Reviewer’s report
Title: 
Commercial sex work among university students: A case study of four public universities in Ghana
Version: 
1 
Date: 
01 Jan 2021
Reviewer's report:
I will like to commend the authors for investigating this sensitive topic. Findings have very important
implications for public health. Here are some suggestions to strengthen the paper.
Study setting
Page 4, Line 25 study setting: Since this is for an international audience, please provide some contextual
information about the four selected cities/towns. 
Page 4, Line 30-37 study setting: I am not sure how being the oldest, more renowned and largest by
student population suggests homogeneity. The authors should consider removing the rationale provided
for the selection of those universities (in those cities). This phrase: "and therefore chosen for the study to
ensure that the lifestyle, religion, cultural, and traditional backgrounds of the respondents are relatively
homogenous". 
First, longevity of a university does not evidence a necessary correlation with the lifestyle of students.
Unless the study is establishing the selected universities engenders those lifestyles. Second the authors are
somewhat suggesting the lifestyles mentioned are prevalent across the student population there. If this was
the case, this must be quickly acknowledged at the outset of the research.
Third, still on homogenization, the study is also extending the lifestyles even beyond the student body in
question to the society itself. Were it to be true, then there will be no need to select these universities in
the first place.
Sampling
Page 4, Line 48: consider replacing the slang "joint" with "location". Also in line 9 of the Results section.
Data collection procedure:
Page 5, Line 40: "In-depth Interview "- should not be capitalized
Page 5, Line 43: Should be GHS20. Also provide USD equivalent so that this is more informative for
international audience
Ethical consideration
Page 6-7, Last two sentences are not necessary. The authors should consider deleting it.
Results
Page 7, Subheading: "Characteristics"- The "c" should not be capitalized. The "t" in "Table 1" should be
capitalized.
Discussion
Page 14, Line 38 (2nd paragraph of discussion section): I believe the correct word is 'predominant' not
predominate.
Second paragraph of the discussion section should be deleted. This information is already presented in the
results section
Page 16, Line 43-51 (7th paragraph of the discussion section): This section is confusing. Not clear what
the argument is. Consider revising this part to improve clarity
List of Abbreviations
Please review the abbreviation list to ensure all abbreviations in the manuscript are captured in the list and
those not mentioned are excluded.
General
Check the manuscript for inconsistent/wrong capitalization of "u" in university, "P" in prostitution or
prostitute.
The "t" in Tables 1, 2 or 3 throughout the manuscript should be capitalized.
The authors should consider including limitations of the study
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 publish my name with my report.
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?
Yes
Is the presentation of the work clear?
Yes
Are the images in this manuscript (including electrophoretic gels and blots) free from apparent
manipulation?
Yes