Reviewer’s report
Title: 
“Feeling Clean”: Stigma and Intravaginal Practices among Female
Entertainment Workers in Cambodia
Version: 
2 
Date: 
01 Dec 2020
Reviewer's report:
Please include all comments for the authors in this box rather than uploading
your report as an attachment. Please only upload as attachments annotated
versions of manuscripts, graphs, supporting materials or other aspects of your
report which cannot be included in a text format.
Please overwrite this text when adding your comments to the authors.
Reviewer Comments
Manuscript: BMWH-D-20-00992
Full Title: "Feeling Clean": Stigma and Intravaginal Practices among Female
Entertainment Workers in Cambodia
Reviewer: Nicholas Israel Nii-Trebi, PhD
OBSERVATIONS, COMMENTS AND SUGGESTIONS
I have reviewed the manuscript and have made some observations and
comments for the consideration of the authors. 
Line 57: ….practice, instead of practices
Line 117: ……. FGDs and IDIs ……… I think it is necessary to write these in
full (Focus Group Discussion and In-depth interview) at first mention before
abbreviating.
Line 118: The research center of a Cambodian health organization…….. who
has been working … 
The 'center' is personalized used as subject here and it does not sound correct.
Please reconsider and correct.
Line 131: debriefed. I am wondering why this should not be 'debriefing'. Please
reconsider and/or revise the construction to make the thought clearer.
Line 144/5: The project coordinator oversaw the implementation of the tools and
coordinated of transcribers and translators to meet tight deadlines.
Did the project coordinator coordinate the transcribers and translators (which
does not seem correct) OR he coordinated their activities (in which case the
sentence has to be reworded accordingly)? 
Line 152: …. each participant received a signed copy of the consent form. Who
signed the consent form? 
164: Please insert discussions between groups and to
166: ……..analyzed, the …… 
Please change comma (,) to full stop (.) to end that
short sentence and start a new sentence with a T in the.
Line 170: Phnom Penh and Siem Reap at venues during …… 
I think at venues is
not needed
Line 172: Questions asked about …… 
Please insert were between Questions and
asked.
Line 190: Secondary ……. 'Secondly' suggested
Line 307: The opening quotation mark is missing. Please insert.
Line 316-318: Sentence looks a bit clumsy - it lacks clarity. Please consider
rewording. If possible, put in two simple, straightforward sentences. Also,
'providers' should be qualified. Does this refer to health care providers? Is the
same referring to 'doctors' used earlier or different? Please be consistent. It is
advisable the same terminology is used if the intent or reference is the same and
within the same context.
Line 373/374: Theme of stigma. I do not see any stigma issue presented here. Is
Promotion of hygiene and prevention of infection an issue of stigma? Please
come out clear and let the finding speak for itself. Otherwise please delete the
second sentence in line 373.
Line 420: It is not convincing how these constitute stigma. In any case, is that the
perception of the doctors only or also among the general population?
Line 439: ….internalized or internal? Please be consistent
Line 442: It is not clear what purpose the square brackets are serving. In this
particular case the sentence is incorrect and meaningless without the words in the
square bracket. Please either remove the square bracket or reword to make
meaning whether with or without the brackets. The same should be ensured in all
cases in which the square bracket has been used.
Lines 433-435: Sentence is incomplete
Line 453: '….those who do not ……were ……' should rather read 'one who does
not …….. was'
Line 466: …IVP cessation intervention among ….. 
cessation of what?
Line 467: ….decrease in some vaginal bacteria such as vaginal candidiasis after
…. 
This is not correct for two reasons - (1) candidiasis is not an organism, to be
stated as an example of a bacterium. It is a disease condition or infection; (2) as
a disease condition, it is caused by a yeast (a type of fungus) called Candida
(normally Candida albicans). Please correct.
Lines 466-471: It does not seem reasonable to compare different pathogens
(fungal and viral) infections in different populations (in different continents) as a
function of to assess outcome of a common practice (IVP). Tissue affinities for
these pathogens are not the same. Please consider comparing similar classes of
organisms (whether bacteria, viruses, fungi, etc) and in comparable populations
for a defined effect.
Lines 474-478: Please rewrite this in a clearer, better punctuated (if needed)
sentences. Besides, the word 'portending' as used in line 477 does not seem
appropriated. Kindly consider revising.
Line 482: Sentence beginning with 'In our study, we found that ……
Is this not over generalization?
Line 494: …. as none such exist. 
Can this be put in another, better way? None in existence, say. Or, insert 'of'
between none and such.
Line 499: …. IVPs are widely practiced …. 
Where please? Please specify. 
Additionally,
1. Leave space after each paragraph before a next sub-heading. Egs. Lines
131/132; 141/142; etc.
2. In the conclusion section the authors mentioned a 'harm reduction approach",
which was neither discussed/explained nor mentioned anywhere in the text of the
manuscript. One would wonder what that approach entails and so it will be
helpful that the authors more appropriately engage this term in a manner that
makes it clear to readers what it is about or what it means. 
3. Practically, how were data transcription and translation done?
Publons Reviewer Recognition
. Springer Nature can send verification of this
review directly to Publons (a subsidiary of Clarivate Analytics). If you would
like to take advantage of this service, please click on the “Yes” option below.
Your name, email address, title of the reviewed manuscript, name of the journal,
and date of your review submission (the “Review Data”) will then be transmitted
to Publons after the final decision on the manuscript has been made. If you have
already registered at Publons, they will notify you of the receipt of this review
and update your profile 
as per your settings and their policy. If you are not
registered with Publons, you will receive an email from them asking you to
register in order for them to be able to recognize your review on your new
profile page. Publons may use the Review Data to generate derivative metadata
for the benefit of Publons and you as a reviewer, carefully considering the
sensitivity of such information. For example, Publons may verify your record as
a reviewer by updating your profile published on its webservice if you have
registered for such service or help editors to identify candidate reviewers. Please
find the details of processing in Publons’ privacy policy
https://publons.com/about/terms
Yes
Declaration of competing interests
Please complete a declaration of competing interests, considering the following
questions:
1
. 
Have you in the past five years received reimbursements, fees, funding, or
salary from an organisation that may in any way gain or lose financially
from the publication of this manuscript, either now or in the future?
2
. 
Do you hold any stocks or shares in an organisation that may in any way
gain or lose financially from the publication of this manuscript, either now
or in the future?
3
. 
Do you hold or are you currently applying for any patents relating to the
content of the manuscript?
4
. 
Have you received reimbursements, fees, funding, or salary from an
organization that holds or has applied for patents relating to the content of
the manuscript?
5
. 
Do you have any other financial competing interests?
6
. 
Do you have any non-financial competing interests in relation to this
paper?
If you can answer no to all of the above, write 'I declare that I have no competing
interests' below. If your reply is yes to any, please give details below.
I declare that I have no competing interests
Reviewer Publication Consent.
 I agree for my report to be made available
under an Open Access Creative Commons CC-BY License (
http://creativecommons.org/licenses/by/4.0
) if this manuscript is accepted for
publication. Any comments that I do not wish to be included in the published
report have been included as confidential comments to the editor, which will not
be published.
If you are not happy for us to publish this report, please contact the editorial
office before completing the review.
If you wish, you can include your name in your published report. Please note
you must decide whether to include your name at the start of the process and
confirm this decision whenever prompted. If you change your decision later, we
will not be able to publish your name.
I agree to the terms of the CC-BY 4.0 license; please 
do not
 publish my name
with my report. (default)
Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
Yes
Are the methods sufficiently described to allow the study to be repeated?
Yes
Is the use of statistics and treatment of uncertainties appropriate?
No
Is the presentation of the work clear?
Yes
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
No