Title: Risky sexual behavior and associated factors among reproductive age women in Eastern
African countries: A multilevel analysis of the recent demographic and health survey
Version: 0 Date: 09 Mar 2024
Reviewer's report:
A review report for the manuscript entitled: Risky sexual behavior and associated factors
among sexually active women in Eastern African countries: A multilevel analysis of the recent
demographic and health survey is given as follows.
• The topic is interesting and the scope is broad enough to reach international audiences,
especially those who are interested in risky sexual behaviour of women in developing countries.
I have some comments which hopefully can help the author(s) improve the manuscript.
• Title, Abstract and Introduction: The overall evaluation is outstanding since it indicates clearly
the research gaps, objective/hypothesis and applied methods except some grammar/punctuation
issues. For example: You have said, . … “is a devastating problem in low and middle-income
countries studies on the factors associated with risky sexual behavior are limited”.
• Study Design/Methods and Statistical Criteria: The overall evaluation is sound with minor
modification. For example:
- You have said, four models model I, model II, model III, and Model IV were used to assess
the variability of risky sexual behaviour…, but what are they? So it is better if you write them
clearly in the methods part of the manuscript. Also, the naming should be consistent with the
analysis part too. E.g. in Table 3: Null model is model I or not?
- You have said, variables with a p-value of <0.025, were candidates for the multivariable
analysis in univariate analysis at 95% confidence intervals …, How? Please justify and correct it.
- Also, you have included age at first sex in your study but you have said nothing about it either
descriptively or inferentially.
- Lastly, keep consistency of naming variable. E.g. in study variables part you called Community
literacy (low, high) but in the analysis part Community illiteracy (low, high).
• Results / Data Analysis: The overall evaluation is sound with minor modification. Since
appropriated statistical models were fitted and outstanding figures and tables were presented
except some minor modifications. For example:
- In Table 5, under the models there is a number 1. What does it mean? Better if you delete the
number 1 and you simply specify the reference category.
- Check model result for variable Tested for HIV. What is the reference category? No or Yes?
So modify your interpretation accordingly.
- Based on your result for Drink alcohol, who is more likely? Check your interpretation! Since
you have said that the odds of risky sexual behavior were 1.75 (AOR=1.75, 95% CI: 1.48, 2.06)
among women who drank alcohol as compared with women who didn’t drink alcohol. So for
whom it is higher?
• Discussions: The overall evaluation is outstanding because authors have used recent previous
works in their discussion.
• Conclusions: The overall evaluation is also outstanding.
• References: The overall evaluation is sound and it is uniformly written with full bibliographic
reference
• In general, recommend the manuscript to be published because the paper is technically
outstanding and several points were already well addressed. The statistical analysis of the data
is genuinely performed, the findings are fully supported with recent data driven evidences and
they are appropriately discussed in the context of recent literatures. But I have mentioned a very
few and minor comments which may help you improve the paper.