Title: Creating allies: qualitative exploration of young women’s preferences for PrEP methods
and parents' role in PrEP uptake and user support in urban and rural Zambia
Version: 1 Date: 28 Sep 2023
Reviewer's report:
While the authors have chosen and important and timely topic of study, PrEP platform
preferences among Zambian AGYW and their parents and the ability of those 2 groups to work
together, enthusiasm for this study was dampened by several factors.
First, the authors should consider breaking this paper up into 2. One on parents and AGYW
desires to communicate with each other and the second paper should be on PrEP knowledge
and platform preferences. Second, the paper feels like at minimum it was written by 2 different
people and the results section felt like it was written by 3 different people.  There are significant
organizational challenges with this paper as well, likely from the many voices and styles
throughout. Finally, the entire paper can be written much more succinctly.
Introduction: No major issues other than it clearly stands out that there are two major aspects to
this project that have been included in this paper making it feel clunky.
Methods:
-Description of Figure 1 makes specific mention of "transnational boundaries" but it appears
that all provinces have transnational boundaries.  More info is needed as to why inclusion of
this specific qualifier is needed for this set of provinces.
-More background information is needed for every organization mentioned throughout this
paper.  Ex. National AIDS Coucil and DREAMS. There are many organizations mentioned that
contribute to either instrument development, recruitment, or even analysis (the conference where
data was presented) and it is important for readers to know what these organizations do and who
they are comprised of (before getting to the discussion section).
-There is a sentence in the methods section talking about "site selection focused on structure
and ..."  What does "structures" mean?
-Also in the methods section you mention engaging "technical assistance project."  What does
this mean? Who is this?
-You mention administering a demographic survey and then in the results section highlight how
many people use smartphones. Please describe briefly what was included in the demographic
survey and why? Why did you ask about smartphones etc?
-Also, did AGYW have to be sexually active to participate. Studies around the country vary on
whether AGYW who are not sexually active participate.  Please specify if participants had to be
sexually active to participate and define sexual activity (e.g. in last 3 months, 6 months, ever).
- Additional descriptions are needed about the interviewers. Consider re-phrasing all of this
more succinctly.  Also, what type of "Specific training" did they receive- qualitative, culturally-
responsive?
-Reread your methods section as there are a lot of redundancies.
- Please provide citations for your rapid qualitative analysis approach
- Who was present at the stakeholder consultation because you can't say they "validated the
results" without us knowing if AGYW and parents were included in this group.
Results:
-In the methods section you mention that the goal was to have 10 FGDs per group because the
citation you provided said that would uncover 80% of potential themes. You did not mention
anything about thematic saturation, so please provide information about why the parent group
only had 7 FGDs.  Did those 7 FGDs reach thematic saturation?
- Regarding the rest of the results section, it feels like it was written by 3 people. There are 2
sections that have no quotes. There is one section that makes generalizations and provides the
number (N) of respondents that felt a specific way. The remainder of the section has quotes.
Discussion:
The first paragraph should be much more succinct and I feel part of the problem is that there is
too much data trying to be summarized here.  Most of the discussion should be focused on how
these finding compare to other studies on these topics.