Reviewer's report
Title:Contraceptive use and Unmet need for Family Planning among HIV
Positive Women on Antiretroviral Therapy in Kumasi, Ghana
Version:1Date:30 April 2014
Reviewer: Frank Kaharuza
Reviewer's report:
• Major Compulsory Revisions
1. Background
Dual protection and dual methods for HIV infected women is a recommended
practice that should be described for this paper. This will help the readers
understand the critical role of condom use among the HIV infected individuals
and perhaps explain the high condom use
Methods
The methods section lack information on the data collected- and how it was
managed- the authors should tell us what data was collected- and how it was
manipulated
Results
Main outcome: contraceptive use: It is important to show what the contraceptive
method mix is for all the participants. Table 8 only shows the method mix for
those that no fertility desire. Unless the readers understand the method mix in
this population it will be assess contraceptive prevalence
Are the contraceptive methods used mutually exclusive. In the HIV population we
need to understand if dual methods are being used- and are they also being
promoted. The prevalence of Dual method use should also be presented if it was
collected. Figure 1 presents the distribution of methods used but it will be
important to include dual methods
Reported Partner desire for children.: The author should clarify respondent and
partner desire. There are four potential outcome: Both Partner and respondent
desire children, Partner disires respondent doesn’t, respondent desires partner
doesn’t, and both don’t desire- currently you report 53.5 respondent desire
children 54.6% partners desire children- but no information on discordant disires
Limitations
Please clarify that partner use is reported by the respondent. It is therefore
important to consider this as a limitation of the study- since condom use is
recommended in HIV positive individual and the response on condom use could
be high because of social desirability
Did the authors collect information on education? This would have been
desirable information to have since education has a role to play in uptake of
contraceptive services. If it wasn’t collected then this should be mentioned in the
limitations
Any comment on the wide confidence intervals seen in the results could be
included given the small sample size
The author must respond to these before a decision on publication can be
reached. For example, additional necessary experiments or controls, statistical
mistakes, errors in interpretation.
• Minor Essential Revisions
The author can be trusted to make these. For example, missing labels on figures,
the wrong use of a term, spelling mistakes.
Methods
Using a design effect of 1 is similar to no design effect? Since you used SRS,
you don’t need to include the design effect in the sentence
How did you define previous STI that would give you a high STI prevalence
among respondents? Please include in the methods section
Tables: Table structure: there are many tables presented and some of the tables
can be merged for example tables 5,6,7 present data on association of marital
status and contraceptive use
Results
In text results for clarity it may be necessary to state the denominator of interest
in presenting some of these results- for example. “Among those with current
sexual partners (PROVIDE THE N), only 3.2% of the respondents indicated a
partner STI during the one year
• Discretionary Revisions
Methods
The sentence on ethics can be revised to improve readability “ data collection
was between December 2012 and March 2013” and “Participation was voluntary
and followed the receipt of informed consent”
Discussion – you opinion on the mean age and “
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I declare that I have no competing interests