Reviewer's report
Title:An assessment of the likely acceptability of vaginal microbicide for HIV
prevention among women in rural Ghana
Version: 1Date:10 April 2012
Reviewer: Rebecca Giguere
Reviewer's report:
Major compulsory revisions
1. In the qualitative methods section on p.6, the authors should include a
description of how qualitative data was coded and how many people reviewed
the qualitative data (along with how intercoder agreement was assessed).
2. The authors comment on their findings regarding religious persuasion and
acceptability in the discussion, but very little information on this is provided in the
results section and the table at the end is not referred to in the results section.
For clarity, the authors should refer to the table and elaborate a little more on
their most significant findings. Perhaps there is some qualitative data about
religion that could be included?
Minor essential revisions
3. In abstract (Results, line 6 and line 7), on p.9 (second and fourth paragraphs
under Acceptability), p.10 (last paragraph before Discussion), and p.11 (last
paragraph, line 11) and p.12 (2nd paragraph, line 2), please change discrete to
discreet. Discrete is often for variables and means distinct or separate; discreet
means self-restrained, or tactful (and may be similar to covert, as it is used here).
Discretionary Revisions
4. In the introduction at the bottom of page 3, the authors mention the findings of
the CAPRISA study in which tenofovir 1% gel was found to reduce HIV infection
by 39%. In order to provide the most updated information about the field, the
authors should also include findings from the VOICE trial, which did not confirm
the CAPRISA findings and was stopped for futility based on a DSMB assessment
that there were no differences between tenofovir and placebo gels.
5. The headings in the results section could be modified to be clearer. Perhaps:
Awareness (1st paragraph on p.7 in current Awareness and acceptability
section); Comparison to Other Products (Paragraph on p.7 starting with “In trying
to appreciate how a microbicide might work on”…up to paragraph starting with
“Beyond health-related facilities” on p.8); Overall Acceptability (include first
paragraph currently under acceptability on p.9 and final paragraph in section
describing quant analyses on p.10); Preferred Vendors (move paragraph on p.8
starting with “Beyond health-related facilities”), Formulation Preferences (move
paragraph on p.8 starting with “Gels or creams” to this section), and Covert Use
(Paragraph on p.9 starting with “About 71% of women”… through sentence
ending in “its effect on sexual pleasure.”)
6. On p.12, the first complete sentence repeats the word “actually” twice. It would
read better if you removed the first mention.
7. The authors discuss the limitations to their work in the first paragraph on p.11,
but might want to be more explicit that they are working with a limitation of
surveying participants who were unfamiliar with microbicides and who are not
using a microbicide candidate, placebo gel, or microbicide surrogate.
Other Comments:
8. The authors make a good argument for why this article is relevant to the field.
The authors assessed likely microbicide acceptability among women at antenatal
clinics in Ghana, most of whom had never heard of microbicides before. The
authors surveyed women and then conducted focus groups with women and
men. It is wonderful that the authors included focus groups with men to get their
perspectives. The discussion also provides some interesting comments that
support continued assessment of acceptability.
Level of interest: An article of importance in its field
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.