Community-Based Strategies as Transformative Approaches for Health Promotion and Empowerment among Commercial Sex Workers in India
Round 1
Reviewer 1 Report
Dear authors,
The current paper examines the utilization of community mobilization as a strategic health communication technique in an intervention to reduce human immunodeficiency virus (HIV) and sexually transmitted infections (STI) rates among marginalized and at-risk populations like com-mercial female sex workers in a red-light district in India.
This study presents important contributions to communication and health.
However, the study presents some problems that must be solved.
1) Method - the method must be improved. It is not clear which items the researcher employed in semi-structured interviews
2) It is not clear which methods were used for the analysis of the interviews. Was qualitative analysis software used to analyze the results of the interviews?
3) The study after the description of the methods presents the discussion. You should present the results achieved more clearly before discussing the results.
4) The study should explore more clearly the contributions of this research to communication and health strategies
5) Is there a more recent bibliography on the subject?
If the authors can make the revisions to improve.
Thank you for allowing me to read and review your article.
Author Response
All additions to the main text (made according to reviewer suggestions) are in blue font.
- Additions made to methods section (p. 6).
- Qualitative analysis done manually using grounded theory, no software was used. Clarification provided in page 6.
- A findings section has been added before the discussion (pp. 6-7).
- Portions on health communication and STI/HIV interventions added throughout the text (p. 5, p. 8, p. 11)
- Newer studies (conducted in the last ten years) have been added to the text.
Reviewer 2 Report
Thank you for the opportunity to review the article “Community-based Strategies as Transformative Approaches for Health Promotion and Empowerment among Commercial Sex Workers in India”. It is a relevant contribution to promote a better quality of life of a highly stigmatized population. Nevertheless, I recommend some improvements before it is published:
- The abstract should include more specific information about materials and methods, as well as main results.
- The numbering of references should appear in the text in ascending order.
- The introduction would benefit from epidemiological data regarding HIV and STI infection among female sex workers in India and if Community-based communication strategies are common and/or effective.
- The objectives of the study should be clearly mentioned before the Methods section.
- This article has no “results” section. I understand that the author merges results with the discussion, but this not recommendable, as a “results”’ section should be clearly written. I suggest the inclusion of a results section and respective changes in the text.
- More information on participants is needed namely sociodemographic characteristics.
- More information on the interview script is needed. Examples of questions posed should be given.
- More information on qualitative analysis is needed. What strategy? Did you use any software to analyze data?
- No ethical information is provided in the article, this is necessary. Research approval must clearly state that ethical principles of research conducted with human participants were taken into consideration.
- Separating the results from the discussion will hopefully improve clarity because it is not clear how the information provided by participants clearly adds to the topic being discussed.
- I expected to see more information focusing on HIV and STI-specific strategies among sex workers in the results section, as the title suggests. Community mobilization and peer outreach in Sonagachi; Negotiation with stakeholders, and Ensuring economic empowerment don’t seem to meet that goal. I would advise the author to reformulate the results to meet the objectives (which were not clearly stated).
- The author should incorporate “Limitations” and a “Implications” or “future directions” sections in the text.
Best wishes.
Author Response
Thank you for your reviewing. All additions to the main text (made according to reviewer suggestions) are in blue font. My replies are as follows:
1. The abstract should include more specific information about materials and methods, as well as main results.
Reply: Information added to abstract (p.1)
2. The numbering of references should appear in the text in ascending order.
Reply: Numbering has been changed.
3. The introduction would benefit from epidemiological data regarding HIV and STI infection among female sex workers in India and if Community-based communication strategies are common and/or effective.
Reply: Epidemiological data has been added (pp. 1-2) and information on community based communication strategies in India has been added (p. 5)
4. The objectives of the study should be clearly mentioned before the Methods section.
Reply: A separate section on objectives has been added (p. 5).
5. This article has no “results” section. I understand that the author merges results with the discussion, but this not recommendable, as a “results”’ section should be clearly written. I suggest the inclusion of a results section and respective changes in the text
Reply: Added "findings" before the discussion section (pp. 6-7).
6. More information on participants is needed namely sociodemographic characteristics
Reply: No sociodemographic details (including age, health status, years of work etc.) were asked during the interviews
7. More information on the interview script is needed. Examples of questions posed should be given
Reply: An interview script has been added a separate appendix
8. More information on qualitative analysis is needed. What strategy? Did you use any software to analyze data?
Reply: Information on qualitative analysis added (p. 6)
9. No ethical information is provided in the article, this is necessary. Research approval must clearly state that ethical principles of research conducted with human participants were taken into consideration.
Reply: Ethical information has been provided in text (p. 5 and p. 12) (Institutional Review Board Statement: IRB research approval was obtained from Temple University (protocol # 13456). Approval to conduct the project was also obtained from Durbar Mahila Samanwaya Committee (DMSC).Informed consent was obtained from all subjects involved in the study.)
10. Separating the results from the discussion will hopefully improve clarity because it is not clear how the information provided by participants clearly adds to the topic being discussed.
Reply: Results separated as findings (pp. 6-7)
11. I expected to see more information focusing on HIV and STI-specific strategies among sex workers in the results section, as the title suggests. Community mobilization and peer outreach in Sonagachi; Negotiation with stakeholders, and Ensuring economic empowerment don’t seem to meet that goal. I would advise the author to reformulate the results to meet the objectives (which were not clearly stated).
Reply: Information has been added and results reformulated (p. 8, p. 11)
12. The author should incorporate “Limitations” and a “Implications” or “future directions” sections in the text.
Reply: Limitations and future direction added (pp. 11-12)
Round 2
Reviewer 2 Report
Thank you for the implementation of all requested changes. The paper's quality has improved substantially.