Reviewer ’s report  
 
Title: Role of HIV in the desire of procreation a nd motherhood in women living with HIV in 
Spain: a qualitative approach  
 
Version: 0 Date: 09 Mar 2017  
 
Reviewer: Saara Greene  
 
Reviewer's report:  
 
1. Understanding and supporting the fertility and mothering desires of women living with HIV 
is an important area of research, specifically in order to ensure that women living with HIV  
know that they can have a healthy pregnancy and baby. I would like to offer a number of 
suggestions that could strengthen this paper in order that it can be published.  One concern I 
have in my own reading is regarding the language barrier - it may be tha t some of my 
concerns are due to my own lack of understanding or interpretation of the arguments that the 
authors were attempting to get across.  
2. The background should include a more comprehensive review of scholarship in the area. For 
example, please i nclude Loutfy, Hart, Mohammed et al (2009) paper on fertility desires. 
Although it is quantitative, it does provide important background information.  
3. Theoretical Framework - This should come before the methods section and what is currently 
there, shoul d go under the METHODS.   I suggest moving the section on concepts of 
motherhood to your theoretical framework section and elucidate how the four dimensions 
shape your analysis and understanding of the women's experiences in your study.  
4. Methods - in thi s order - recruitment and participant information; method of data collection 
(in-depth interviews drawing on who?; method of analysis - thematic? How did you code? 
Etc…your analysis section must be much clearer and in -depth. You suggest content analysis 
but do not explain what this is and how you are doing it. Ethics approval?  
5. Results - participant info should be in methods section. Start with a paragraph on what you 
asked and some of the main themes we can expect to see moving forward from this point. I 
would omit impact of diagnosis and start from the point of this paper by giving us your 
analysis of how the women conceptualized motherhood in the context of HIV - this would 
be in line with your theoretical framework. I would separate out desires to bec ome a mother 
(maybe procreation is a bit too clinical a term given the emphasis on motherhood identity in 
this paper) from the barriers.  Provide a deeper and more cohesive analysis of how women 
living with HIV make decisions to become or not become mother s.  
6. Discussion - must be in line with the theoretical framework and provide a clear discussion of 
how women make decisions to become mothers or not - and what health care providers etc 
can do to support women in making these decisions.  
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.  
 
Unable to assess  
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments  to the authors.  
 
No 
 
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:  
 
Not suitable for publication unless extensively edited  
 
Declaration of competing interests  
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3. Do you hold or are you curr ently applying for any patents relating to the content of the  
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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?  
 
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