Reviewer’s report
Title: 
"I expected little, although I learned a lot": Perceived benefits of
participating in HIV risk reduction sessions among women engaged in sex work
in Uganda
Version: 
1 
Date: 
31 Mar 2022
Reviewer: 
Maria Pyra
Reviewer's report:
The authors present qualitative results from the mid-point of an interventional
study to reduce HIV risk behaviors among women engaged in sex work in high
prevalence areas of Uganda. The interventions are guided by social cognitive and
harm reduction theories and this data assesses the acceptability and usefulness of
the information presented to the participants. Overall, the work is interesting and
important to improve HIV prevention - though many of the women in the sample
already have HIV. Minor comments are listed below, and I look forward to
seeing the quantitative results in the future as well.
Pg 4, Ln 19 - I am unclear what "behavior change communication" means
ln 51 - How is behavior change communication different from behavior theory
informed?
Pg 7 - While self-efficacy has been found to be a predictor of using prevention
behaviors, it is a feeling within an individual that they will be able to do the
behavior. How did the authors help develop this feeling among participants and
how was it measured?
The inclusion of women living with HIV is interesting, given the focus on HIV
prevention. Was this framed as prevention to sexual partners? Were supports for
ART adherence and counseling on U=U provided?
Pg 11, ln 48 - six themes but only 5 are listed
It seems quite impressive that women stopped alcohol and drug use after simple
receiving information about the risks related to HIV. Were other skills or support
provided?
Did the women report any barriers or reasons why they were less interested in
PrEP?
Was "massaging" part of the curriculum or was it brought up by the participants?
Are they taught to use condoms for oral sex?
Given the stratification by attendance, were there any notable differences in the
responses?
How does social cognitive theory and harm reduction influence the
understanding of the qualitative data? As the authors state these theories were
helpful in developing the curriculum and improved outcomes, it would
strengthen the paper to tie the theories into the results in some way.
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