Reviewer's report
Title:Intimate partner violence among women with HIV infection in rural Uganda:
critical implications for policy and practice
Version: 1Date:23 May 2011
Reviewer: Rachel Jewkes
Reviewer's report:
Thank you for asking me to review this paper. I believe it’s generally well written
and should be interesting but there is a need for quite substantial revision of the
tables – and following from this the results section etc. I would like this done and
to see the paper again.
Para 2 – introduction – I don’t think you can just reduce women’s sexual risk
taking and IPV to lack of knowledge. The literature rather supports a view that
women are exposed to IPV because their sexual risky practices are seen as a
threat/challenge to male control of them. Often they may also provoke jealousy
(as such practices of men do). There are also explanations that the mental health
impact of IPV on women leads to elevated risk of substance abuse and risky sex
is often associated with substance abuse or in the case of transactional sex, sex
is exchanged for beer and entertainment.
Last line page 4 – should read increases risk of IPV (not HIV)
The section on sample size is somewhat misleading as it is possible to estimate
a prevalence in a sample of any size, the question is the precision of the estimate
and that varies depending on the proportion and the sample size. So this section
should rather give the precision that was desired and show how the sample size
would have reasonably achieved this at different estimates of prevalence. To be
honest I believe it is completely unnecessary to include a sample size calculation
section in a descriptive study – at this stage ‘you get what you get’. The precision
must be reported for measures, the one guessed prior to conduct of the study is
not really any more of interest – it has no relevance for interpreting the findings,
unlike in a sample size calculation in an intervention study.
Tables & analysis
The authors need to simplify their exposure measure as they need to make sure
there are no abused women in the reference group. Given that the sample size
isn’t huge, the options are probably to derive a three level variable – physical IPV
/ sexual or emotional IPV / no IPV and do a multinominal regressional model with
‘none’ as the common reference category. Alternatively dichotomising on
physical or sexual versus no physical or sexual IPV would be in keeping with
routes followed often in the literature.
The presentation of results could be strengthened. I would like to see tables 1 &
2 presented with columns for exposed to IPV and not exposed. I would suggest
taking the lead for these columns from the decision around the regression model
– so either having 2 or 3 and presenting a column % (n) for each and a p value.
In all the tables I would carefully consider which are the best variable names as
it’s highly desirable to make these as explicit of the actual relationships/variable
levels presented (and compared).
Discussion – I have not given comments on this yet as the tables and results
need to be revised before the discussion can be considered in detail
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, and I have assessed the statistics in my report.
Declaration of competing interests:
'I declare that I have no competing interests'