Reviewer ’s report  
 
Title:  Sexual compulsivity and its relationship with condomless sex amon g unmarried female 
migrant workers in Shanghai, China: a cross -sectional study  
 
Version: 0 Date: 25 May 2018 
 
Reviewer:  Zixin  Wang  
 
Reviewer’s report:  
 
Given the large population size, sexual health of female internal migrant workers i s an important 
public health issue. This cross -sectional study investigated the association between sexual 
compulsivity and condomless sex among 1325 unmarried female internal migrant workers in 
Shanghai. I have the following concerns:  
 
1. It would be bet ter for the authors to explain why they limit their sample only to unmarried 
female internal migrants with premarital sex behaviors? Why exclude those age over 40 years 
old? How many of the unmarried female internal migrants were excluded for not having 
premarital sex behaviors? What is the response rate of this study?  
 
2. The dependent variable of this study, condomless sex, was based on self -reported frequency of 
condom use during vaginal sex in the last six months. Indicators of condomless sex should al so 
include unwanted pregnancy and incident STI/HIV infection (Wall et al. Journal of Women's 
Health, 2017).  
 
3. The authors mentioned that the Sexual Compulsivity Scale has been validated in Chinese 
population with good psychometric properties. It would be better for the authors to explain why 
they want to validate a validated scale in this study. Moreover, the f actor loading of the scale in 
this study is very different from the one published by Liao et al. The authors should comment on 
why these are such big differences between these two populations in the discussion?  
 
4. Due to the Chinese culture, females tend to be more submissive during sexual behaviors. They 
may have lower power in negotiating condom use. Therefore, types of male sex partners 
involved and whether such partners would like to use condom consistently may have large 
influence on condomless sex. S ince these interpersonal variables were not included in this study, 
it is unclear whether sexual compulsivity plays a major role in condomless sex in this case.  
 
 
Minor comments:  
 
1. It is unclear why the authors use age=22, and income=3200RMB as cut -off po ints when 
performing logistic regression analysis.  
 
2. In table 1, low formal education was defined as ≤9 years, while high was defined as >20 years, 
how about 10 -20 years?  
3. How many of the participants were sexually active in the last six months?  
 
4. "Unprotected sex" and "condomless sex" were used simultaneously, please use "condomless 
sex" consistently throughout the text.  
 
5. Line 103: Should be "We hypothesized ….." instead of "We hypothesis …..".  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in  the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Qualit y of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an 
organisation that may in any way gain or lose financially from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any w ay gain or lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the 
manuscript?  
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can ans wer no to all of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give details below.  
 
I declare that I have no competing inter est 
 
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