Reviewer ’s report  
 
Title: Factors influencing the experience of sexual and reproductive healthcare for female 
adolescents with perinatally -acquired H IV: A qualitative case study  
 
Version: 0 Date: 24 Apr 2017  
 
Reviewer: Cynthia Fair  
 
Reviewer's report:  
 
Thank you for the opportunity to review your manuscript titled Factors influencing the 
experience of sexual and reproductive healthcare for female adolescents with perinatally -
acquired HIV: A qualitative case study.  Understand ing the lived experiences of young women 
with PHIV, particularly related to SRH care is an important topic.  
 
Abstract:  
Abstract conveys the main points of the study.  Data are plural.  
 
Introduction:  
The authors convey the importance of attending to the SR H care received by adolescents with 
PHIV.  However, the focus is primarily on the negative aspects of pregnancy.   
 Paper would be strengthened by inclusion of literature on the fertility desires and intentions 
of young women with HIV.  Also, research suggests that motherhood can have some positive 
aspects for women living with HIV? As it stands the introduction is pr imarily focused on 
barriers and fears.   
Question is clearly articulated.  
 
Methods:  
I particularly like the fact that the authors included both a caregiver as well as a medical provider 
for each young woman who participated.   
Below are some questions de signed to further strengthen the methods section.  
 It would be helpful to know how many were approached?  How many agreed to participate?   
 More detail is needed on the kinds of questions asked each type of participant.  
 How long did interviews last?  
 
Results:  
Qualitative analyses provide a rich understanding of the challenges faced by young women with 
PHIV in Malawi as they try to navigate SRH care.   
 On page 9, lines 39 -42 is an example of fertility intentions. The speaker clearly sees having 
children as a goal in the future.  For many young people with HIV (both men and women) 
childbearing is greatly desired and is viewed as a way to make for past losses.  Was this 
theme seen anywhere else in your interviews?  
 
Discussion  
Generally, the discussio n nicely situates the study within the existing literature. However, I 
encourage the authors to more fully explore the cultural role of childbearing and integrate the 
available literature on fertility desires and intentions of this population.   
An additi onal limitation is that the sample excluded young men with PHIV who also need 
assistance accessing SRH care.  
Best of luck with your work! Fascinating study.   
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does th e 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 aut hors.  
 
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 ed itors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following quest ions:  
 
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 way 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 answer 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 interests.  
 
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