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: 4 Date: 15 Jan 2024
Reviewer's report:
PEER REVIEWER ASSESSMENTS:
OBJECTIVE - Full research articles: is there a clear objective that addresses a testable research
question(s) (brief or other article types: is there a clear objective)?
Yes - there is a clear objective
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for
the objective?
Yes - the approach is appropriate
EXECUTION - Are the experiments and analyses performed with technical rigor to allow
confidence in the results?
Yes - experiments and analyses were performed appropriately
STATISTICS - Is the use of statistics in the manuscript appropriate?
N/A - there are no statistics in this study
INTERPRETATION - Is the current interpretation/discussion of the results reasonable and not
overstated?
Yes - the author's interpretation is reasonable
OVERALL MANUSCRIPT POTENTIAL - Is the current version of this work technically
sound? If not, can revisions be made to make the work technically sound?
Yes - current version is technically sound
PEER REVIEWER COMMENTS:
GENERAL COMMENTS: -- What are the major findings of the manuscript?
The paper outlines the key opportunities and barriers to PrEP use in general for girls in Zambia,
alongside newly developed methods of PrEP. Given the importance of engaging parents, the
paper also outlined the perspectives of parents. There were barriers and opportunities from the
perspective of both girls and parents.
-- What specifically have the authors done well?
The paper is well written and argued. They collected a lot of qualitative data, separately for
girls and parents. The methods are described well, the results are presented logically and the
discussion brings together the key findings and makes them amenable to policy makers and
program managers who might be thinking of translating them into practice.
-- Does the manuscript contain any unusual or novel methods or findings?
I don't think the paper is hugely innovative, although it’s not usual to see such large qualitative
datasets collected from the perspective of both parents and girls. Possible the innovation also
lies in the fact that some new forms of PrEP are coming into the market in Zambia.
-- How does this work contribute to the field, and/or how could other researchers use the
information presented in this paper in their own work?
This is possibly the key strength of this paper - it is very much related to policy/practice, whereby
they are clear on the opportunities and barriers to utilising/accessing PrEP (and new forms of
PrEP) for girls in Zambia, which could also be translated into other Sub Saharan countries with
similar HIV rates, cultures and access to forms of PrEP.
There has already been 1 round of reviews on this paper. The previous 2 reviewers provided a
number of very detailed comments. On reading these comments and the original paper, I agree
with them. The authors have responded very well to all of the comments by the reviewers and
the revised version of the paper is now much better. In particular, the Results and Discussion
sections are tighter and more focused.
Given the authors have appropriately responded to all of the original comments from the 2
reviewers, I have no further additional comments.