Reviewer’s report
Title: 
Actions taken by female sex workers (FSWs) after condom failure in semi
urban Blantyre, Malawi
Version: 
2 
Date: 
25 Oct 2020
Reviewer's report:
Thank you for the opportunity to review this manuscript, I have no COI to
disclose. 
The authors present a qualitative cross-sectional study of female sex workers in
Malawi regarding actions they take in cases of condom failure. The study
addresses a very important topic, and would be interesting to the readers of BMC
Women's health. Just reading the comments provided by the participants is
interesting enough, and sheds light on the reality of this topic among sex
workers. The main limitation of the study is the relative small sample size, but
nevertheless, 40 participants is still good for a qualitative study. 
Few comments: 
The authors should give some numbers in the abstract instead of just saying
"some" or "few".
"Findings are expected to guide in designing policies and programs to promote
FSWs' health, their clients, partners and children. To the best of our knowledge
there is no published study which explored the action taken by FSWs in the
aftermath of condom failure in semi urban Blantyre, Malawi." Please remove
this sentence from the introduction, and mention those points in the discussion
instead. 
Please include a sub-heading at the beginning of the methods section. Maybe
"Study design and population" 
"The majority of FSWs interviewed had attended only primary school" Please
give numbers. The authors do this thing at many points where they just say
"many", "few"… providing actual numbers and percentages is needed here.
"The majority of FSWs interviewed were Christian" same comment. Please fix
this throughout the abstract and text, 
""[Age range 25-30 years old FSW] " what does this mean? 
"Many FSWs experienced condom slippages and breakages, before the
interviews. " no need to say "before the interviews"… this is quite obvious. 
In the section "Access to contraceptives, pre- and post-exposure prophylaxis
(PrEP &PEP) of HIV " the authors present only participants' comments, I
suggest including some summary of the results by the authors' words as well.
I would add to the limitations that the sample size was relatively small, and that
the population was only in one city in Malawi, which may limit the
generalizability of results to other contexts. 
The authors should attach the questionnaire they used as a supplement (I may
have missed that, so I apologize in advance if I have…). 
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Is the study design appropriate to answer the research question (including the use
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presented?
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