Reviewer ’s report  
 
Title: Spanish Validation of Female Condom Attitude Scale and Female Condom Use in  Colombian Young Women  
 
Version: 1 Date: 27 Apr 2019  
 
Reviewer: Susan Witte  
 
Reviewer's report:  
 
 
This is a very important topic that has significant ramifications for HIV research and health 
promotion.  The authors addressed most of the concerns noted by the earlier reviews. However, a 
few small edits will strengthen the quality o f the manuscript: filling in some information related 
to variables and theory in the Background, and then more carefully tying these concepts in to the 
Discussion is needed.  
 Please clarify whether Colombia is considered a developing country or a low -resourced country, 
adjectives that are used in the manuscript (see additional note later). Please consider using 
definitions, e.g. WHO [LMIC or LEDC, etc].    
In addition, please clarify throughout the "psychological variables" associated with condom use  
and how attitudes are among and associated with those psychological variables.  
Authors are testing criterion validity but never explicitly say so. Instead the figure 1 is called : 
"correlation matrix for the variables used in the present study." In the Back ground and Results 
section, and then again in the Discussion state that you are testing criterion validity. For example, 
on p. 7 -11, "as in other scales and subscales used as criterion," be more explicit to name them to 
remind/refresh/clarify to reader her e what you are doing.  
Finally, in the Discussion the authors refer to theory/theories, but they are not clear about what 
these theories are in the background.  
Please also pay much more attention to the grammatical composition and have the paper 
careful ly edited.  
 
Detailed comments are listed below:  
Line 18 pg. 2 Instead of using participants' quotes, consider discussing the findings of the study 
to support the need to promote female condoms.  
Line 25 pg. 2. Are there two groups of variables? Psychologi cal and attitudinal? This paragraph 
may need clarification in light of what is coming next in line 14 pg. 3  
Line 7. Pg. 3 how they are not the same? Is this because the method of research (qualitative vs. 
quantitative) or because literature indicates ther e are differences.  
Line 25 pg. 5. Please clarify which scale was translated. As it is written this paragraph could be 
related to the UCLS scale.  
Line 25 pg. 5. This link maybe useful for the translation 
https://www.who.int/substance_abuse/research_tools/ translation/en/  
Please explain within the text the rationale you offer the reviewer for why you did not back -
translate the instrument.  
Line 25 pg. 7. The authors refer again to the "psychological variables," but this has not been 
elaborated or clarified i n the background.  
Line 13 pg. 8 this paragraph discusses the findings in agreement or disagreement with "the 
theory." Could you elaborate on which theory and how and what are the items that were different 
from the Portuguese version. In addition to the st atistical difference, do you have any explanation 
why Portuguese version was different from the Spanish one?  
Line 30. Pg. 8 Could you elaborate more about how the pleasure -related sexual attitudes and 
attitudes toward sexuality in general support your obse rvations.  
Line 10. Pg. 9 this paragraph needs more clarification and grammar. What kind of approach is 
not cross -sectional? Why do you expect a bigger impact in sexual health promotion programs?  
Line 15. Pg. 9. Please provide citation for "90% of women in developing/developed 
countries…". Is Colombia considered a developing country?  
Line 17. Pg. 9 When you say American women are you referring to women in the U.S?  
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.  
 
No 
 
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.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs so me 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 th at 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, eith er 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 t o 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.  
 
This reviewer has been recruited by a partner organization, Research Square. Reviewers with 
declared or apparent competing interests are not utilized for these reviews. This reviewer has 
agreed to publication of their comments online under a Creative Commo ns Attribution License 
attributed to Research Square and was paid a small honorarium for completing the review within 
a specified timeframe. Honoraria for reviews such as this are paid regardless of the reviewer 
recommendation.  
 
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