed. Thank you. Reviewers' comments: https://doi.org/10.1371/journal.pone.0309200.r003
Formally Accepted
13 Aug 2024 Acceptance Letter - Matt A Price, Editor PONE-D-24-11274R1 PLOS ONE Dear Dr. Osborne, 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 Dr. Matt A Price Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0309200.r004

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