Reviewer ’s report  
 
Title: Sexual Risk Behavior and Substance Use among Young, Diverse Women Seeking Care at 
a Reproductive Health Clinic  
 
Version: 0 Date: 27 Aug 2018  
 
Reviewer: Kelly Cue Davis  
 
Reviewer's report:  
 
The present manuscript is a descriptive survey study of young w omen attending a reproductive 
health care clinic for routine medical exams. It describes their sexual risk behaviors, STI 
diagnoses, substance use, and depressive symptoms, and then assesses for differences in these 
based on race/ethnicity. The manuscript is well -written and clear. Although the findings are not 
particularly novel, they do support previous results and may be somewhat useful for informing 
intervention practices. I hope the authors find the below critiques useful when crafting their 
revision f or this or another outlet.  
 
Abstract - page 2, line 30. Please clarify the difference between "White only" and "non -Hispanic 
White". Please also clarify this in the results section and describe how the "White only" women 
were coded for analyses. Are they i n the non -Hispanic White group or something else? In lines 
41-44, make clear whether these differences were statistically significant. The conclusions in 
lines 45 -47 could briefly address racial/ethnic differences in the findings.  
 
Introduction - page 4, l ines 88 -90 are awkwardly worded. Please rephrase. On page 5, it would 
strengthen the manuscript to present research on racial/ethnic differences in substance use and 
depression, particularly as these are cited later as reasons for the hypotheses. In the pa ragraph 
beginning on line 107, it would be useful to also include depressive symptoms here and in the 
next paragraph starting on line 116. I also suggest referring to this throughout as depressive 
symptoms rather than depression given that no formal diagno sis is made.   
 
Method - page 7, line 155 - how were 1 and 2 labelled on the condom use scale? On page 8, I 
found the description of the peak daily alcohol use dichotomization confusing. Was this divided 
into 2 drinking variables (binge and high intensity)  and then dichotomized yes/no for each of 
those? Please clarify.  
 
Results - page 10, line 207 - were women who did not fit either of the 3 racial/ethnic groups left 
out of all analyses? Line 223 - how were women coded who did not have any sex partners in t he 
past 3 months? Lines 239 -241 - the numbers in the text do not match the table.  
 
Conclusions - line 297 - number presented does not match the results. One larger point - 
although interest in information was lowest for substance use, all of the categories  were pretty 
low across the groups, with most right at the midpoint of the scale or lower. I think this should be 
addressed in the conclusions, with some possible suggestions for how providers should present 
such information to their patients when needed g iven the relatively low interest levels. 
Additionally, do findings suggest the need for universal screening of any of the 
conditions/behaviors explored here?  
 
 
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 manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects req uire further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
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 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 way gain or lose  
financi ally 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 organiz ation 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 th e 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.  
 
I agree to the open peer review policy of the journal. I understand that my name will  be included 
on my report to the authors and, if the manuscript is accepted f or publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
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which I do not wish to be included in my named report can be in cluded as confidential comments 
to the editors, which will not be p ublished.  
 
I agree to the open peer review policy of the journal