Reviewer ’s repo rt 
 
Title: Rejection, Acceptance and the Spectrum Between: Understanding Male Attitudes and 
Experiences towards Conflict -Related Sexual Violence in Eastern Democratic Republic of 
Congo  
 
Version: 1 Date: 24 Jul 2017  
 
Reviewer: Rafael Van den Bergh  
 
Reviewer's report:  
 
I would like t o congratulate the authors on this innovative study, covering an issue that is rarely 
reported in the literature, and that would benefit from a stronger evidence basis in order to design 
better programmes for holistic care of survivors of sexual violence. I would recommend the 
manuscript for publication, and have only a small number of comments for the authors' 
consideration, to further improve their work:  
1) An overview of the participants would be essential to better understand the results section. 
This could be done as a table, or in full -text, but should include the number/type of 
participant (husbands, fathers, brothers, etc.), if possible an age range, and possibly any 
demographics (such as level of education), if available. The type is essential to m ention, in 
particular in view of the discussion section, line 437 -438, where it is pointed out that 
different pressures are experienced by husbands versus fathers/brothers.  
2) In keeping with the first comment: the observation that different pressures are  experienced by 
different types of participants is not evidenced by the results, and should thus not be posited 
as such in the discussion section.  
3) The results section would be easier to read if the introduction can be ended with a clear 
objective if th e study - this would streamline the manuscript, and would alert the reader on 
what the results section aims to achieve. This could also serve to remove some of the 
redundancy in the results section (e.g. line 243 and beyond versus line 341 and beyond).  
4) In particular, in an objectives paragraph, or elsewhere in the methods, it would be useful to 
discuss the specific outcome of interest - currently, the manuscript focuses extensively on 
rejection of the woman undergoing sexual violence. However, the role of males is not 
restricted to rejecting/accepting a sexual violence survivor: males (as partners or family 
members) can play a role in timely presentation for post -sexual violence care, and in general 
psychological and physical support; interpreting the re sults in this view may add more 
nuance than the binary rejection/acceptance model.  
5) In terms of ethics/consent procedures, the authors state the ethics committees that gave their 
permission (though it is only stated that the committees "approved the met hods used in this 
study", while a full ethics clearance of the complete study on such sensitive matters may be 
important - to consider in function of the journal policy), and that verbal consent was 
obtained. I would be interested to read more on how prote ction of participants was provided 
during the study - did participants have access to a counselor in case the discussions elicited 
traumatic responses, or was this provided by default? And were the women who experienced 
the sexual violence involved in the information and consent procedure in any way?  
6) In general: the study focuses on the attitudes among males, and the perceptions of women 
may be out of scope of the current manuscript. However, a more detailed overview of the 
literature on how women experience the support (or absence thereof) of their  male partners 
and/or family members would benefit the discussion section, and make the study more 
comprehensive.  
7) Throughout the paper, no mention is made of male survivors of sexual violence. This too 
may be a subject out of scope in the current manu script, but as the title suggests the study 
covers male attitudes towards sexual violence in general, a comment on male survivors (of 
direct penetrative rape, and/or being forced to rape family members) would be important to 
offer a complete picture.  
I hope this may be of some relevance to the authors. I look forward to seeing a final draft of this 
manuscript. Warm regards,  
Rafael Van den Bergh  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
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 a n 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the qual ity of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
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