Knowledge and uptake of contraceptive and other sexual reproductive health services among in-school adolescents in three South African townships: Baseline findings from the Girls Achieve Power (GAP Year) Trial

Knowledge and uptake of contraceptive and... | Gates Open Research "use strict";function _typeof(t){return(_typeof="function"==typeof Symbol&&"symbol"==typeof Symbol.iterator?function(t){return typeof t}:function(t){return t&&"function"==typeof Symbol&&t.constructor===Symbol&&t!==Symbol.prototype?"symbol":typeof t})(t)}!function(){var t=function(){var t,e,o=[],n=window,r=n;for(;r;){try{if(r.frames.__tcfapiLocator){t=r;break}}catch(t){}if(r===n.top)break;r=r.parent}t||(!function t(){var e=n.document,o=!!n.frames.__tcfapiLocator;if(!o)if(e.body){var r=e.createElement("iframe");r.style.cssText="display:none",r.name="__tcfapiLocator",e.body.appendChild(r)}else setTimeout(t,5);return!o}(),n.__tcfapi=function(){for(var t=arguments.length,n=new Array(t),r=0;r 3&&2===parseInt(n[1],10)&&"boolean"==typeof n[3]&&(e=n[3],"function"==typeof n[2]&&n[2]("set",!0)):"ping"===n[0]?"function"==typeof n[2]&&n[2]({gdprApplies:e,cmpLoaded:!1,cmpStatus:"stub"}):o.push(n)},n.addEventListener("message",(function(t){var e="string"==typeof t.data,o={};if(e)try{o=JSON.parse(t.data)}catch(t){}else o=t.data;var n="object"===_typeof(o)&&null!==o?o.__tcfapiCall:null;n&&window.__tcfapi(n.command,n.version,(function(o,r){var a={__tcfapiReturn:{returnValue:o,success:r,callId:n.callId}};t&&t.source&&t.source.postMessage&&t.source.postMessage(e?JSON.stringify(a):a,"*")}),n.parameter)}),!1))};"undefined"!=typeof module?module.exports=t:t()}(); dataLayer = dataLayer || []; // Standard GTM initialization - Google Consent Mode handles consent automatically (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start': new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0], j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src= 'https://www.googletagmanager.com/gtm.js?id='+i+dl+ '>m_auth=hzk0Vc3qFsQYhCrIoHz68A>m_preview=env-1>m_cookies_win=x';f.parentNode.insertBefore(j,f); })(window,document,'script','dataLayer','GTM-MWFK8L5J'); ;window.NREUM||(NREUM={});NREUM.init={distributed_tracing:{enabled:true},privacy:{cookies_enabled:true},ajax:{deny_list:["bam.nr-data.net"]}}; ;NREUM.loader_config={accountID:"438030",trustKey:"438030",agentID:"772317073",licenseKey:"97f8f67f26",applicationID:"772317073"} ;NREUM.info={beacon:"bam.nr-data.net",errorBeacon:"bam.nr-data.net",licenseKey:"97f8f67f26",applicationID:"772317073",sa:1} ;/*! For license information please see nr-loader-spa-1.236.0.min.js.LICENSE.txt */ (()=>{"use strict";var e,t,r={5763:(e,t,r)=>{r.d(t,{P_:()=>l,Mt:()=>g,C5:()=>s,DL:()=>v,OP:()=>T,lF:()=>D,Yu:()=>y,Dg:()=>h,CX:()=>c,GE:()=>b,sU:()=>_});var n=r(8632),i=r(9567);const o={beacon:n.ce.beacon,errorBeacon:n.ce.errorBeacon,licenseKey:void 0,applicationID:void 0,sa:void 0,queueTime:void 0,applicationTime:void 0,ttGuid:void 0,user:void 0,account:void 0,product:void 0,extra:void 0,jsAttributes:{},userAttributes:void 0,atts:void 0,transactionName:void 0,tNamePlain:void 0},a={};function s(e){if(!e)throw new Error("All info objects require an agent identifier!");if(!a[e])throw new Error("Info for ".concat(e," was never set"));return a[e]}function c(e,t){if(!e)throw new Error("All info objects require an agent identifier!");a[e]=(0,i.D)(t,o),(0,n.Qy)(e,a[e],"info")}var u=r(7056);const d=()=>{const e={blockSelector:"[data-nr-block]",maskInputOptions:{password:!0}};return{allow_bfcache:!0,privacy:{cookies_enabled:!0},ajax:{deny_list:void 0,enabled:!0,harvestTimeSeconds:10},distributed_tracing:{enabled:void 0,exclude_newrelic_header:void 0,cors_use_newrelic_header:void 0,cors_use_tracecontext_headers:void 0,allowed_origins:void 0},session:{domain:void 0,expiresMs:u.oD,inactiveMs:u.Hb},ssl:void 0,obfuscate:void 0,jserrors:{enabled:!0,harvestTimeSeconds:10},metrics:{enabled:!0},page_action:{enabled:!0,harvestTimeSeconds:30},page_view_event:{enabled:!0},page_view_timing:{enabled:!0,harvestTimeSeconds:30,long_task:!1},session_trace:{enabled:!0,harvestTimeSeconds:10},harvest:{tooManyRequestsDelay:60},session_replay:{enabled:!1,harvestTimeSeconds:60,sampleRate:.1,errorSampleRate:.1,maskTextSelector:"*",maskAllInputs:!0,get blockClass(){return"nr-block"},get ignoreClass(){return"nr-ignore"},get maskTextClass(){return"nr-mask"},get blockSelector(){return e.blockSelector},set blockSelector(t){e.blockSelector+=",".concat(t)},get maskInputOptions(){return e.maskInputOptions},set maskInputOptions(t){e.maskInputOptions={...t,password:!0}}},spa:{enabled:!0,harvestTimeSeconds:10}}},f={};function l(e){if(!e)throw new Error("All configuration objects require an agent identifier!");if(!f[e])throw new Error("Configuration for ".concat(e," was never set"));return f[e]}function h(e,t){if(!e)throw new Error("All configuration objects require an agent identifier!");f[e]=(0,i.D)(t,d()),(0,n.Qy)(e,f[e],"config")}function g(e,t){if(!e)throw new Error("All configuration objects require an agent identifier!");var r=l(e);if(r){for(var n=t.split("."),i=0;i {r.d(t,{D:()=>i});var n=r(50);function i(e,t){try{if(!e||"object"!=typeof e)return(0,n.Z)("Setting a Configurable requires an object as input");if(!t||"object"!=typeof t)return(0,n.Z)("Setting a Configurable requires a model to set its initial properties");const r=Object.create(Object.getPrototypeOf(t),Object.getOwnPropertyDescriptors(t)),o=0===Object.keys(r).length?e:r;for(let a in o)if(void 0!==e[a])try{"object"==typeof e[a]&&"object"==typeof t[a]?r[a]=i(e[a],t[a]):r[a]=e[a]}catch(e){(0,n.Z)("An error occurred while setting a property of a Configurable",e)}return r}catch(e){(0,n.Z)("An error occured while setting a Configurable",e)}}},6818:(e,t,r)=>{r.d(t,{Re:()=>i,gF:()=>o,q4:()=>n});const n="1.236.0",i="PROD",o="CDN"},385:(e,t,r)=>{r.d(t,{FN:()=>a,IF:()=>u,Nk:()=>f,Tt:()=>s,_A:()=>o,il:()=>n,pL:()=>c,v6:()=>i,w1:()=>d});const n="undefined"!=typeof window&&!!window.document,i="undefined"!=typeof WorkerGlobalScope&&("undefined"!=typeof self&&self instanceof WorkerGlobalScope&&self.navigator instanceof WorkerNavigator||"undefined"!=typeof globalThis&&globalThis instanceof WorkerGlobalScope&&globalThis.navigator instanceof WorkerNavigator),o=n?window:"undefined"!=typeof WorkerGlobalScope&&("undefined"!=typeof self&&self instanceof WorkerGlobalScope&&self||"undefined"!=typeof globalThis&&globalThis instanceof WorkerGlobalScope&&globalThis),a=""+o?.location,s=/iPad|iPhone|iPod/.test(navigator.userAgent),c=s&&"undefined"==typeof SharedWorker,u=(()=>{const e=navigator.userAgent.match(/Firefox[/\s](\d+\.\d+)/);return Array.isArray(e)&&e.length>=2?+e[1]:0})(),d=Boolean(n&&window.document.documentMode),f=!!navigator.sendBeacon},1117:(e,t,r)=>{r.d(t,{w:()=>o});var n=r(50);const i={agentIdentifier:"",ee:void 0};class o{constructor(e){try{if("object"!=typeof e)return(0,n.Z)("shared context requires an object as input");this.sharedContext={},Object.assign(this.sharedContext,i),Object.entries(e).forEach((e=>{let[t,r]=e;Object.keys(i).includes(t)&&(this.sharedContext[t]=r)}))}catch(e){(0,n.Z)("An error occured while setting SharedContext",e)}}}},8e3:(e,t,r)=>{r.d(t,{L:()=>d,R:()=>c});var n=r(2177),i=r(1284),o=r(4322),a=r(3325);const s={};function c(e,t){const r={staged:!1,priority:a.p[t]||0};u(e),s[e].get(t)||s[e].set(t,r)}function u(e){e&&(s[e]||(s[e]=new Map))}function d(){let e=arguments.length>0&&void 0!==arguments[0]?arguments[0]:"",t=arguments.length>1&&void 0!==arguments[1]?arguments[1]:"feature";if(u(e),!e||!s[e].get(t))return a(t);s[e].get(t).staged=!0;const r=[...s[e]];function a(t){const r=e?n.ee.get(e):n.ee,a=o.X.handlers;if(r.backlog&&a){var s=r.backlog[t],c=a[t];if(c){for(var u=0;s&&u {let[t,r]=e;return r.staged}))&&(r.sort(((e,t)=>e[1].priority-t[1].priority)),r.forEach((e=>{let[t]=e;a(t)})))}function f(e,t){var r=e[1];(0,i.D)(t[r],(function(t,r){var n=e[0];if(r[0]===n){var i=r[1],o=e[3],a=e[2];i.apply(o,a)}}))}},2177:(e,t,r)=>{r.d(t,{c:()=>f,ee:()=>u});var n=r(8632),i=r(2210),o=r(1284),a=r(5763),s="nr@context";let c=(0,n.fP)();var u;function d(){}function f(e){return(0,i.X)(e,s,l)}function l(){return new d}function h(){u.aborted=!0,u.backlog={}}c.ee?u=c.ee:(u=function e(t,r){var n={},c={},f={},g=!1;try{g=16===r.length&&(0,a.OP)(r).isolatedBacklog}catch(e){}var p={on:b,addEventListener:b,removeEventListener:y,emit:v,get:x,listeners:w,context:m,buffer:A,abort:h,aborted:!1,isBuffering:E,debugId:r,backlog:g?{}:t&&"object"==typeof t.backlog?t.backlog:{}};return p;function m(e){return e&&e instanceof d?e:e?(0,i.X)(e,s,l):l()}function v(e,r,n,i,o){if(!1!==o&&(o=!0),!u.aborted||i){t&&o&&t.emit(e,r,n);for(var a=m(n),s=w(e),d=s.length,f=0;fn,p:()=>i});var n=r(2177).ee.get("handle");function i(e,t,r,i,o){o?(o.buffer([e],i),o.emit(e,t,r)):(n.buffer([e],i),n.emit(e,t,r))}},4322:(e,t,r)=>{r.d(t,{X:()=>o});var n=r(5546);o.on=a;var i=o.handlers={};function o(e,t,r,o){a(o||n.E,i,e,t,r)}function a(e,t,r,i,o){o||(o="feature"),e||(e=n.E);var a=t[o]=t[o]||{};(a[r]=a[r]||[]).push([e,i])}},3239:(e,t,r)=>{r.d(t,{bP:()=>s,iz:()=>c,m$:()=>a});var n=r(385);let i=!1,o=!1;try{const e={get passive(){return i=!0,!1},get signal(){return o=!0,!1}};n._A.addEventListener("test",null,e),n._A.removeEventListener("test",null,e)}catch(e){}function a(e,t){return i||o?{capture:!!e,passive:i,signal:t}:!!e}function s(e,t){let r=arguments.length>2&&void 0!==arguments[2]&&arguments[2],n=arguments.length>3?arguments[3]:void 0;window.addEventListener(e,t,a(r,n))}function c(e,t){let r=arguments.length>2&&void 0!==arguments[2]&&arguments[2],n=arguments.length>3?arguments[3]:void 0;document.addEventListener(e,t,a(r,n))}},4402:(e,t,r)=>{r.d(t,{Ht:()=>u,M:()=>c,Rl:()=>a,ky:()=>s});var n=r(385);const i="xxxxxxxx-xxxx-4xxx-yxxx-xxxxxxxxxxxx";function o(e,t){return e?15&e[t]:16*Math.random()|0}function a(){const e=n._A?.crypto||n._A?.msCrypto;let t,r=0;return e&&e.getRandomValues&&(t=e.getRandomValues(new Uint8Array(31))),i.split("").map((e=>"x"===e?o(t,++r).toString(16):"y"===e?(3&o()|8).toString(16):e)).join("")}function s(e){const t=n._A?.crypto||n._A?.msCrypto;let r,i=0;t&&t.getRandomValues&&(r=t.getRandomValues(new Uint8Array(31)));const a=[];for(var s=0;s {r.d(t,{Bq:()=>n,Hb:()=>o,oD:()=>i});const n="NRBA",i=144e5,o=18e5},7894:(e,t,r)=>{function n(){return Math.round(performance.now())}r.d(t,{z:()=>n})},7243:(e,t,r)=>{r.d(t,{e:()=>o});var n=r(385),i={};function o(e){if(e in i)return i[e];if(0===(e||"").indexOf("data:"))return{protocol:"data"};let t;var r=n._A?.location,o={};if(n.il)t=document.createElement("a"),t.href=e;else try{t=new URL(e,r.href)}catch(e){return o}o.port=t.port;var a=t.href.split("://");!o.port&&a[1]&&(o.port=a[1].split("/")[0].split("@").pop().split(":")[1]),o.port&&"0"!==o.port||(o.port="https"===a[0]?"443":"80"),o.hostname=t.hostname||r.hostname,o.pathname=t.pathname,o.protocol=a[0],"/"!==o.pathname.charAt(0)&&(o.pathname="/"+o.pathname);var s=!t.protocol||":"===t.protocol||t.protocol===r.protocol,c=t.hostname===r.hostname&&t.port===r.port;return o.sameOrigin=s&&(!t.hostname||c),"/"===o.pathname&&(i[e]=o),o}},50:(e,t,r)=>{function n(e,t){"function"==typeof console.warn&&(console.warn("New Relic: ".concat(e)),t&&console.warn(t))}r.d(t,{Z:()=>n})},2587:(e,t,r)=>{r.d(t,{N:()=>c,T:()=>u});var n=r(2177),i=r(5546),o=r(8e3),a=r(3325);const s={stn:[a.D.sessionTrace],err:[a.D.jserrors,a.D.metrics],ins:[a.D.pageAction],spa:[a.D.spa],sr:[a.D.sessionReplay,a.D.sessionTrace]};function c(e,t){const r=n.ee.get(t);e&&"object"==typeof e&&(Object.entries(e).forEach((e=>{let[t,n]=e;void 0===u[t]&&(s[t]?s[t].forEach((e=>{n?(0,i.p)("feat-"+t,[],void 0,e,r):(0,i.p)("block-"+t,[],void 0,e,r),(0,i.p)("rumresp-"+t,[Boolean(n)],void 0,e,r)})):n&&(0,i.p)("feat-"+t,[],void 0,void 0,r),u[t]=Boolean(n))})),Object.keys(s).forEach((e=>{void 0===u[e]&&(s[e]?.forEach((t=>(0,i.p)("rumresp-"+e,[!1],void 0,t,r))),u[e]=!1)})),(0,o.L)(t,a.D.pageViewEvent))}const u={}},2210:(e,t,r)=>{r.d(t,{X:()=>i});var n=Object.prototype.hasOwnProperty;function i(e,t,r){if(n.call(e,t))return e[t];var i=r();if(Object.defineProperty&&Object.keys)try{return Object.defineProperty(e,t,{value:i,writable:!0,enumerable:!1}),i}catch(e){}return e[t]=i,i}},1284:(e,t,r)=>{r.d(t,{D:()=>n});const n=(e,t)=>Object.entries(e||{}).map((e=>{let[r,n]=e;return t(r,n)}))},4351:(e,t,r)=>{r.d(t,{P:()=>o});var n=r(2177);const i=()=>{const e=new WeakSet;return(t,r)=>{if("object"==typeof r&&null!==r){if(e.has(r))return;e.add(r)}return r}};function o(e){try{return JSON.stringify(e,i())}catch(e){try{n.ee.emit("internal-error",[e])}catch(e){}}}},3960:(e,t,r)=>{r.d(t,{K:()=>a,b:()=>o});var n=r(3239);function i(){return"undefined"==typeof document||"complete"===document.readyState}function o(e,t){if(i())return e();(0,n.bP)("load",e,t)}function a(e){if(i())return e();(0,n.iz)("DOMContentLoaded",e)}},8632:(e,t,r)=>{r.d(t,{EZ:()=>u,Qy:()=>c,ce:()=>o,fP:()=>a,gG:()=>d,mF:()=>s});var n=r(7894),i=r(385);const o={beacon:"bam.nr-data.net",errorBeacon:"bam.nr-data.net"};function a(){return i._A.NREUM||(i._A.NREUM={}),void 0===i._A.newrelic&&(i._A.newrelic=i._A.NREUM),i._A.NREUM}function s(){let e=a();return e.o||(e.o={ST:i._A.setTimeout,SI:i._A.setImmediate,CT:i._A.clearTimeout,XHR:i._A.XMLHttpRequest,REQ:i._A.Request,EV:i._A.Event,PR:i._A.Promise,MO:i._A.MutationObserver,FETCH:i._A.fetch}),e}function c(e,t,r){let i=a();const o=i.initializedAgents||{},s=o[e]||{};return Object.keys(s).length||(s.initializedAt={ms:(0,n.z)(),date:new Date}),i.initializedAgents={...o,[e]:{...s,[r]:t}},i}function u(e,t){a()[e]=t}function d(){return function(){let e=a();const t=e.info||{};e.info={beacon:o.beacon,errorBeacon:o.errorBeacon,...t}}(),function(){let e=a();const t=e.init||{};e.init={...t}}(),s(),function(){let e=a();const t=e.loader_config||{};e.loader_config={...t}}(),a()}},7956:(e,t,r)=>{r.d(t,{N:()=>i});var n=r(3239);function i(e){let t=arguments.length>1&&void 0!==arguments[1]&&arguments[1],r=arguments.length>2?arguments[2]:void 0,i=arguments.length>3?arguments[3]:void 0;return void(0,n.iz)("visibilitychange",(function(){if(t)return void("hidden"==document.visibilityState&&e());e(document.visibilityState)}),r,i)}},1214:(e,t,r)=>{r.d(t,{em:()=>v,u5:()=>N,QU:()=>S,_L:()=>I,Gm:()=>L,Lg:()=>M,gy:()=>U,BV:()=>Q,Kf:()=>ee});var n=r(2177);const i="nr@original";var o=Object.prototype.hasOwnProperty,a=!1;function s(e,t){return e||(e=n.ee),r.inPlace=function(e,t,n,i,o){n||(n="");var a,s,c,u="-"===n.charAt(0);for(c=0;c 2?n-2:0),o=2;o {r(A[T],e,w),r(E[T],e,w)})),r(l._A,"fetch",y),t.on(y+"end",(function(e,r){var n=this;if(r){var i=r.headers.get("content-length");null!==i&&(n.rxSize=i),t.emit(y+"done",[null,r],n)}else t.emit(y+"done",[e],n)})),t}const O={},j=["pushState","replaceState"];function S(e){const t=function(e){return(e||n.ee).get("history")}(e);return!l.il||O[t.debugId]++||(O[t.debugId]=1,s(t).inPlace(window.history,j,"-")),t}var P=r(3239);const C={},R=["appendChild","insertBefore","replaceChild"];function I(e){const t=function(e){return(e||n.ee).get("jsonp")}(e);if(!l.il||C[t.debugId])return t;C[t.debugId]=!0;var r=s(t),i=/[?&](?:callback|cb)=([^&#]+)/,o=/(.*)\.([^.]+)/,a=/^(\w+)(\.|$)(.*)$/;function c(e,t){var r=e.match(a),n=r[1],i=r[3];return i?c(i,t[n]):t[n]}return r.inPlace(Node.prototype,R,"dom-"),t.on("dom-start",(function(e){!function(e){if(!e||"string"!=typeof e.nodeName||"script"!==e.nodeName.toLowerCase())return;if("function"!=typeof e.addEventListener)return;var n=(a=e.src,s=a.match(i),s?s[1]:null);var a,s;if(!n)return;var u=function(e){var t=e.match(o);if(t&&t.length>=3)return{key:t[2],parent:c(t[1],window)};return{key:e,parent:window}}(n);if("function"!=typeof u.parent[u.key])return;var d={};function f(){t.emit("jsonp-end",[],d),e.removeEventListener("load",f,(0,P.m$)(!1)),e.removeEventListener("error",l,(0,P.m$)(!1))}function l(){t.emit("jsonp-error",[],d),t.emit("jsonp-end",[],d),e.removeEventListener("load",f,(0,P.m$)(!1)),e.removeEventListener("error",l,(0,P.m$)(!1))}r.inPlace(u.parent,[u.key],"cb-",d),e.addEventListener("load",f,(0,P.m$)(!1)),e.addEventListener("error",l,(0,P.m$)(!1)),t.emit("new-jsonp",[e.src],d)}(e[0])})),t}var k=r(5763);const H={};function L(e){const t=function(e){return(e||n.ee).get("mutation")}(e);if(!l.il||H[t.debugId])return t;H[t.debugId]=!0;var r=s(t),i=k.Yu.MO;return i&&(window.MutationObserver=function(e){return this instanceof i?new i(r(e,"fn-")):i.apply(this,arguments)},MutationObserver.prototype=i.prototype),t}const z={};function M(e){const t=function(e){return(e||n.ee).get("promise")}(e);if(z[t.debugId])return t;z[t.debugId]=!0;var r=n.c,o=s(t),a=k.Yu.PR;return a&&function(){function e(r){var n=t.context(),i=o(r,"executor-",n,null,!1);const s=Reflect.construct(a,[i],e);return t.context(s).getCtx=function(){return n},s}l._A.Promise=e,Object.defineProperty(e,"name",{value:"Promise"}),e.toString=function(){return a.toString()},Object.setPrototypeOf(e,a),["all","race"].forEach((function(r){const n=a[r];e[r]=function(e){let i=!1;[...e||[]].forEach((e=>{this.resolve(e).then(a("all"===r),a(!1))}));const o=n.apply(this,arguments);return o;function a(e){return function(){t.emit("propagate",[null,!i],o,!1,!1),i=i||!e}}}})),["resolve","reject"].forEach((function(r){const n=a[r];e[r]=function(e){const r=n.apply(this,arguments);return e!==r&&t.emit("propagate",[e,!0],r,!1,!1),r}})),e.prototype=a.prototype;const n=a.prototype.then;a.prototype.then=function(){var e=this,i=r(e);i.promise=e;for(var a=arguments.length,s=new Array(a),c=0;c e())),t};function m(e,t){i.inPlace(t,["onreadystatechange"],"fn-",E)}function b(){var e=this,t=r.context(e);e.readyState>3&&!t.resolved&&(t.resolved=!0,r.emit("xhr-resolved",[],e)),i.inPlace(e,f,"fn-",E)}if(function(e,t){for(var r in e)t[r]=e[r]}(o,p),p.prototype=o.prototype,i.inPlace(p.prototype,J,"-xhr-",E),r.on("send-xhr-start",(function(e,t){m(e,t),function(e){h.push(e),a&&(y?y.then(A):u?u(A):(w=-w,x.data=w))}(t)})),r.on("open-xhr-start",m),a){var y=c&&c.resolve();if(!u&&!c){var w=1,x=document.createTextNode(w);new a(A).observe(x,{characterData:!0})}}else t.on("fn-end",(function(e){e[0]&&e[0].type===d||A()}));function A(){for(var e=0;e {r.d(t,{t:()=>n});const n=r(3325).D.ajax},6660:(e,t,r)=>{r.d(t,{A:()=>i,t:()=>n});const n=r(3325).D.jserrors,i="nr@seenError"},3081:(e,t,r)=>{r.d(t,{gF:()=>o,mY:()=>i,t9:()=>n,vz:()=>s,xS:()=>a});const n=r(3325).D.metrics,i="sm",o="cm",a="storeSupportabilityMetrics",s="storeEventMetrics"},4649:(e,t,r)=>{r.d(t,{t:()=>n});const n=r(3325).D.pageAction},7633:(e,t,r)=>{r.d(t,{Dz:()=>i,OJ:()=>a,qw:()=>o,t9:()=>n});const n=r(3325).D.pageViewEvent,i="firstbyte",o="domcontent",a="windowload"},9251:(e,t,r)=>{r.d(t,{t:()=>n});const n=r(3325).D.pageViewTiming},3614:(e,t,r)=>{r.d(t,{BST_RESOURCE:()=>i,END:()=>s,FEATURE_NAME:()=>n,FN_END:()=>u,FN_START:()=>c,PUSH_STATE:()=>d,RESOURCE:()=>o,START:()=>a});const n=r(3325).D.sessionTrace,i="bstResource",o="resource",a="-start",s="-end",c="fn"+a,u="fn"+s,d="pushState"},7836:(e,t,r)=>{r.d(t,{BODY:()=>A,CB_END:()=>E,CB_START:()=>u,END:()=>x,FEATURE_NAME:()=>i,FETCH:()=>_,FETCH_BODY:()=>v,FETCH_DONE:()=>m,FETCH_START:()=>p,FN_END:()=>c,FN_START:()=>s,INTERACTION:()=>l,INTERACTION_API:()=>d,INTERACTION_EVENTS:()=>o,JSONP_END:()=>b,JSONP_NODE:()=>g,JS_TIME:()=>T,MAX_TIMER_BUDGET:()=>a,REMAINING:()=>f,SPA_NODE:()=>h,START:()=>w,originalSetTimeout:()=>y});var n=r(5763);const i=r(3325).D.spa,o=["click","submit","keypress","keydown","keyup","change"],a=999,s="fn-start",c="fn-end",u="cb-start",d="api-ixn-",f="remaining",l="interaction",h="spaNode",g="jsonpNode",p="fetch-start",m="fetch-done",v="fetch-body-",b="jsonp-end",y=n.Yu.ST,w="-start",x="-end",A="-body",E="cb"+x,T="jsTime",_="fetch"},5938:(e,t,r)=>{r.d(t,{W:()=>o});var n=r(5763),i=r(2177);class o{constructor(e,t,r){this.agentIdentifier=e,this.aggregator=t,this.ee=i.ee.get(e,(0,n.OP)(this.agentIdentifier).isolatedBacklog),this.featureName=r,this.blocked=!1}}},9144:(e,t,r)=>{r.d(t,{j:()=>m});var n=r(3325),i=r(5763),o=r(5546),a=r(2177),s=r(7894),c=r(8e3),u=r(3960),d=r(385),f=r(50),l=r(3081),h=r(8632);function g(){const e=(0,h.gG)();["setErrorHandler","finished","addToTrace","inlineHit","addRelease","addPageAction","setCurrentRouteName","setPageViewName","setCustomAttribute","interaction","noticeError","setUserId"].forEach((t=>{e[t]=function(){for(var r=arguments.length,n=new Array(r),i=0;i 1?r-1:0),i=1;i {e.exposed&&e.api[t]&&o.push(e.api[t](...n))})),o.length>1?o:o[0]}(t,...n)}}))}var p=r(2587);function m(e){let t=arguments.length>1&&void 0!==arguments[1]?arguments[1]:{},m=arguments.length>2?arguments[2]:void 0,v=arguments.length>3?arguments[3]:void 0,{init:b,info:y,loader_config:w,runtime:x={loaderType:m},exposed:A=!0}=t;const E=(0,h.gG)();y||(b=E.init,y=E.info,w=E.loader_config),(0,i.Dg)(e,b||{}),(0,i.GE)(e,w||{}),(0,i.sU)(e,x),y.jsAttributes??={},d.v6&&(y.jsAttributes.isWorker=!0),(0,i.CX)(e,y),g();const T=function(e,t){t||(0,c.R)(e,"api");const h={};var g=a.ee.get(e),p=g.get("tracer"),m="api-",v=m+"ixn-";function b(t,r,n,o){const a=(0,i.C5)(e);return null===r?delete a.jsAttributes[t]:(0,i.CX)(e,{...a,jsAttributes:{...a.jsAttributes,[t]:r}}),x(m,n,!0,o||null===r?"session":void 0)(t,r)}function y(){}["setErrorHandler","finished","addToTrace","inlineHit","addRelease"].forEach((e=>h[e]=x(m,e,!0,"api"))),h.addPageAction=x(m,"addPageAction",!0,n.D.pageAction),h.setCurrentRouteName=x(m,"routeName",!0,n.D.spa),h.setPageViewName=function(t,r){if("string"==typeof t)return"/"!==t.charAt(0)&&(t="/"+t),(0,i.OP)(e).customTransaction=(r||"http://custom.transaction")+t,x(m,"setPageViewName",!0)()},h.setCustomAttribute=function(e,t){let r=arguments.length>2&&void 0!==arguments[2]&&arguments[2];if("string"==typeof e){if(["string","number"].includes(typeof t)||null===t)return b(e,t,"setCustomAttribute",r);(0,f.Z)("Failed to execute setCustomAttribute.\nNon-null value must be a string or number type, but a type of was provided."))}else(0,f.Z)("Failed to execute setCustomAttribute.\nName must be a string type, but a type of was provided."))},h.setUserId=function(e){if("string"==typeof e||null===e)return b("enduser.id",e,"setUserId",!0);(0,f.Z)("Failed to execute setUserId.\nNon-null value must be a string type, but a type of was provided."))},h.interaction=function(){return(new y).get()};var w=y.prototype={createTracer:function(e,t){var r={},i=this,a="function"==typeof t;return(0,o.p)(v+"tracer",[(0,s.z)(),e,r],i,n.D.spa,g),function(){if(p.emit((a?"":"no-")+"fn-start",[(0,s.z)(),i,a],r),a)try{return t.apply(this,arguments)}catch(e){throw p.emit("fn-err",[arguments,this,"string"==typeof e?new Error(e):e],r),e}finally{p.emit("fn-end",[(0,s.z)()],r)}}}};function x(e,t,r,i){return function(){return(0,o.p)(l.xS,["API/"+t+"/called"],void 0,n.D.metrics,g),i&&(0,o.p)(e+t,[(0,s.z)(),...arguments],r?null:this,i,g),r?void 0:this}}function A(){r.e(439).then(r.bind(r,7438)).then((t=>{let{setAPI:r}=t;r(e),(0,c.L)(e,"api")})).catch((()=>(0,f.Z)("Downloading runtime APIs failed...")))}return["actionText","setName","setAttribute","save","ignore","onEnd","getContext","end","get"].forEach((e=>{w[e]=x(v,e,void 0,n.D.spa)})),h.noticeError=function(e,t){"string"==typeof e&&(e=new Error(e)),(0,o.p)(l.xS,["API/noticeError/called"],void 0,n.D.metrics,g),(0,o.p)("err",[e,(0,s.z)(),!1,t],void 0,n.D.jserrors,g)},d.il?(0,u.b)((()=>A()),!0):A(),h}(e,v);return(0,h.Qy)(e,T,"api"),(0,h.Qy)(e,A,"exposed"),(0,h.EZ)("activatedFeatures",p.T),T}},3325:(e,t,r)=>{r.d(t,{D:()=>n,p:()=>i});const n={ajax:"ajax",jserrors:"jserrors",metrics:"metrics",pageAction:"page_action",pageViewEvent:"page_view_event",pageViewTiming:"page_view_timing",sessionReplay:"session_replay",sessionTrace:"session_trace",spa:"spa"},i={[n.pageViewEvent]:1,[n.pageViewTiming]:2,[n.metrics]:3,[n.jserrors]:4,[n.ajax]:5,[n.sessionTrace]:6,[n.pageAction]:7,[n.spa]:8,[n.sessionReplay]:9}}},n={};function i(e){var t=n[e];if(void 0!==t)return t.exports;var o=n[e]={exports:{}};return r[e](o,o.exports,i),o.exports}i.m=r,i.d=(e,t)=>{for(var r in t)i.o(t,r)&&!i.o(e,r)&&Object.defineProperty(e,r,{enumerable:!0,get:t[r]})},i.f={},i.e=e=>Promise.all(Object.keys(i.f).reduce(((t,r)=>(i.f[r](e,t),t)),[])),i.u=e=>(({78:"page_action-aggregate",147:"metrics-aggregate",242:"session-manager",317:"jserrors-aggregate",348:"page_view_timing-aggregate",412:"lazy-feature-loader",439:"async-api",538:"recorder",590:"session_replay-aggregate",675:"compressor",733:"session_trace-aggregate",786:"page_view_event-aggregate",873:"spa-aggregate",898:"ajax-aggregate"}[e]||e)+"."+{78:"ac76d497",147:"3dc53903",148:"1a20d5fe",242:"2a64278a",317:"49e41428",348:"bd6de33a",412:"2f55ce66",439:"30bd804e",538:"1b18459f",590:"cf0efb30",675:"ae9f91a8",733:"83105561",786:"06482edd",860:"03a8b7a5",873:"e6b09d52",898:"998ef92b"}[e]+"-1.236.0.min.js"),i.o=(e,t)=>Object.prototype.hasOwnProperty.call(e,t),e={},t="NRBA:",i.l=(r,n,o,a)=>{if(e[r])e[r].push(n);else{var s,c;if(void 0!==o)for(var u=document.getElementsByTagName("script"),d=0;d {s.onerror=s.onload=null,clearTimeout(h);var i=e[r];if(delete e[r],s.parentNode&&s.parentNode.removeChild(s),i&&i.forEach((e=>e(n))),t)return t(n)},h=setTimeout(l.bind(null,void 0,{type:"timeout",target:s}),12e4);s.onerror=l.bind(null,s.onerror),s.onload=l.bind(null,s.onload),c&&document.head.appendChild(s)}},i.r=e=>{"undefined"!=typeof Symbol&&Symbol.toStringTag&&Object.defineProperty(e,Symbol.toStringTag,{value:"Module"}),Object.defineProperty(e,"__esModule",{value:!0})},i.j=364,i.p="https://js-agent.newrelic.com/",(()=>{var e={364:0,953:0};i.f.j=(t,r)=>{var n=i.o(e,t)?e[t]:void 0;if(0!==n)if(n)r.push(n[2]);else{var o=new Promise(((r,i)=>n=e[t]=[r,i]));r.push(n[2]=o);var a=i.p+i.u(t),s=new Error;i.l(a,(r=>{if(i.o(e,t)&&(0!==(n=e[t])&&(e[t]=void 0),n)){var o=r&&("load"===r.type?"missing":r.type),a=r&&r.target&&r.target.src;s.message="Loading chunk "+t+" failed.\n("+o+": "+a+")",s.name="ChunkLoadError",s.type=o,s.request=a,n[1](s)}}),"chunk-"+t,t)}};var t=(t,r)=>{var n,o,[a,s,c]=r,u=0;if(a.some((t=>0!==e[t]))){for(n in s)i.o(s,n)&&(i.m[n]=s[n]);if(c)c(i)}for(t&&t(r);u {i.r(o);var e=i(3325),t=i(5763);const r=Object.values(e.D);function n(e){const n={};return r.forEach((r=>{n[r]=function(e,r){return!1!==(0,t.Mt)(r,"".concat(e,".enabled"))}(r,e)})),n}var a=i(9144);var s=i(5546),c=i(385),u=i(8e3),d=i(5938),f=i(3960),l=i(50);class h extends d.W{constructor(e,t,r){let n=!(arguments.length>3&&void 0!==arguments[3])||arguments[3];super(e,t,r),this.auto=n,this.abortHandler,this.featAggregate,this.onAggregateImported,n&&(0,u.R)(e,r)}importAggregator(){let e=arguments.length>0&&void 0!==arguments[0]?arguments[0]:{};if(this.featAggregate||!this.auto)return;const r=c.il&&!0===(0,t.Mt)(this.agentIdentifier,"privacy.cookies_enabled");let n;this.onAggregateImported=new Promise((e=>{n=e}));const o=async()=>{let t;try{if(r){const{setupAgentSession:e}=await Promise.all([i.e(860),i.e(242)]).then(i.bind(i,3228));t=e(this.agentIdentifier)}}catch(e){(0,l.Z)("A problem occurred when starting up session manager. This page will not start or extend any session.",e)}try{if(!this.shouldImportAgg(this.featureName,t))return void(0,u.L)(this.agentIdentifier,this.featureName);const{lazyFeatureLoader:r}=await i.e(412).then(i.bind(i,8582)),{Aggregate:o}=await r(this.featureName,"aggregate");this.featAggregate=new o(this.agentIdentifier,this.aggregator,e),n(!0)}catch(e){(0,l.Z)("Downloading and initializing ".concat(this.featureName," failed..."),e),this.abortHandler?.(),n(!1)}};c.il?(0,f.b)((()=>o()),!0):o()}shouldImportAgg(r,n){return r!==e.D.sessionReplay||!1!==(0,t.Mt)(this.agentIdentifier,"session_trace.enabled")&&(!!n?.isNew||!!n?.state.sessionReplay)}}var g=i(7633),p=i(7894);class m extends h{static featureName=g.t9;constructor(r,n){let i=!(arguments.length>2&&void 0!==arguments[2])||arguments[2];if(super(r,n,g.t9,i),("undefined"==typeof PerformanceNavigationTiming||c.Tt)&&"undefined"!=typeof PerformanceTiming){const n=(0,t.OP)(r);n[g.Dz]=Math.max(Date.now()-n.offset,0),(0,f.K)((()=>n[g.qw]=Math.max((0,p.z)()-n[g.Dz],0))),(0,f.b)((()=>{const t=(0,p.z)();n[g.OJ]=Math.max(t-n[g.Dz],0),(0,s.p)("timing",["load",t],void 0,e.D.pageViewTiming,this.ee)}))}this.importAggregator()}}var v=i(1117),b=i(1284);class y extends v.w{constructor(e){super(e),this.aggregatedData={}}store(e,t,r,n,i){var o=this.getBucket(e,t,r,i);return o.metrics=function(e,t){t||(t={count:0});return t.count+=1,(0,b.D)(e,(function(e,r){t[e]=w(r,t[e])})),t}(n,o.metrics),o}merge(e,t,r,n,i){var o=this.getBucket(e,t,n,i);if(o.metrics){var a=o.metrics;a.count+=r.count,(0,b.D)(r,(function(e,t){if("count"!==e){var n=a[e],i=r[e];i&&!i.c?a[e]=w(i.t,n):a[e]=function(e,t){if(!t)return e;t.c||(t=x(t.t));return t.min=Math.min(e.min,t.min),t.max=Math.max(e.max,t.max),t.t+=e.t,t.sos+=e.sos,t.c+=e.c,t}(i,a[e])}}))}else o.metrics=r}storeMetric(e,t,r,n){var i=this.getBucket(e,t,r);return i.stats=w(n,i.stats),i}getBucket(e,t,r,n){this.aggregatedData[e]||(this.aggregatedData[e]={});var i=this.aggregatedData[e][t];return i||(i=this.aggregatedData[e][t]={params:r||{}},n&&(i.custom=n)),i}get(e,t){return t?this.aggregatedData[e]&&this.aggregatedData[e][t]:this.aggregatedData[e]}take(e){for(var t={},r="",n=!1,i=0;i t.max&&(t.max=e),e 2&&void 0!==arguments[2])||arguments[2];super(e,r,j.t,n),c.il&&((0,t.OP)(e).initHidden=Boolean("hidden"===document.visibilityState),(0,N.N)((()=>(0,s.p)("docHidden",[(0,p.z)()],void 0,j.t,this.ee)),!0),(0,O.bP)("pagehide",(()=>(0,s.p)("winPagehide",[(0,p.z)()],void 0,j.t,this.ee))),this.importAggregator())}}var P=i(3081);class C extends h{static featureName=P.t9;constructor(e,t){let r=!(arguments.length>2&&void 0!==arguments[2])||arguments[2];super(e,t,P.t9,r),this.importAggregator()}}var R,I=i(2210),k=i(1214),H=i(2177),L={};try{R=localStorage.getItem("__nr_flags").split(","),console&&"function"==typeof console.log&&(L.console=!0,-1!==R.indexOf("dev")&&(L.dev=!0),-1!==R.indexOf("nr_dev")&&(L.nrDev=!0))}catch(e){}function z(e){try{L.console&&z(e)}catch(e){}}L.nrDev&&H.ee.on("internal-error",(function(e){z(e.stack)})),L.dev&&H.ee.on("fn-err",(function(e,t,r){z(r.stack)})),L.dev&&(z("NR AGENT IN DEVELOPMENT MODE"),z("flags: "+(0,b.D)(L,(function(e,t){return e})).join(", ")));var M=i(6660);class B extends h{static featureName=M.t;constructor(r,n){let i=!(arguments.length>2&&void 0!==arguments[2])||arguments[2];super(r,n,M.t,i),this.skipNext=0;try{this.removeOnAbort=new AbortController}catch(e){}const o=this;o.ee.on("fn-start",(function(e,t,r){o.abortHandler&&(o.skipNext+=1)})),o.ee.on("fn-err",(function(t,r,n){o.abortHandler&&!n[M.A]&&((0,I.X)(n,M.A,(function(){return!0})),this.thrown=!0,(0,s.p)("err",[n,(0,p.z)()],void 0,e.D.jserrors,o.ee))})),o.ee.on("fn-end",(function(){o.abortHandler&&!this.thrown&&o.skipNext>0&&(o.skipNext-=1)})),o.ee.on("internal-error",(function(t){(0,s.p)("ierr",[t,(0,p.z)(),!0],void 0,e.D.jserrors,o.ee)})),this.origOnerror=c._A.onerror,c._A.onerror=this.onerrorHandler.bind(this),c._A.addEventListener("unhandledrejection",(t=>{const r=function(e){let t="Unhandled Promise Rejection: ";if(e instanceof Error)try{return e.message=t+e.message,e}catch(t){return e}if(void 0===e)return new Error(t);try{return new Error(t+(0,D.P)(e))}catch(e){return new Error(t)}}(t.reason);(0,s.p)("err",[r,(0,p.z)(),!1,{unhandledPromiseRejection:1}],void 0,e.D.jserrors,this.ee)}),(0,O.m$)(!1,this.removeOnAbort?.signal)),(0,k.gy)(this.ee),(0,k.BV)(this.ee),(0,k.em)(this.ee),(0,t.OP)(r).xhrWrappable&&(0,k.Kf)(this.ee),this.abortHandler=this.#e,this.importAggregator()}#e(){this.removeOnAbort?.abort(),this.abortHandler=void 0}onerrorHandler(t,r,n,i,o){"function"==typeof this.origOnerror&&this.origOnerror(...arguments);try{this.skipNext?this.skipNext-=1:(0,s.p)("err",[o||new F(t,r,n),(0,p.z)()],void 0,e.D.jserrors,this.ee)}catch(t){try{(0,s.p)("ierr",[t,(0,p.z)(),!0],void 0,e.D.jserrors,this.ee)}catch(e){}}return!1}}function F(e,t,r){this.message=e||"Uncaught error with no additional information",this.sourceURL=t,this.line=r}let U=1;const q="nr@id";function G(e){const t=typeof e;return!e||"object"!==t&&"function"!==t?-1:e===c._A?0:(0,I.X)(e,q,(function(){return U++}))}function V(e){if("string"==typeof e&&e.length)return e.length;if("object"==typeof e){if("undefined"!=typeof ArrayBuffer&&e instanceof ArrayBuffer&&e.byteLength)return e.byteLength;if("undefined"!=typeof Blob&&e instanceof Blob&&e.size)return e.size;if(!("undefined"!=typeof FormData&&e instanceof FormData))try{return(0,D.P)(e).length}catch(e){return}}}var X=i(7243);class W{constructor(e){this.agentIdentifier=e,this.generateTracePayload=this.generateTracePayload.bind(this),this.shouldGenerateTrace=this.shouldGenerateTrace.bind(this)}generateTracePayload(e){if(!this.shouldGenerateTrace(e))return null;var r=(0,t.DL)(this.agentIdentifier);if(!r)return null;var n=(r.accountID||"").toString()||null,i=(r.agentID||"").toString()||null,o=(r.trustKey||"").toString()||null;if(!n||!i)return null;var a=(0,_.M)(),s=(0,_.Ht)(),c=Date.now(),u={spanId:a,traceId:s,timestamp:c};return(e.sameOrigin||this.isAllowedOrigin(e)&&this.useTraceContextHeadersForCors())&&(u.traceContextParentHeader=this.generateTraceContextParentHeader(a,s),u.traceContextStateHeader=this.generateTraceContextStateHeader(a,c,n,i,o)),(e.sameOrigin&&!this.excludeNewrelicHeader()||!e.sameOrigin&&this.isAllowedOrigin(e)&&this.useNewrelicHeaderForCors())&&(u.newrelicHeader=this.generateTraceHeader(a,s,c,n,i,o)),u}generateTraceContextParentHeader(e,t){return"00-"+t+"-"+e+"-01"}generateTraceContextStateHeader(e,t,r,n,i){return i+"@nr=0-1-"+r+"-"+n+"-"+e+"----"+t}generateTraceHeader(e,t,r,n,i,o){if(!("function"==typeof c._A?.btoa))return null;var a={v:[0,1],d:{ty:"Browser",ac:n,ap:i,id:e,tr:t,ti:r}};return o&&n!==o&&(a.d.tk=o),btoa((0,D.P)(a))}shouldGenerateTrace(e){return this.isDtEnabled()&&this.isAllowedOrigin(e)}isAllowedOrigin(e){var r=!1,n={};if((0,t.Mt)(this.agentIdentifier,"distributed_tracing")&&(n=(0,t.P_)(this.agentIdentifier).distributed_tracing),e.sameOrigin)r=!0;else if(n.allowed_origins instanceof Array)for(var i=0;i 2&&void 0!==arguments[2])||arguments[2];super(r,n,Z.t,i),(0,t.OP)(r).xhrWrappable&&(this.dt=new W(r),this.handler=(e,t,r,n)=>(0,s.p)(e,t,r,n,this.ee),(0,k.u5)(this.ee),(0,k.Kf)(this.ee),function(r,n,i,o){function a(e){var t=this;t.totalCbs=0,t.called=0,t.cbTime=0,t.end=E,t.ended=!1,t.xhrGuids={},t.lastSize=null,t.loadCaptureCalled=!1,t.params=this.params||{},t.metrics=this.metrics||{},e.addEventListener("load",(function(r){_(t,e)}),(0,O.m$)(!1)),c.IF||e.addEventListener("progress",(function(e){t.lastSize=e.loaded}),(0,O.m$)(!1))}function s(e){this.params={method:e[0]},T(this,e[1]),this.metrics={}}function u(e,n){var i=(0,t.DL)(r);i.xpid&&this.sameOrigin&&n.setRequestHeader("X-NewRelic-ID",i.xpid);var a=o.generateTracePayload(this.parsedOrigin);if(a){var s=!1;a.newrelicHeader&&(n.setRequestHeader("newrelic",a.newrelicHeader),s=!0),a.traceContextParentHeader&&(n.setRequestHeader("traceparent",a.traceContextParentHeader),a.traceContextStateHeader&&n.setRequestHeader("tracestate",a.traceContextStateHeader),s=!0),s&&(this.dt=a)}}function d(e,t){var r=this.metrics,i=e[0],o=this;if(r&&i){var a=V(i);a&&(r.txSize=a)}this.startTime=(0,p.z)(),this.listener=function(e){try{"abort"!==e.type||o.loadCaptureCalled||(o.params.aborted=!0),("load"!==e.type||o.called===o.totalCbs&&(o.onloadCalled||"function"!=typeof t.onload)&&"function"==typeof o.end)&&o.end(t)}catch(e){try{n.emit("internal-error",[e])}catch(e){}}};for(var s=0;s 1?e[1]=i:e.push(i)}else e[0]&&e[0].headers&&s(e[0].headers,n)&&(this.dt=n);function s(e,t){var r=!1;return t.newrelicHeader&&(e.set("newrelic",t.newrelicHeader),r=!0),t.traceContextParentHeader&&(e.set("traceparent",t.traceContextParentHeader),t.traceContextStateHeader&&e.set("tracestate",t.traceContextStateHeader),r=!0),r}}function x(e,t){this.params={},this.metrics={},this.startTime=(0,p.z)(),this.dt=t,e.length>=1&&(this.target=e[0]),e.length>=2&&(this.opts=e[1]);var r,n=this.opts||{},i=this.target;"string"==typeof i?r=i:"object"==typeof i&&i instanceof Y?r=i.url:c._A?.URL&&"object"==typeof i&&i instanceof URL&&(r=i.href),T(this,r);var o=(""+(i&&i instanceof Y&&i.method||n.method||"GET")).toUpperCase();this.params.method=o,this.txSize=V(n.body)||0}function A(t,r){var n;this.endTime=(0,p.z)(),this.params||(this.params={}),this.params.status=r?r.status:0,"string"==typeof this.rxSize&&this.rxSize.length>0&&(n=+this.rxSize);var o={txSize:this.txSize,rxSize:n,duration:(0,p.z)()-this.startTime};i("xhr",[this.params,o,this.startTime,this.endTime,"fetch"],this,e.D.ajax)}function E(t){var r=this.params,n=this.metrics;if(!this.ended){this.ended=!0;for(var o=0;o 2&&void 0!==arguments[2])||arguments[2];super(e,t,we.t,r),this.importAggregator()}}new class{constructor(e){let t=arguments.length>1&&void 0!==arguments[1]?arguments[1]:(0,_.ky)(16);c._A?(this.agentIdentifier=t,this.sharedAggregator=new y({agentIdentifier:this.agentIdentifier}),this.features={},this.desiredFeatures=new Set(e.features||[]),this.desiredFeatures.add(m),Object.assign(this,(0,a.j)(this.agentIdentifier,e,e.loaderType||"agent")),this.start()):(0,l.Z)("Failed to initial the agent. Could not determine the runtime environment.")}get config(){return{info:(0,t.C5)(this.agentIdentifier),init:(0,t.P_)(this.agentIdentifier),loader_config:(0,t.DL)(this.agentIdentifier),runtime:(0,t.OP)(this.agentIdentifier)}}start(){const t="features";try{const r=n(this.agentIdentifier),i=[...this.desiredFeatures];i.sort(((t,r)=>e.p[t.featureName]-e.p[r.featureName])),i.forEach((t=>{if(r[t.featureName]||t.featureName===e.D.pageViewEvent){const n=function(t){switch(t){case e.D.ajax:return[e.D.jserrors];case e.D.sessionTrace:return[e.D.ajax,e.D.pageViewEvent];case e.D.sessionReplay:return[e.D.sessionTrace];case e.D.pageViewTiming:return[e.D.pageViewEvent];default:return[]}}(t.featureName);n.every((e=>r[e]))||(0,l.Z)("".concat(t.featureName," is enabled but one or more dependent features has been disabled (").concat((0,D.P)(n),"). This may cause unintended consequences or missing data...")),this.features[t.featureName]=new t(this.agentIdentifier,this.sharedAggregator)}})),(0,T.Qy)(this.agentIdentifier,this.features,t)}catch(e){(0,l.Z)("Failed to initialize all enabled instrument classes (agent aborted) -",e);for(const e in this.features)this.features[e].abortHandler?.();const r=(0,T.fP)();return delete r.initializedAgents[this.agentIdentifier]?.api,delete r.initializedAgents[this.agentIdentifier]?.[t],delete this.sharedAggregator,r.ee?.abort(),delete r.ee?.get(this.agentIdentifier),!1}}}({features:[J,m,S,class extends h{static featureName=oe;constructor(t,r){if(super(t,r,oe,!(arguments.length>2&&void 0!==arguments[2])||arguments[2]),!c.il)return;const n=this.ee;let i;(0,k.QU)(n),this.eventsEE=(0,k.em)(n),this.eventsEE.on(se,(function(e,t){this.bstStart=(0,p.z)()})),this.eventsEE.on(ae,(function(t,r){(0,s.p)("bst",[t[0],r,this.bstStart,(0,p.z)()],void 0,e.D.sessionTrace,n)})),n.on(ce+ne,(function(e){this.time=(0,p.z)(),this.startPath=location.pathname+location.hash})),n.on(ce+ie,(function(t){(0,s.p)("bstHist",[location.pathname+location.hash,this.startPath,this.time],void 0,e.D.sessionTrace,n)}));try{i=new PerformanceObserver((t=>{const r=t.getEntries();(0,s.p)(te,[r],void 0,e.D.sessionTrace,n)})),i.observe({type:re,buffered:!0})}catch(e){}this.importAggregator({resourceObserver:i})}},C,xe,B,class extends h{static featureName=de;constructor(e,r){if(super(e,r,de,!(arguments.length>2&&void 0!==arguments[2])||arguments[2]),!c.il)return;if(!(0,t.OP)(e).xhrWrappable)return;try{this.removeOnAbort=new AbortController}catch(e){}let n,i=0;const o=this.ee.get("tracer"),a=(0,k._L)(this.ee),s=(0,k.Lg)(this.ee),u=(0,k.BV)(this.ee),d=(0,k.Kf)(this.ee),f=this.ee.get("events"),l=(0,k.u5)(this.ee),h=(0,k.QU)(this.ee),g=(0,k.Gm)(this.ee);function m(e,t){h.emit("newURL",[""+window.location,t])}function v(){i++,n=window.location.hash,this[ve]=(0,p.z)()}function b(){i--,window.location.hash!==n&&m(0,!0);var e=(0,p.z)();this[pe]=~~this[pe]+e-this[ve],this[ye]=e}function y(e,t){e.on(t,(function(){this[t]=(0,p.z)()}))}this.ee.on(ve,v),s.on(be,v),a.on(be,v),this.ee.on(ye,b),s.on(ge,b),a.on(ge,b),this.ee.buffer([ve,ye,"xhr-resolved"],this.featureName),f.buffer([ve],this.featureName),u.buffer(["setTimeout"+le,"clearTimeout"+fe,ve],this.featureName),d.buffer([ve,"new-xhr","send-xhr"+fe],this.featureName),l.buffer([me+fe,me+"-done",me+he+fe,me+he+le],this.featureName),h.buffer(["newURL"],this.featureName),g.buffer([ve],this.featureName),s.buffer(["propagate",be,ge,"executor-err","resolve"+fe],this.featureName),o.buffer([ve,"no-"+ve],this.featureName),a.buffer(["new-jsonp","cb-start","jsonp-error","jsonp-end"],this.featureName),y(l,me+fe),y(l,me+"-done"),y(a,"new-jsonp"),y(a,"jsonp-end"),y(a,"cb-start"),h.on("pushState-end",m),h.on("replaceState-end",m),window.addEventListener("hashchange",m,(0,O.m$)(!0,this.removeOnAbort?.signal)),window.addEventListener("load",m,(0,O.m$)(!0,this.removeOnAbort?.signal)),window.addEventListener("popstate",(function(){m(0,i>1)}),(0,O.m$)(!0,this.removeOnAbort?.signal)),this.abortHandler=this.#e,this.importAggregator()}#e(){this.removeOnAbort?.abort(),this.abortHandler=void 0}}],loaderType:"spa"})})(),window.NRBA=o})(); window.jQuery || document.write(' ') CKEDITOR_BASEPATH='https://gatesopenresearch.org/js/vendor/ckeditor/' window.reactTheme = 'gates'; window.MathJax = { CommonHTML: { linebreaks: { automatic: true } }, 'HTML-CSS': { linebreaks: { automatic: true } }, SVG: { linebreaks: { automatic: true } }, AuthorInit: function() { MathJax.Hub.Register.MessageHook('End Process', function () { let timeout = false; // holder for timeout id const delay = 250; // delay after event is "complete" to run callback const reflowMath = function() { const dispFormulas = document.querySelectorAll('.disp-formula.panel'); if (!dispFormulas) { return; } for (const dispFormula of dispFormulas) { const child = dispFormula.querySelector('.MathJax_Preview').nextSibling.firstChild; const isMultiline = MathJax.Hub.getAllJax(dispFormula)[0].root.isMultiline; if (dispFormula.offsetWidth < child.offsetWidth || isMultiline) { MathJax.Hub.Queue(['Rerender', MathJax.Hub, dispFormula]); } } }; window.addEventListener('resize', function() { clearTimeout(timeout); // clear the timeout timeout = setTimeout(reflowMath, delay); // start timing for event "completion" }); }); }, }; if (window.location.hash == '#_=_'){ window.location = window.location.href.split('#')[0] } !function(f,b,e,v,n,t,s){if(f.fbq)return;n=f.fbq=function() {n.callMethod? n.callMethod.apply(n,arguments):n.queue.push(arguments)} ;if(!f._fbq)f._fbq=n; n.push=n;n.loaded=!0;n.version='2.0';n.queue=[];t=b.createElement(e);t.async=!0; t.src=v;s=b.getElementsByTagName(e)[0];s.parentNode.insertBefore(t,s)}(window, document,'script','https://connect.facebook.net/en_US/fbevents.js'); fbq('init', '1641728616063202'); fbq('track', "PixelInitialized", {}); Skip to content Gates Open Research file_upload Submit via VeriXiv search clear search menu close clear Search Browse Gateways & Collections How to Publish Submit via VeriXiv My Submissions Article Guidelines Article Guidelines (New Versions) Open Data, Software and Code Guidelines Open Data and Accessible Source Materials Guidelines (HSS) Prepublication Checks Production Process Posters and Slides Guidelines Document Guidelines Publication Charges Finding Article Reviewers About How it Works For Reviewers Our Advisors Policies Glossary FAQs For Developers Contact Blog My Account Submissions Content and Tracking Alerts My Details Sign In Submit via VeriXiv { "@context": "https://schema.org", "@type": "ScholarlyArticle", "mainEntityOfPage": { "@type": "WebPage", "@id": "https://gatesopenresearch.org/articles/6-67" }, "headline": "Knowledge and uptake of contraceptive and other sexual reproductive health services among in-school...", "datePublished": "2022-05-25T13:56:23", "dateModified": "2024-11-11T15:50:01", "author": [ { "@type": "Person", "name": "Melanie Pleaner" }, { "@type": "Person", "name": "Alison Kutywayo" }, { "@type": "Person", "name": "Mags Beksinska" }, { "@type": "Person", "name": "Khuthala Mabetha" }, { "@type": "Person", "name": "Nicolette Naidoo" }, { "@type": "Person", "name": "Saiqa Mullick" } ], "publisher": { "@type": "Organization", "name": "Gates Open Research", "logo": { "@type": "ImageObject", "url": "https://gatesopenresearch.org/img/AMP/Gates_image.png", "height": 600, "width": 47 } }, "image": { "@type": "ImageObject", "url": "https://gatesopenresearch.org/img/AMP/Gates_image.png", "height": 1200, "width": 94 }, "description": " Background South African adolescents experience barriers to sexual and reproductive health (SRH) knowledge and uptake. This study provides insight into contraceptive and other SRH service knowledge, perceptions, and uptake among adolescents in high HIV prevalence settings. Methods A baseline cross sectional survey was conducted among 3432 grade 8s enrolled into the Girls Achieve Power (GAP Year) trial from 26 public high schools across three South African townships (Soweto, Thembisa and Khayelitsha) (2017 - 2018). An interviewer-led survey collected information on SRH knowledge and perceptions; an audio computer-assisted self-interviewing technique gathered SRH service uptake. Descriptive analysis indicates frequency distribution of socio-demographics and knowledge, uptake and perceptions of SRH services. Chi-square test tested for associations between age and sex and selected variables that measure SRH knowledge and uptake. Results In total, 2383 participants completed both survey components. Of these, 63.1% (n=1504) were female and 81.4% (n=1938) aged 12-14. Almost a fifth (18.3%, n=436) had ever had sex and less than 1% had accessed SRH services in the last year. Of the 157 females who had ever had sex, 50.9% had ever used contraception. Of those who had sex in the last three months, 59.0% reported using a contraceptive method. Condom use was inconsistent: almost all females said they had not used or could not remember if a condom was used at last sex. Conclusion This paper contributes to the evidence strengthening learner SRH education, including the national Integrated School Health Programme. Key themes include the need for age-appropriate, differentiated comprehensive sexuality education (CSE) for the range of ages found in the same grade in South African schools. Education on different contraceptive methods, informed decision-making, and emergency contraception is key. School-based interventions should embrace integrated HIV, STI, and pregnancy prevention messages. Closer links with health services need to be constantly fostered and reinforced. " } { "@context": "http://schema.org", "@type": "BreadcrumbList", "itemListElement": [ { "@type": "ListItem", "position": "1", "item": { "@id": "https://gatesopenresearch.org/", "name": "Home" } }, { "@type": "ListItem", "position": "2", "item": { "@id": "https://gatesopenresearch.org/browse/articles", "name": "Browse" } }, { "@type": "ListItem", "position": "3", "item": { "@id": "https://gatesopenresearch.org/articles/6-67/v3", "name": "Knowledge and uptake of contraceptive and other sexual reproductive..." } } ] } Home Browse Knowledge and uptake of contraceptive and other sexual reproductive... ALL Metrics - Views Downloads Get PDF Get XML Cite How to cite this article Pleaner M, Kutywayo A, Beksinska M et al. Knowledge and uptake of contraceptive and other sexual reproductive health services among in-school adolescents in three South African townships: Baseline findings from the Girls Achieve Power (GAP Year) Trial [version 3; peer review: 2 approved, 2 approved with reservations] . Gates Open Res 2024, 6 :67 ( https://doi.org/10.12688/gatesopenres.13636.3 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Research Article Revised Knowledge and uptake of contraceptive and other sexual reproductive health services among in-school adolescents in three South African townships: Baseline findings from the Girls Achieve Power (GAP Year) Trial [version 3; peer review: 2 approved, 2 approved with reservations] Previous Title 'Knowledge, uptake and patterns of contraception use among in-school adolescents in three South African townships: Baseline findings from the Girls Achieve Power (GAP Year) Trial' Melanie Pleaner https://orcid.org/0000-0003-1323-6162 1 , Alison Kutywayo https://orcid.org/0000-0001-5545-7030 1 , Mags Beksinska 2 , Khuthala Mabetha 1 , Nicolette Naidoo https://orcid.org/0000-0002-7197-9426 1 , Saiqa Mullick https://orcid.org/0000-0001-7039-1949 1 Melanie Pleaner https://orcid.org/0000-0003-1323-6162 1 , Alison Kutywayo https://orcid.org/0000-0001-5545-7030 1 , [...] Mags Beksinska 2 , Khuthala Mabetha 1 , Nicolette Naidoo https://orcid.org/0000-0002-7197-9426 1 , Saiqa Mullick https://orcid.org/0000-0001-7039-1949 1 PUBLISHED 11 Nov 2024 Author details Author details 1 Wits RHI, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, 2193, South Africa 2 MRU (MatCH Research Unit), Department of Obstetrics and Gynaecology, University of the Witwatersrand, Durban, Kwa zulu Natal, 4001, South Africa Melanie Pleaner Roles: Writing – Original Draft Preparation Alison Kutywayo Roles: Investigation, Project Administration, Writing – Original Draft Preparation, Writing – Review & Editing Mags Beksinska Roles: Formal Analysis, Writing – Review & Editing Khuthala Mabetha Roles: Data Curation, Formal Analysis, Writing – Review & Editing Nicolette Naidoo Roles: Conceptualization, Funding Acquisition, Methodology, Supervision, Writing – Review & Editing Saiqa Mullick Roles: Conceptualization, Funding Acquisition, Supervision, Writing – Review & Editing OPEN PEER REVIEW DETAILS REVIEWER STATUS Abstract Background South African adolescents experience barriers to sexual and reproductive health (SRH) knowledge and uptake. This study provides insight into contraceptive and other SRH service knowledge, perceptions, and uptake among adolescents in high HIV prevalence settings. Methods A baseline cross sectional survey was conducted among 3432 grade 8s enrolled into the Girls Achieve Power (GAP Year) trial from 26 public high schools across three South African townships (Soweto, Thembisa and Khayelitsha) (2017 - 2018). An interviewer-led survey collected information on SRH knowledge and perceptions; an audio computer-assisted self-interviewing technique gathered SRH service uptake. Descriptive analysis indicates frequency distribution of socio-demographics and knowledge, uptake and perceptions of SRH services. Chi-square test tested for associations between age and sex and selected variables that measure SRH knowledge and uptake. Results In total, 2383 participants completed both survey components. Of these, 63.1% (n=1504) were female and 81.4% (n=1938) aged 12-14. Almost a fifth (18.3%, n=436) had ever had sex and less than 1% had accessed SRH services in the last year. Of the 157 females who had ever had sex, 50.9% had ever used contraception. Of those who had sex in the last three months, 59.0% reported using a contraceptive method. Condom use was inconsistent: almost all females said they had not used or could not remember if a condom was used at last sex. Conclusion This paper contributes to the evidence strengthening learner SRH education, including the national Integrated School Health Programme. Key themes include the need for age-appropriate, differentiated comprehensive sexuality education (CSE) for the range of ages found in the same grade in South African schools. Education on different contraceptive methods, informed decision-making, and emergency contraception is key. School-based interventions should embrace integrated HIV, STI, and pregnancy prevention messages. Closer links with health services need to be constantly fostered and reinforced. READ ALL READ LESS Keywords Adolescents, Contraception Use, South Africa, SRH Knowledge, Uptake Corresponding Author(s) Melanie Pleaner ( [email protected] ) Close Corresponding author: Melanie Pleaner Competing interests: No competing interests were disclosed. Grant information: This work was supported, in whole by the Gates Foundation [INV-007156]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Copyright: © 2024 Pleaner M et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Pleaner M, Kutywayo A, Beksinska M et al. Knowledge and uptake of contraceptive and other sexual reproductive health services among in-school adolescents in three South African townships: Baseline findings from the Girls Achieve Power (GAP Year) Trial [version 3; peer review: 2 approved, 2 approved with reservations] . Gates Open Res 2024, 6 :67 ( https://doi.org/10.12688/gatesopenres.13636.3 ) First published: 25 May 2022, 6 :67 ( https://doi.org/10.12688/gatesopenres.13636.1 ) Latest published: 11 Nov 2024, 6 :67 ( https://doi.org/10.12688/gatesopenres.13636.3 ) Revised Amendments from Version 2 Changes were made to the title, to reflect the focus of the manuscript. Clarified use of the term 'knowledge', in this manuscript. Tables have been updated: removed the p-values which were non-significant (Table 3), indicating where there were multiple response answers. Streamlined Discussion in line with key findings, acknowledging the resource constrained context. Reference made to the GAP Year intervention in the Discussion have been removed. Added sentence about refusal rate, reporting bias, generalizability, and sample size in Limitations. Changes were made to the title, to reflect the focus of the manuscript. Clarified use of the term 'knowledge', in this manuscript. Tables have been updated: removed the p-values which were non-significant (Table 3), indicating where there were multiple response answers. Streamlined Discussion in line with key findings, acknowledging the resource constrained context. Reference made to the GAP Year intervention in the Discussion have been removed. Added sentence about refusal rate, reporting bias, generalizability, and sample size in Limitations. See the authors' detailed response to the review by Julie Hernandez See the authors' detailed response to the review by Belete Yimer See the authors' detailed response to the review by Catherine MacPhail See the authors' detailed response to the review by Megan A Cohen READ REVIEWER RESPONSES Introduction Globally, there has been significant focus on the potential dividends to be gained by investing in and prioritising adolescent health, including sexual and reproductive health (SRH) and HIV. Although great strides have been made since the SRH historical landmark - the International Conference on Population and Development (ICPD) in 1994 - there are still multiple challenges in accessible SRH service provision for adolescents, resulting in poor health outcomes 1 , 2 . This is particularly so for adolescent girls and young women (AGYW) in sub-Saharan Africa, who continue to experience significant inequalities, challenges and unmet needs for SRH services, together with an associated increased risk of unintended pregnancies, HIV, STIs, complications related to early age pregnancy, and other SRH complications 3 , 4 . In sub-Saharan Africa, more than 50% of rural AGYW aged 15–24 years, and 42% of those in urban areas have been pregnant before the age of 18, with one in five new HIV infections occurring in this age group, despite representing only 10% of the population 5 . This is primarily attributed to limited information, barriers to access, constraints in exercising their SRH rights, lack of comprehensive programmes and service provision, and in many countries, framed by an unsupportive legislative and policy environment 6 , 7 . Although South Africa has progressive and enabling rights-based laws, policies, guidelines and programmes relating to SRH and young people 8 – 10 , the challenges faced in relation to SRH and HIV mirrors similar trends in sub-Saharan Africa. In terms of HIV, 7% of young people age 15–24 are HIV-positive, with AGYW having a four times higher prevalence rate than their male counterparts (12% versus 3%) 11 . The most recent South African National HIV Prevalence, Incidence, Behaviour and Communication Survey ((SABSSM V) 12 provides insight into some of the most important drivers of HIV in young people in South Africa, including early sexual debut, age disparate sex, and condom use. In terms of sexual debut in young people who have had sex, 13.6% reported having had sex before the age of 15 years. More males (aged 15–24) reported this compared to females (13.6% males vs 7.6% females). This pattern has been consistent over the previous four surveys 12 . Teenage pregnancy and its consequences are an ongoing problem 13 , 14 . The 2016 South African Demographic and Health Survey (SADHS) found that 15.6% of South African adolescent females aged 15–19 have begun childbearing. Although adolescent pregnancy has been a major social and economic challenge in South Africa for decades, the prevalence of unintended pregnancies among females aged 15–19 has remained unchanged for the last 20 years 11 . The ramifications of unsupported teenage pregnancy are far reaching and have been well documented, and include early exiting from education 15 , reduced opportunities in employment and further education, socio-economic challenges, associated health risks for both the woman and the infant, increased vulnerably for STIs, HIV and gender-based violence, together with the need for social protection and support 14 – 17 . Contraceptive prevalence in sexually active adolescents aged 15–19 was 60.4% in the 2016 SADHS, with reliance primarily on injectables and male condoms 11 . However consistency in condom use in this age group is poor 12 leaving young women open to unintended pregnancy. Factors contributing to poor contraceptive uptake in adolescents are cross cutting and multi-fold, and include health inequalities, limited contraception knowledge, barriers to accessing services, challenges with regards continuation and correct use, and gender-based violence 18 – 20 . Knowledge about contraception and various contraceptive options is low among South African youth, particularly in relation to both long-acting reversible contraceptives and emergency contraception. For example, data from the 2012 South African household survey indicated only 30.9% of 15–19-year-old females knew of intrauterine devices (IUD), and 36.2% of emergency contraception 21 . A school-based study focusing on secondary school girl learners in grades 10–12 22 showed that while there was awareness about methods, this information was superficial - 58% knew about condoms, 50% injections, 43% oral contraceptive pills, 40% female condom and 10% IUDs, and only 17% knew about emergency contraception, but did not know how to take them. Similarly, there was a lack of information about how to take oral contraceptive pills 22 . In this manuscript knowledge refers to awareness of both services and of methods used. The need to use evidence to understand and design effective, responsive strategies to improve the provision of SRH services for AGYW, and more specifically, preventing teenage pregnancy and the promotion of contraception is now as urgent as ever. However, there is still a gap in research relating to adolescents' use and knowledge of contraception and related services 23 . This study seeks to contribute to the evidence and understanding of the factors influencing adolescent contraception uptake. To this end, we aim to gain insight into the knowledge and uptake of contraception among grade 8 adolescents in a high HIV prevalence setting and utilise the findings to guide interventions to improve access to SRH services, inform comprehensive sexual education (CSE) and strengthen strategies to prevent unintended pregnancies, within the framework of the Integrated School Health Programme (ISHP). Methods Study design and setting This research is part of the Girls Achieve Power Trial ( GAP Year ) cluster randomized controlled trial (cRCT) conducted in 26 non-fee-paying high schools, in three peri-urban townships of South Africa: Khayelitsha (Western Cape Province), and Soweto and Thembisa (Gauteng Province) 24 – 28 . GAP Year was seeking to test the effectiveness of a CSE asset-building intervention aiming to reduce school dropout among adolescent girls between grades 8–10 while shifting gender attitudes and encouraging positive behaviour change among adolescent boys 27 . The GAP Year intervention adopted a four-pronged approach, across the ecological model: a sports-based after-school intervention, parent intervention which includes dialogues and text messaging, linkage to care and school safety 27 . Half of the schools were randomised to the study arm, whilst the other 13 were in the control arm. Schools were selected using the following inclusion criteria: mixed sex public high schools in in quintiles 1–3 * which had not been exposed to any asset building interventions in the past six months. The exclusion criteria for the study were: single-sex schools; private schools; schools that have been exposed to similar interventions and public schools that cater for learners with special needs. A baseline cross sectional analysis was conducted for grade 8 learners enrolled in GAP Year to assess the knowledge, patterns and uptake of contraception among adolescent learners. Data collection took place between April 2017 and September 2018 for all 26 schools. Study population All grade 8 adolescents at selected schools, irrespective of age, sex or race, were invited to participate. The grade 8 learner age range is approximately 12–14 years however due to learners repeating grades and other reasons, the age range is commonly wider with older learners enrolled up to 18 years 29 , 30 . Sample size justification The sample size was computed using cluster-randomized size methodology, suggested by Hayes and Bennett 31 , based on the study’s primary outcome measures, (school dropout and increased reporting of GBV among adolescent girls). The effect size of dropout was factored from other similar studies accounting for a large conservative and representative sample size to measure outcomes. Based on other local studies, it was hypothesized a reduction in drop-out rate from 17.8% as reported by Branson, Hofmeyr 30 to less than 14% (estimated effect size of 20%), with an anticipated attrition rate of 5% per year based on a similar local study 32 . These calculations resulted in an upper limit sample size of 2730 adolescent girls and 1850 boys to determine the association between intervention and control school’s dropout rate and GBV variables, which reflects the sample of the actual trial. Measures The baseline survey was comprised of two components: firstly, an interviewer-led questionnaire and secondly, an audio computer-assisted self-administered interview (ACASI). The first section lasted between 45 minutes to 1 hour, providing information on the participants’ demographic and socio-economic characteristics, knowledge and attitudes pertaining to school safety, social support and social networks, sexuality, gender and norms, sexual reproductive health and rights (SRHR) and care-seeking behaviours. It was conducted by trained fieldworkers and captured directly on an android tablet, formatted with the Research Electronic Data Capture (REDCap) system 33 . In the second section, administered using the Audio Computer Assisted Self-interviewing (ACASI) method, participants were asked sensitive questions regarding their actual practices and behaviour, including questions on uptake of health care services, contraceptive use, sexual debut and relationships. This section lasted 20–30 minutes. The ACASI method was adopted, was seeking to reduce social desirability bias, and later exported into the REDCap online system. The survey was developed in English and back translated into Xhosa (a commonly spoken language at one site) and then pre-tested among selected participants for comprehension. Participants indicated that they preferred to complete the survey in English and therefore translation for the other sites was not provided. During data collection, participants were assigned unique person identifiers. As such, names and other personal information of the participants were not revealed in the datasets. The data were analysed at two levels. Descriptive analysis was used to show the frequency distribution of the sociodemographic characteristics of the respondents as well as the knowledge, uptake and perceptions of sexual and reproductive health services. At the bivariate level, a chi-square test of association was employed to test for an association between age and sex categories and selected variables that measure sexual and reproductive health. Data management and analysis The tablets that were used to collect data utilised password-protected mechanisms to protect the data and the synced data was stored on Wits RHI secured servers. All the data from the REDCap and ACASI systems was exported into Stata 17 34 for analysis. At the univariate level, descriptive frequency tables were used to describe the socio-demographic characteristics of the participants by age and sex. At the bivariate level, variables measuring knowledge, uptake and perceptions around SRH were assessed to examine their association with both sex and age category. Participants’ age was presented in groups (12–14 years and 15–18 years), this is because the 15–18-year age group represent a group that are older than the standard age appropriate range for that grade. They comprised of those who have repeated or skipped a year of schooling or started school later. They may represent a more vulnerable group whose education has been affected by social or economic circumstances. It should be noted that the “no” category has been removed for all dichotomous variables [variables with a Yes or No Response] shown in the results tables. Ethical approval and considerations The study was approved by the University of the Witwatersrand Human Research Ethics Committee (#M160940) in September 2016. The study was also approved by the provincial research committees of the Western Cape and Gauteng Departments of Health and of Education. This was followed by the schools’ approval and written parental informed consent and learner assent. The participating schools, parents and participants were fully informed about the voluntary nature of participation in the study, and of the confidentiality of data management. All data collection was supervised by the research team. Interviewer environments were set up to ensure confidentiality. Where feasible, interviewers were the same sex as the learner. Participants could stop the interview process at any time and were free to refuse to respond to any question(s) they felt uncomfortable answering. Social workers were employed to provide psychosocial support to participants during data collection and study intervention and a social harm form was developed to facilitate prompt referrals, where needed. The Good Participatory Practice Framework was adapted and adopted in the GAP Year trial to guide stakeholder engagement throughout the lifecycle 27 . Results As previously reported 24 – 26 , 28 , overall, 3432 eligible participants across 26 schools participated in the baseline survey: we included 2383 in the analysis who completed both sections of the survey. In some cases, due to lack of time, participants were unable to complete both components and were excluded from this analysis. Table 1 provides the socio-demographic characteristics of participants, by sex and age group. As previously reported 24 – 26 , 28 , of the 2383 participants, 63.1% (n=1504) were female and the majority were Black African (96.9%, n=2309). Overall, Gauteng province represented just over half of all participants (53.6%, n=1278), with more males than females (57.0% vs 51.7%, p=0.012). Almost one in five participants (18.1%, n=433) in grade 8 were older than 14 years with 5.1% 16 years and older. Under half of all participants (41.4%, n=967) reported living with both parents. Over two thirds of participants’ parents/guardians’ households were receiving government grants (67.3%, n=1498). Table 1. Socio-demographic characteristics of participants, by sex and age category. Sex Age groups 1 Total Female (n=1504) % (n) Male (n = 879) (n) P-value 12–14 (n = 1938) % (n) 15–18 (n =443) % (n) P-value (n=2383) % (n) Racial group African 96.8 (1456) 97.0 (853) 0.751 96.7 (1874) 97.7 (433) 0.253 96.9 (2309) Coloured 3.2 (48) 3.0 (26) 3.3 (64) 2.3 (10) 3.1 (74) Province Western Cape 48.3 (727) 43.0 (378) 0.012 44.5 (863) 54.6 (242) <0.001 46.5 (1105) Gauteng 51.7 (777) 57.0 (501) 55.5 (1075) 45.4 (201) 53.6 (1278 Lives with Both parents 39.4 (580) 44.8 (387) 0.018 42.2 (803) 38.0 (164) 0.006 41.4 (967) Single parent 41.5 (611) 39.7 (343) 41.3 (785) 39.1 (169) 40.9 (954) Relative/guardian 19.0 (280) 15.5 (134) 16.5 (314) 22.9 (99) 17.7 (414) Not stated 33 15 36 11 48 Parent/guardian employed 2 , 3 66.9 (1002) 72.0 (631) 0.010 69.6 (1344) 65.2 (288) 0.069 68.8 (1633) Parent/guardian receives government grant 68.7 (965) 64.9 (533) 0.068 66.3 (1202) 71.4 (294) 0.050 67.3 (1498) Don’t know 99 58 126 31 157 Dating or in a relationship 46.7 (703) 59.3 (521) 0.000 48.4 (938) 64.1 (284) 0.000 51.4 (1224) Ever had sex 4 10.4 (157) 31.7 (279) <0.001 15.0 (291) 32.7 (145) <0.001 18.3 (436) Age of sexual debut 5 (yrs) 7–10 7.0 (11) 21.8 (56) <0.001 19.0 (52) 10.7 (15) <0.001 15.4 (67) 11–14 69.2 (108) 64.6 (166) 75.8 (207) 47.9 (67) 62.8 (274) 15–17 23.7 (37) 13.6 (35) 0.0 (0) 37.3 (72) 6.2 (72) 1 Missing age category n=2 2 At least one parent or guardian employed 3 Parent or guardian employed missing n=8 4 Ever had sex missing n=3 5 Age of sexual debut not disclosed n=23 Just over half of participants (51.4% n=1224) reported that they were dating or in a relationship. Almost a fifth (18.3%, n=436) had ever had sex, with significant group differences by age group and sex (p=0.001). While fifteen percent of those aged 12–14 years reported ever having sex, this more than doubled (32.7%) in the 15–18 year olds. Almost two-thirds (62.8%) were aged 11–14 years when they first had sex. Knowledge, uptake and perceptions of sexual and reproductive health services Table 2 outlines knowledge, uptake and perceptions of SRH services, by sex and age group. Although over two thirds of participants (66.8%, n=1557) perceived that they have a right to access health care services without being discriminated or stigmatized by health workers, this was significantly different between male and female participants (p=<0.001). Table 2. Knowledge, uptake and perceptions of sexual and reproductive health services, by sex and age category. Sex Age groups Total Female (n=1504) % (n) Male (n = 879) % (n) P-value 12–14 (n = 1938) % (n) 15–18 (n =443) % (n) P-value (n=2383) % (n) Have a right to access healthcare without being discriminated or stigmatized by a health worker (n=2332) 65.2 (965) 69.5 (592) <0.001 66.8 (1269) 66.4 (287) 0.504 66.8 (1557) Ever participated in an SRH programme (n=781) 37.8 (557) 26.3 (224) <0.001 32.5 (615) 38.3 (165) 0.006 33.6 (781) Place where you participated in this programme (n=777) <0.001 0.285 School 75.0 (415) 71.0 (159) 74.5 (455) 71.5 (118) 73.8 (573) Church 12.5 (69) 25.0 (56) 15.2 (93) 19.4 (32) 16.1 (125) Private organisation 9.6 (53) 0.4 (1) 7.5 (46) 4.8 (8) 7.0 (54) Other 2.9 (16) 3.6 (8) 2.8 (17) 4.2 (7) 3.1 (24) Participated in a SRH programme in last 2 years (n=781) 36.8 (205) 36.6 (82) 0.959 35.8 (220) 40.0 (66) 0.317 36.7 (287) Know of a place in community where young people can find out about SRHR (n=2335) 30.9 (455) 32.2 (277) 0.184 29.6 (561) 39.2 (171) <0.001 31.4 (732) Accessed health care in the last year (n=2337) 56.6 (836) 59.5 (512) 0.166 58.4 (1108) 54.8 (239) 0.178 57.7 (1348) SRH Health services required a Sexually transmitted infections (STIs) 0.7 (17) 0.5 (12) 0.5 (20) 1.0 (9) 0.7 (29) HIV testing services (HTS) 0.5 (11) 0.5 (13) 0.4 (17) 0.8 (7) 0.4 (24) Pregnancy test 1.2 (29) N/A 1.0 (19) 2.3 (10) 1.6 (29) Contraceptives 2.6 (61) 0.4 (10) 1.1 (44) 3.0 (27) 2.1 (71) Injury 3.9 (88) 4.6 (105) 4.1 (158) 3.9 (35) 4.0 (193) Non-SRH Services 36.5 (789) 23.2 (461) 27.4 (1061) 21.2 (189) 24.3 (1250) Health care site accessed at last visit (n=1345) Youth clinic 3.6 (30) 1.8 (9) 0.025 2.6 (29) 4.2 (10) 0.464 2.9 (39) Private clinic/ hospital 6.0 (50) 9.0 (46) 7.2 (79) 7.1 (17) 7.1 (96) Government/ public clinic 89.6 (748) 87.7 (447) 89.2 (986) 87.0 (208) 88.9 (1195) Other 0.8 (7) 1.7 (8) 1.0 (11) 1.7 (4) 1.1 (15) Felt comfortable to ask questions at my last visit (n=1324) 51.7 (426) 46.6 (233) 0.072 51.4 (559) 42.1 (99) 0.010 49.8 (659) Questions asked at last consultation were answered adequately (n=1304) 48.2 (391) 47.5 (234) 0.793 49.5 (529) 40.4 (95) 0.011 47.9 (625) Enough confidentiality at last visit (1315) 34.7 (283) 31.9 (159) 0.294 33.1 (356) 35.9 (85) 0.407 33.6 (442) Requested contraceptive services at last visit (n=1757) 26.2 (16) N/A 27.8 (10) 24.0 (6) 0.741 26.2 (16) Main source of SRHR information b School teacher 58.1 (874) 58.3 (746) 56.7 (127) 58.1 (873) Mother 38.9 (585) 40.0 (512) 32.6 (73) 38.9 (585) Television 12.2 (183) 12.7 (162) 9.4 (21) 12.2 (183) Friends 10.6 (150) 10.2 (131) 13.0 (29) 10.6 (160) Sister 10.4 (157) 9.9 (127) 13.4 (30) 10.4 (157) Other family members 9.6 (144) 9.5 (121) 10.3 (23) 9.6 (144) Books/ magazines 7.2 (108) 7.7 (99) 4.0 (9) 7.2 (108) Healthcare workers 6.5 (97) 6.4 (82) 6.7 (15) 6.5 (97) Radio 4.6 (70) 4.8 (61) 4.0 (9) 4.6 (70) Father 3.5 (53) 3.4 (44) 4.0 (9) 3.5 (53) Online 3.5 (53) 3.8 (49) 1.8 (4) 3.5 (53) Films / videos 2.1 (31) 2.4 (31) 0.0 (0) 2.1 (31) Brother 1.7 (25) 1.6 (21) 1.8 (4) 1.7 (25) Other 2.5 (44) 3.0 (38) 2.7 (6) 2.5 (44) a Multiple response answer b Multiple response answers, question not asked of males A third (33.6%, n=781) had ever participated in an SRH programme in the past 2 years † , with males (p<0.001) and those aged 12–14 years (p=0.006) more likely to have participated than females and those 15 –18 years. Almost three-quarters participated in the SRH programme in their school. Far fewer had participated in an SRH programme in the last two years (12.0%, n=287). Less than a third of all participants knew of a place in their community where they could access SRH information, with older adolescents (15–18 years) more likely to know where to access this information (39.2% vs 29.6%, p=0.001). Over half of participants (57.7%, n=1348) had accessed healthcare in the past year, with most requiring non-SRH services. Less than 1.0% accessed HIV or STI services, and a small number (2.1%, n=71) accessed contraception. Most participants used public health clinics (88.9%, n=1195), with only 2.9% (n=39) having accessed a youth clinic at their last visit. During their last healthcare visit, almost half (49.8%, n=659) felt comfortable enough to ask questions, with 47.9% (n=625) having their questions answered adequately. In relation to rights, only one third (33.6%, n=442) felt there was enough confidentiality during their last visit. The main source of SRH and rights education in females were school teachers (58.1%, n= 873) and mothers (38.9%, n= 585). Uptake and patterns of contraceptive use in females Table 3 reports on contraceptive history and current use in females who had ever had sex. Males are not presented as most were unsure about their partners current contraception method use. Of the 157 females who had ever had sex, half (51.0%, n=80) had ever used a contraceptive method. Due to the small sample of females who had ever used a contraceptive, Table 3 presents descriptive statistics by age group. The injection and condoms were the most common method ever used in the 12–14 age group. Almost all (96.4%, n=27) of those aged 15–18 years had ever used the injection. Of the whole sample, 36 females were current contraceptive users, although 29 of these had not had sex in the last three months. Table 3. Uptake and patterns of contraceptive use of females who have ever had sex, by age. Age groups Total 12–14 (n=109) % (n) 15–18 (n = 48) % (n) (n=157) % (n) Ever used contraceptives 46.8 (51) 60.4 (29) 51.0 (80) Contraceptive method ever used a Injection 63.3 (31) 96.4 (27) 75.3 (58) Condoms 59.2 (29) 21.4 (6) 45.4 (35) Pill 4.1 (2) 7.1 (2) 5.2 (4) Emergency contraceptives 2.0 (1) 3.6 (1) 2.6 (2) Implant 4.1 (2) 0.0 (0) 2.6 (2) Vaginal ring 2.0 (1) 0.0 (0) 1.3 (1) Intrauterine Device (IUD) 2.0 (1) 0.0 (0) 1.3 (1) Traditional methods b 3.92 (2) 0.0 (0) 2.6 (2) Sexually active in last three months (N=61) 38.8 (40) 46.7 (21) 41.2 (61) Current contraceptive method use (N=36) 57.5 (23) 61.9 (13) 59.0 (36) Condoms 69.6 (16) 38.5 (5) 58.3 (21) Injection 56.5 (13) 92.3 (12) 69.4 (25) Implant 4.3 (1) 0.0 (0) 2.8 (1) Intrauterine device (IUD) 0.0 (0) 7.7 (1) 2.8 (1) Emergency contraception 0.0 (0) 7.7 (1) 2.8 (1) Dual method c 40.8 (7) 25.8 (5) 33.3 (12) Condom use at last sex No 0.0 (0) 0.0 (0) 0.0 (0) Can’t remember 22.5 (9) 14.3 (3) 19.7 (12) Know that condoms can prevent HIV and STIs 84.4 (38) 92.6 (25) 87.5 (63) It was my choice to start using contraception (n=80) d 2.5 (1) 4.5 (1) 3.2 (2) If no, who made the decision for you (n=60) Parents 100.0 (39) 100.0 (21) 100.0 (60) Ever discussed contraception with my partner (n=157) 0.0 (0) 0.0 (0) 0.0 (0) Method used (Self/partner) to prevent pregnancy and STIs at first sex (n=157) 56.3 (58) 55.6 (25) 56.1 (83) Knowledge of where to get contraceptives (n=157) 82.4 (89) 83.3 (40) 82.7 (129) Can obtain contraception without my parents’ permission (n=157) 27.4 (29) 22.9 (11) 26.0 (40) a Of those who are currently using contraception, they had a multiple response option to select their current forms of contraception b Traditional methods refer to withdrawal and thigh sex c Condoms only or hormonal method and condoms d 18 missing responses Of the 157 females who had ever had sex, 41.2% (n=61) reported having sex in the last three months. Of these 59% (n=36) reported current contraceptive use with two-thirds (69.4%, n=25) using the injection with close to 60% using the condom (58.3%, n=21). Almost half of the injectable users mentioned using condoms as an additional method but not one of these or the condom only group reported use of a condom at last sex. Most knew condoms could prevent HIV and STIs. A small proportion mentioned hormonal methods (implants, injections and oral pills) could prevent HIV and STIs. Similarly, a small number (2.8%) mentioned the vaginal ring. Of the 80 who had ever used contraceptives, only two said it was their decision to start using a method. Sixty said it was their parents/guardians who made the decision for them, while 18 did not say who had made the decision. None of the females who had ever had sex had ever discussed contraception with their partner. At the first sexual encounter, just over half (56.1%, n=83) did something to prevent pregnancy, HIV or sexually transmitted infections. Most (82.7%, n=129) knew where to get contraceptives but fewer (26.0%, n= 40) knew that they could get contraceptives without their parents’ permission. Of the 80 females who have ever had sex and ever used a contraceptive method, the majority got the method from a public/government clinic (33.8%, n=26), followed by a private clinic (23.4%, n=18), pharmacy (10.4%, n=8), corner shop (6.5%, n=5), and friend (5.2%, n=4), while some did not say where they had obtained their method. Of those who reported they had never had sex, a small proportion reported using a contraceptive method. Five females, of the 157 who had ever had sex, had ever been pregnant (0.3%, n=5): two got pregnant at 14 years, one at 15 years and two at 16 years (p=0.001). Of those who had ever been pregnant, two were pregnant at the time of the survey, one had terminated the pregnancy and two had gone on to have a live birth. Discussion We set out to explore adolescent experience with SRH service knowledge and uptake, in particular contraception, in three peri-urban settings in South Africa. Although the data collection was undertaken in one school grade, a considerable proportion were above the standard expected age for the grade, this has been previously reported 35 . These older participants are known to experience a number of challenges 30 , 35 , 36 , and may be missing out on age-appropriate school-based CSE which would be received if they were in a higher grade. In terms of sexual experience, over half of the participants were dating or in a relationship and just under a fifth, (18.3%) had ever had sex. Two-thirds had their first sexual experience between the ages 11–14 years, and a small number below this age. Of those who had had sex, many did nothing or did not remember if a method was used to prevent pregnancy, HIV or STIs during that first sexual encounter. This highlights the importance of programmes focussing on early adolescents, including age appropriate SRH information to be provided ensuring adolescents, including very young adolescents, are equipped with the knowledge around safe sexual practices, rights and gender awareness 37 , 38 . The GAP Year afterschool intervention sought to address this gap in knowledge 27 . Interestingly, participants reported that parents were commonly involved in their decision to use contraception – this is a potential area for further research. Although over half the participants reported having accessed healthcare services in the last year, only around 1% or less in the 12–14 age group reported they required SRH services, and this was only slightly higher (up to 3%) in the older age group. Additionally, less than 5% attended a dedicated youth service for a service. The low reporting of SRH services may be simply a reflection of the demand for services in a population where under a fifth had ever had sex, and of these only a small proportion had ever used contraception, had an HIV or a pregnancy test. The latest SADHS 11 indicated that the most popular method used by adolescents is the male condom and condoms are available outside of public health sector services. Of those who had used healthcare services, they commonly perceived a lack of confidentiality and the ability to ask questions, and were concerned about discrimination, this was especially so for those who mentioned healthcare workers as their primary source of SRHR information. The older age group reported being less comfortable about asking questions- at their last healthcare visit. However this may be due to the higher proportion of sexually active participants in this age group who may have wanted to ask more questions on SRH issues. Addressing barriers to health care is an integral part of SRH promotion 39 , highlighting the need to improve young people’s access to youth friendly services from a rights-based perspective. Given the low knowledge and uptake of youth-friendly SRH services in this study, dismantling barriers, improving access, and developing effective responses to adolescent SRH and contraceptive programming is vital. Studies show that high impact interventions include improved access to youth friendly services 40 , school-based interventions 41 , and in particular well designed, and age-appropriate CSE 42 , 43 , focusing on early adolescents, where patterns of behaviour are being formed 44 . The provision of quality, youth-friendly contraceptive services, sensitive to and responsive to the needs of young people is a fundamental requirement for promoting the SRH of young people 45 , as well as services that promote informed choice and decision-making, including long acting reversible contraception in the method mix 46 . In addition, the need for interventions targeting adolescent males as well has been underscored 47 . School teachers and mothers were noted as the most common source of SRH information. While the survey did not ask about the satisfaction of the participants with information from these specific sources, it highlights two important priorities – to equip parents with quality knowledge and skills to communicate effectively with their children about sex, and the need to provide teachers with the knowledge and skills to provide information, supported by comprehensive curricula and policies. Interventions focussing on parents have been shown to be constructive but neglected and should be included in programmatic interventions 48 , 49 . This finding reinforced the importance of including parent dialogues and events in the GAP Year intervention 27 . In South Africa, in 2010 the Department of Education introduced scripted lesson plans to strengthen the SRH content and implementation of the Life Orientation Curriculum 50 . Despite the support school teachers received, no impact was observed on the primary outcomes of HIV knowledge, attitudes, condom use and pregnancy incidence 50 . These findings question whether this was due to the programme being ineffectively designed or challenges with programme implementation and lack of programme fidelity 51 , 52 . The National Integrated School Health Policy 8 outlines what areas should be included in the school health package per learner phase. Contraception is included in the two senior phases from grade 9–12, however there are no further details or guidance given. The Standard Operating Procedures for the Provision of Sexual and Reproductive Health, Rights and Social Services in Secondary Schools 9 mention the need to counsel on the full range of available methods as laid out in the National Contraception Policy 53 . There was similar contraceptive ever and current use in sexually active females to previously reported data in this age group 11 . It was interesting to note that a number of females who had not had sex in the last three months reported that they were using a contraceptive method as were some who reported never having had sex. Although this was not probed in more detail, this may reflect an intention to have sex, or prevention in the event that they have sex. This, too, is an interesting trend for further research. Contraceptive method use was similar to national surveys in South Africa with injectables and condoms as the main methods of contraception ever and currently used in sexually active participants 11 . These method choices reflect those of all women in South Africa where injectables are the most popular method of contraception 11 . The hormonal implant was introduced in 2014 and uptake was low in the first few years, however, it is now the second most popular method to the injectable DMPA 54 . Whilst we didn’t directly assess knowledge on various contraceptive methods, it highlights the need to promote all available contraceptive options, particularly the use of long acting, reversible contraceptive methods which are both highly effective, do not rely on regular visits to the clinic, nor clients remembering to take them daily 55 . In addition, only two girls mentioned having ever used emergency contraception, and noting that only half who had had sex had ever used contraception, the need to promote emergency contraception is also an important, but underused option 56 . The Standard Operating Procedures for the Provision of Sexual and Reproductive Health, Rights and Social Services in Secondary Schools 9 clearly states the need to inform learners of emergency contraception and where it is available. These guidelines should be specifically targeted to educators involved in school SRH programme delivery. There are several factors associated with contraceptive uptake, and these all need to be accompanied by strengthened adolescent and youth friendly services and improved outreach concerning available SRH and HIV prevention and services – for example, it was shown that some participants thought the hormonal contraception could prevent HIV and STIs, the majority of participants reported not using protection at sexual debut, and a very low percentage used condoms at last sex. This calls for ongoing messaging concerning dual protection and the promotion of condom use and other HIV and STI prevention options, such as oral PrEP. This study endorses existing literature which shows awareness of contraception and contraceptive services is low 21 , 22 . This is important because knowledge, access to, and use of contraception plays a significant role in averting and decreasing millions of unintended pregnancies, births, abortions, and maternal deaths each year. Improving knowledge about contraception, as well as an understanding of their rights can help AGYW make informed decisions that can positively impact their SRH, education and psychosocial well-being 40 , 57 . This all serves to highlight the need for school-based interventions that work across the ecological model 27 - empowering individuals; promoting supportive relationships with sexual partners 58 , parents, and peers and teachers and at the community level. Strengths and limitations There are strengths and limitations that should be considered when reviewing these findings. Whilst this study was conducted in 26 schools in three highly populated diverse townships of South Africa, its generalizability is limited to similar contexts. The study was cross sectional therefore only representing one point in time. The final study sample size was less than originally planned however the prevalence of contraceptive use and method mix reflect that of the most recent South African demographic health survey 11 . Participation was voluntary, however the refusal rate was not collected which may have potentially introduced a participation bias. There were many participants who didn’t complete both components of the survey which reduced the sample size when analysing specific variables. There was a higher proportion of participants aged 12–14 years in relation to those aged 15–18 years increasing power which results in these significant age differences: therefore, the results should be interpreted with caution given that the proportion of participants in these age groups is unbalanced. There were some significant differences presented in the results in relation to ‘ever had sex’ and ‘ever participated in an SRH program’ which could be attributed to underreporting of sexual activity and the targeting of AGYW in SRH programs. Conclusion This paper aimed to build on the body of evidence to guide school-based interventions to improve the SRH of school-going participants. The paper highlights the need to encourage health seeking behaviour and promote the idea that health services not only for problems but important for prevention and health promotion - especially in relation to sexual health, including HIV, STI and pregnancy prevention. This means the importance of knowing where services are located, as well as building partnerships with public health clinics to ensure that services are accessible and responsive to the needs of young people. The importance of school teachers and parents as the primary source of SRH information for learners requires an expanded, enhanced, programme to equip both teachers and parents to provide accurate, relevant and accessible information. Several points related to life orientation, life skills and CSE were underscored including the need for age-appropriate, differentiated approaches to cater for the range of ages, and particularly for over-aged learners, in South African schools; the need for CSE to start with early grades; as well as the need to deal with issues rooted in young people’s realities and sexual lives – such as communicating with sexual partners about safer sex, using protection at first sexual encounters (and thereafter) and the ongoing need to negotiate and use condoms. In addition, the need for education in relation to contraceptive options and sexual and reproductive health rights was highlighted. Consent Participants and their parents or guardians provided written informed consent for the publication of this data. Data availability These data are comprised of aggregated survey responses, data codebooks and the survey tool. These data are available from: Underlying data This project contains the following underlying data, found at: ", https://doi.org/10.7910/DVN/V6XMJ3 - GAP Year_Quantitative SRH data 59 The following tools are found at: https://doi.org/10.7910/DVN/AHHWNL 60 - GAPYear_REDCap Codebook.pdf - GAP Year_ACASI Boys Survey Codebook.pdf - GAP Year_ACASI Girls Survey Codebook.pdf Extended data Harvard Dataverse: GAP Year_Violence REDCap and ACASI data, https://doi.org/10.7910/DVN/AHHWNL 60 . This project contains the following extended data: GAP Year Boys ACASI Survey Questionnaire.pdf GAP Year Girls ACASI Survey Questionnaire.pdf GAP Year Boys REDCap Survey Questionnaire.pdf GAP Year Boys REDCap Survey Questionnaire.pdf Data are available under the terms of the Creative Commons Zero "No rights reserved" data waiver (CC0 1.0 Public domain dedication). Acknowledgements We would like to acknowledge the participants and their parents for their valued contribution to this research. The Department of Education stakeholders at national, provincial, district and school level who provided research guidance and support. Clarence Yah was the Senior Researcher, leading the research. Kiran Kalpee managed this dataset, with fieldworkers and Indigo MO who supported with data collection. Grassroots Soccer and Sonke Gender Justice were our study partners, implementing the GAP Year intervention, also supported with school buy-in. Footnotes * Quintile 1–3 schools are non-fee-paying schools, serving the poorest communities. Quintile 1 is the group of schools in each province catering for the poorest 20% of learners and receiving the highest allocation of Government funding per learner to support these poorer schools. † Defined as a program that teaches you about sexual and reproductive health Faculty Opinions recommended References 1. Kabiru CW: Adolescents' sexual and reproductive health and rights: what has been achieved in the 25 years since the 1994 International Conference on Population and Development and what remains to be done? J Adolesc Health. 2019; 65 (6s): S1–s2. PubMed Abstract | Publisher Full Text 2. Chandra-Mouli V, Akwara E, Engel D, et al. : Progress in adolescent sexual and reproductive health and rights globally between 1990 and 2016: what progress has been made, what contributed to this, and what are the implications for the future? Sex Reprod Health Matters. 2020; 28 (1): 1741495. PubMed Abstract | Publisher Full Text | Free Full Text 3. Guttmacher Institute: From bad to worse: the COVID-19 pandemic risks further undermining adolescents’ sexual and reproductive health and rights. Guttmacher Institute: New York, 2020. Reference Source 4. Melesse DY, Mutua MK, Choudhury A, et al. : Adolescent sexual and reproductive health in sub-Saharan Africa: who is left behind? BMJ Glob Health. 2020; 5 (1): e002231. PubMed Abstract | Publisher Full Text | Free Full Text 5. UNAIDS: Women and HIV: a spotlight on adolescent girls and young women. 2019. Reference Source 6. Starrs AM, Ezeh AC, Barker G, et al. : Accelerate progress-sexual and reproductive health and rights for all: report of the Guttmacher- Lancet Commission. Lancet. 2018; 391 (10140): 2642–2692. PubMed Abstract | Publisher Full Text 7. Chandra-Mouli V, Neal S, Moller AB: Adolescent sexual and reproductive health for all in sub-Saharan Africa: a spotlight on inequalities. Reprod Health. 2021; 18 (Suppl 1): 118. PubMed Abstract | Publisher Full Text | Free Full Text 8. Department of Basic Education: Integrated School Health Policy. DBE, 2012. Reference Source 9. Department of Basic Education: Standard Operating Procedures for the provision sexual and reproductive health and social services in secondary schools. 2019. Reference Source 10. National Department of Health: National integrated Sexual Reproductive Health and Rights (SRHR) policy. National Department of Health: Pretoria, South Africa. 2019. 11. National Department of Health (NDoH), Statistics South Africa (Stats SA), South African Medical Research Council (SAMRC), et al. : South Africa Demographic and Health Survey 2016. NDoH, Stats SA SAMRC, and ICF: Pretoria South Africa, and Rockville, Maryland, USA, 2019. Reference Source 12. Simbayi L, Zuma K, Zungu N, et al. : South African National HIV Prevalence, Incidence, Behaviour and Communication Survey, 2017: towards achieving the UNAIDS 90-90-90 targets. HSRC Press.\: Cape Town, 2019. Reference Source 13. Seutlwadi L, Peltzer K, Mchunu G, et al. : Contraceptive use and associated factors among South African youth (18 - 24 years): A population-based survey. S Afr J Obstet Gynaecol. 2012; 18 : 43–47. Reference Source 14. Jonas K, Crutzen R, van den Borne B, et al. : Teenage pregnancy rates and associations with other health risk behaviours: a three-wave cross-sectional study among South African school-going adolescents. Reprod Health. 2016; 13 (1): 50. PubMed Abstract | Publisher Full Text | Free Full Text 15. Willan S: A review of teenage pregnancy in South Africa. Partners in Sexual Health, 2013. 16. Macleod CI: Public reproductive health and 'unintended' pregnancies: introducing the construct 'supportability'. J Public Health (Oxf). 2016; 38 (3): e384–e391. PubMed Abstract | Publisher Full Text 17. Ramulumo M, Pitsoe VJ: Teenage Pregnancy in South African Schools: challenges, trends and policy issues. Mediterr J Soc Sci. 2013; 4 (13): 755–760. Publisher Full Text 18. Lince-Deroche N, Pleaner M, Morroni C, et al. : Achieving universal access to sexual and reproductive health services: the potential and pitfalls for contraceptive services in South Africa. S Afr Health Rev. 2016; 2016 (1): 95–108. Reference Source 19. Munakampe MN, Zulu JM, Michelo C: Contraception and abortion knowledge, attitudes and practices among adolescents from low and middle-income countries: a systematic review. BMC Health Serv Res. 2018; 18 (1): 909. PubMed Abstract | Publisher Full Text | Free Full Text 20. Makola L, Mlangeni L, Mabaso M, et al. : Predictors of contraceptive use among Adolescent Girls and Young Women (AGYW) aged 15 to 24 years in South Africa: results from the 2012 national population-based household survey. BMC Womens Health. 2019; 19 (1): 158. PubMed Abstract | Publisher Full Text | Free Full Text 21. Chersich MF, Wabiri N, Risher K, et al. : Contraception coverage and methods used among women in South Africa: a national household survey. S Afr Med J. 2017; 107 (4): 307–314. PubMed Abstract | Publisher Full Text 22. Ramathuba DU, Khoza LB, Netshikweta ML: Knowledge, attitudes and practice of secondary school girls towards contraception in Limpopo Province. Curationis. 2012; 35 (1): 45. PubMed Abstract | Publisher Full Text 23. Smith J: Improving adolescent access to contraception in Sub-Saharan Africa: a review of the evidence. Afr J Reprod Health. 2020; 24 (1): 152–164. PubMed Abstract 24. Gordon K, Kutywayo A, Frade S, et al. : Socio-demographic and social support factors related to substance use in South African in-school adolescents: Insights from the Girls Achieve Power (GAP Year) trial in three peri-urban settings [version 1; peer review: 2 approved]. Gates Open Res. 2021; 5 : 154. PubMed Abstract | Publisher Full Text | Free Full Text 25. Kutywayo A, Frade S, Gordon K, et al. : Who's got the power? Expressions of empowerment among in-school adolescents enrolled in the Girls Achieve Power (GAP Year) trial in three peri-urban settings of South Africa [version 1; peer review: awaiting peer review]. Gates Open Res. 2021; 5 : 104. Publisher Full Text 26. Kutywayo A, Frade S, Mahuma T, et al. : Experiences of violence among female and male grade eight learners: baseline findings from the Girls Achieve Power (GAP Year) trial across three South African townships [version 1; peer review: 2 approved with reservations]. Gates Open Res. 2021; 5 : 89. Publisher Full Text 27. Kutywayo A, Yah CS, Naidoo NP, et al. : Implementing the good participatory practice guidelines in the girls achieve power trial in South Africa. Sage Open. 2018; 8 (4): 1–12. PubMed Abstract | Publisher Full Text | Free Full Text 28. Pleaner M, Milford C, Kutywayo A, et al. : Sexual and reproductive health and rights knowledge, perceptions, and experiences of adolescent learners from three South African townships: qualitative findings from the Girls Achieve Power (GAP Year) Trial [version 1; peer review: 1 approved with reservations]. Gates Open Res. 2022; 6 : 60. Publisher Full Text 29. Barnes K, Brynard S, de Wet C: The influence of school culture and school climate on violence in schools of the Eastern Cape Province. S Afr J Educ. 2012; 32 (1): 69–82. Publisher Full Text 30. Branson N, Hofmeyr C, Lam D: Progress through school and the determinants of school dropout in South Africa. Dev South Afr. 2014; 31 (1): 106–126. Publisher Full Text 31. Hayes RJ, Bennett S: Simple sample size calculation for cluster-randomized trials. Int J Epidemiol. 1999; 28 (2): 319–26. PubMed Abstract | Publisher Full Text 32. Pettifor A, MacPhail C, Selin A, et al. : HPTN 068: a randomized control trial of a conditional cash transfer to reduce HIV infection in young women in South Africa-Study design and baseline results. AIDS Behav. 2016; 20 (9): 1863–82. PubMed Abstract | Publisher Full Text | Free Full Text 33. Harris PA, Taylor R, Minor BL, et al. : The REDCap consortium: building an international community of software platform partners. J Biomed Inform. 2019; 95 : 103208. PubMed Abstract | Publisher Full Text | Free Full Text 34. StataCorp: Stata Statistical Software: Release 15. College StationTX: StataCorp LLC, 2017. Reference Source 35. Weybright EH, Caldwell LL, Xie HJ, et al. : Predicting secondary school dropout among South African adolescents: a survival analysis approach. S Afr J Educ. 2017; 37 (2): 1353. PubMed Abstract | Publisher Full Text | Free Full Text 36. Marteleto L, Lam D, Ranchhod V: Sexual behavior, pregnancy, and schooling among young people in urban South Africa. Stud Fam Plann. 2008; 39 (4): 351–68. PubMed Abstract | Publisher Full Text | Free Full Text 37. Blum RW, Mmari K, Moreau C: It begins at 10: how gender expectations shape early adolescence around the world. J Adolesc Health. 2017; 61 (4 Suppl): S3–S4. PubMed Abstract | Publisher Full Text | Free Full Text 38. Woog V, Kågesten A: The Sexual and Reproductive Health Needs of Very Young Adolescents Aged 10–14 in developing countries: what does the evidence show? 2017. Reference Source 39. Engel DMC, Paul M, Chalasani S, et al. : A package of sexual and reproductive health and rights interventions-what does it mean for adolescents? J Adolesc Health. 2019; 65 (6S): S41–S50. PubMed Abstract | Publisher Full Text 40. Chandra-Mouli V, McCarraher DR, Phillips SJ, et al. : Contraception for adolescents in low and middle income countries: needs, barriers, and access. Reprod Health. 2014; 11 (1): 1. PubMed Abstract | Publisher Full Text | Free Full Text 41. Lopez LM, Bernholc A, Chen M, et al. : School-based interventions for improving contraceptive use in adolescents. Cochrane Database Syst Rev. 2016; 2016 (6): Cd012249. PubMed Abstract | Publisher Full Text | Free Full Text 42. Chandra-Mouli V, Lane C, Wong S: What does not work in adolescent sexual and reproductive health: a review of evidence on interventions commonly accepted as best practices. Glob Health Sci Pract. 2015; 3 (3): 333–340. PubMed Abstract | Publisher Full Text | Free Full Text 43. Bakaroudis M, Blum R, Hopkins J: The evaluation of comprehensive sexuality education programmes: a focus on the gender and empowerment outcomes. Unfpa, 2015. Reference Source 44. Kemigisha E, Bruce K, Ivanova O, et al. : Evaluation of a school based comprehensive sexuality education program among very young adolescents in rural Uganda. BMC Public Health. 2019; 19 (1): 1393. PubMed Abstract | Publisher Full Text | Free Full Text 45. Chandra-Mouli V, Akwara E: Improving access to and use of contraception by adolescents: What progress has been made, what lessons have been learnt, and what are the implications for action? Best Pract Res Clin Obstet Gynaecol. 2020; 66 : 107–118. PubMed Abstract | Publisher Full Text | Free Full Text 46. Pleaner M, Morroni C, Smit J, et al. : Lessons learnt from the introduction of the contraceptive implant in South Africa. S Afr Med J. 2017; 107 (11): 933–938. PubMed Abstract | Publisher Full Text 47. IPPF, UNFPA: Global sexual and reproductive health service package for men and adolescent boys. London: IPPF and New York City: UNFPA, 2017. Reference Source 48. Dinaj-Koci V, Deveaux L, Wang B, et al. : Adolescent sexual health education: parents benefit too! Health Educ Behav. 2015; 42 (5): 648–653. PubMed Abstract | Publisher Full Text | Free Full Text 49. Barr EM, Moore MJ, Johnson T, et al. : New evidence: data documenting parental support for earlier sexuality education. J Sch Health. 2014; 84 (1): 10–7. PubMed Abstract | Publisher Full Text 50. Speizer IS, Mandal M, Xiong K, et al. : Impact evaluation of scripted lesson plans for HIV-related content in a life orientation curriculum: results from two provinces in South Africa. BMC Public Health. 2020; 20 (1): 1542. PubMed Abstract | Publisher Full Text | Free Full Text 51. Wang B, Deveaux L, Knowles V, et al. : Fidelity of implementation of an evidence-based HIV prevention program among Bahamian sixth grade students. Prev Sci. 2015; 16 (1): 110–21. PubMed Abstract | Publisher Full Text | Free Full Text 52. Tucker LA, George G, Reardon C, et al. : Sexuality education in South African schools: the challenge for civil society organisations. Health Educ J. 2017; 76 (1): 77–88. Publisher Full Text 53. Department of Health: National contraception guidelines. Department of Health Pretoria, South Africa, 2012. Reference Source 54. Ndlovu N, Padarath A, editors: District health barometer 2022/23. Durban: Health Systems Trust; February 2024. Reference Source 55. Todd N, Black A: Contraception for adolescents. J Clin Res Pediatr Endocrinol. 2020; 12 (Suppl 1): 28–40. PubMed Abstract | Publisher Full Text | Free Full Text 56. Society for Adolescent Health and Medicine: Emergency contraception for adolescents and young adults: guidance for health care professionals. J Adolesc Health. 2016; 58 (2): 245–8. PubMed Abstract | Publisher Full Text 57. Aibe S, Scoggins S: Strong alliances, further together: country engagement at FP2020: 2012–2020 FP2020. 2020. 58. Kriel Y, Milford C, Cordero J, et al. : Male partner influence on family planning and contraceptive use: perspectives from community members and healthcare providers in KwaZulu-Natal, South Africa. Reprod Health. 2019; 16 (1): 89. PubMed Abstract | Publisher Full Text | Free Full Text 59. Kutywayo A: GAP Year_Quantitative SRH manuscript. Harvard Dataverse. 2022. 60. Kutywayo A: GAP Year_Violence REDCap and ACASI data. Harvard Dataverse. 2021. Comments on this article Comments (0) Version 3 VERSION 3 PUBLISHED 25 May 2022 ADD YOUR COMMENT Comment Author details Author details 1 Wits RHI, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, 2193, South Africa 2 MRU (MatCH Research Unit), Department of Obstetrics and Gynaecology, University of the Witwatersrand, Durban, Kwa zulu Natal, 4001, South Africa Melanie Pleaner Roles: Writing – Original Draft Preparation Alison Kutywayo Roles: Investigation, Project Administration, Writing – Original Draft Preparation, Writing – Review & Editing Mags Beksinska Roles: Formal Analysis, Writing – Review & Editing Khuthala Mabetha Roles: Data Curation, Formal Analysis, Writing – Review & Editing Nicolette Naidoo Roles: Conceptualization, Funding Acquisition, Methodology, Supervision, Writing – Review & Editing Saiqa Mullick Roles: Conceptualization, Funding Acquisition, Supervision, Writing – Review & Editing Competing interests No competing interests were disclosed. Grant information This work was supported, in whole by the Gates Foundation [INV-007156]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Article Versions (3) version 3 Revised Published: 11 Nov 2024, 6:67 https://doi.org/10.12688/gatesopenres.13636.3 version 2 Revised Published: 18 Jul 2022, 6:67 https://doi.org/10.12688/gatesopenres.13636.2 version 1 Published: 25 May 2022, 6:67 https://doi.org/10.12688/gatesopenres.13636.1 Copyright © 2024 Pleaner M et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics Views Downloads Gates Open Research - - PubMed Central info_outline Data from PMC are received and updated monthly. - - Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article Pleaner M, Kutywayo A, Beksinska M et al. Knowledge and uptake of contraceptive and other sexual reproductive health services among in-school adolescents in three South African townships: Baseline findings from the Girls Achieve Power (GAP Year) Trial [version 3; peer review: 2 approved, 2 approved with reservations] . Gates Open Res 2024, 6 :67 ( https://doi.org/10.12688/gatesopenres.13636.3 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS track receive updates on this article Track an article to receive email alerts on any updates to this article. TRACK THIS ARTICLE Share Open Peer Review Current Reviewer Status: ? Key to Reviewer Statuses VIEW HIDE Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Version 3 VERSION 3 PUBLISHED 11 Nov 2024 Revised Views 0 Cite How to cite this report: Hernandez J. Reviewer Report For: Knowledge and uptake of contraceptive and other sexual reproductive health services among in-school adolescents in three South African townships: Baseline findings from the Girls Achieve Power (GAP Year) Trial [version 3; peer review: 2 approved, 2 approved with reservations] . Gates Open Res 2024, 6 :67 ( https://doi.org/10.21956/gatesopenres.16764.r38445 ) The direct URL for this report is: https://gatesopenresearch.org/articles/6-67/v3#referee-response-38445 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 05 Dec 2024 Julie Hernandez , Department of Health Management and Policy, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA Approved VIEWS 0 https://doi.org/10.21956/gatesopenres.16764.r38445 I reviewed and I approve ... Continue reading READ ALL I reviewed and I approve the manuscript with the proposed revisions. Competing Interests: No competing interests were disclosed. Reviewer Expertise: International family planning I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Hernandez J. Reviewer Report For: Knowledge and uptake of contraceptive and other sexual reproductive health services among in-school adolescents in three South African townships: Baseline findings from the Girls Achieve Power (GAP Year) Trial [version 3; peer review: 2 approved, 2 approved with reservations] . Gates Open Res 2024, 6 :67 ( https://doi.org/10.21956/gatesopenres.16764.r38445 ) The direct URL for this report is: https://gatesopenresearch.org/articles/6-67/v3#referee-response-38445 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Version 2 VERSION 2 PUBLISHED 18 Jul 2022 Revised Views 0 Cite How to cite this report: A Cohen M. Reviewer Report For: Knowledge and uptake of contraceptive and other sexual reproductive health services among in-school adolescents in three South African townships: Baseline findings from the Girls Achieve Power (GAP Year) Trial [version 3; peer review: 2 approved, 2 approved with reservations] . Gates Open Res 2024, 6 :67 ( https://doi.org/10.21956/gatesopenres.14980.r33165 ) The direct URL for this report is: https://gatesopenresearch.org/articles/6-67/v2#referee-response-33165 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 30 May 2023 Megan A Cohen , Emory University, Atlanta, Georgia, USA Approved with Reservations VIEWS 0 https://doi.org/10.21956/gatesopenres.14980.r33165 This is a cross-sectional baseline study on SRH knowledge and practices of grade 8 schoolchildren in South Africa. The information was gathered as part of a larger interventional study. Knowledge and practices are important topics and relevant to readers. However, ... Continue reading READ ALL This is a cross-sectional baseline study on SRH knowledge and practices of grade 8 schoolchildren in South Africa. The information was gathered as part of a larger interventional study. Knowledge and practices are important topics and relevant to readers. However, several issues remain to be strengthened. There is now too much information on the GAP Year intervention trial included such that it is confusing. I do not see any information provided on knowledge of contraceptive methods. Was there any collected? I would definitely recommend including that if so. The discussion still appears to state conclusions and recommendations that are more editorializing and are not directly derived from the results. I really do not see where this was amended per the recommendation of a prior reviewer, except to add information on where the GAP Year trial aimed to address issues. For example, in the paragraph starting with "school teachers and mothers were noted as the most common source of SRH information," the authors then state that an important priority is "to equip parents with the knowledge and skills to communicate effectively with their children about sex," but no information in this study actually addressed whether the students felt that their parents lacked knowledge or that they felt they could not communicate with them; that is assumed by the authors. As another example, the authors mention in the discussion the need to promote availability of other contraceptive options such as the contraceptive implant and the IUD, but there is no actually information presented regarding knowledge on contraceptive methods. Therefore, it is unclear if the participants were aware of the implant as an option but chose another method instead, or if they were unaware of the methods. I have some concerns regarding discrepancies in the data reported in the tables, see below. Specific suggestions: Methods: Too much information is reported on the GAP Year trial which confuses what this study actually entails. I suggest editing information to a general, concise overview of the trial. Particularly I would remove information on randomization as that is irrelevant to this study. The sample size justification reflects that of the actual trial. I would clearly state that. Were the outcomes of this study powered for in any way? Results: Table 1– how does the 12-14 year old group have 14 people with sexual debut at 15-17? Table 2 – footnote a for “SRH services required” states multiple choice question not asked of males, but there are data provided for the male participants. Please explain. It would also be helpful to provide the n of the sample asked if it differs from the n=2337 listed above, but again it is not clear if this is actually a different subsample since data are presented for male participants. Table 2 – What is the n of participants who were asked the question “Requested contraceptive services at last visit?” There is an “*” on “Main Source of SRHR information” that does not correspond to any footnote I can see. However there are no male data presented – perhaps that was supposed to correspond to the note for footnote a “multiple choice question, not asked of males?” And please clarify "multiple choice" – it appears that means “select all that apply” such that the values may surpass 100%. I believe the correct terminology should be “multiple response” or “multiple answer” instead of “multiple choice.” Table 3 – please specify in the table that the question “contraceptive method ever used” is calculated based only on those who have used a contraceptive method as the denominator. For example I would consider putting the “n” in the table per age group in the same line as the heading, or list the total “n” before the footnote. Table 3, footnote a – again would recommend changing to “multiple response” or “multiple answer”. Table 3 “Current contraceptive method used” – it looks like this is also a multiple response question? Please clarify and specify if so. Table 3 - Why is there no p-value listed for “know that condoms can prevent HIV and STIs”? Table 3 - The numbers are not adding up correctly for “if no, who made the decision for you?” States n=80 but 60 answers and 100% in each group chose parents. I think it is because there are 18 missing responses, but this is confusing. In this case would change the n to be n=60. The text states that “65 females were current contraceptive users” but I do not see how that reflected anywhere in Table 3 and seems to conflict with the table, I would recommend adding it to Table 3 if it was asked as a question and it is accurate. All I see is that 80 had ever used contraception, and it appears that 36 answered the question regarding current contraception used. The authors state, “Of these 59% (n=36) reported current contraceptive use with two-thirds (69.4%, n=25) using the injection while a quarter (25.0%, n=9) using the condom” but the values stated for condom use directly conflict with the numbers stated in the table (58.3%, n=21). Discussion: I would recommend changing “experienced a lack of confidentiality” to “ perceived a lack of confidentiality”. I would recommend revising based on recommendations in the beginning. The authors state, "final study sample size was less than originally planned however the results maintain power to draw these conclusions," but again, I do not think these outcomes and sub-analyses were powered for at all? Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Partly Competing Interests: No competing interests were disclosed. Reviewer Expertise: sexual and reproductive health, global family planning, contraception I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT A Cohen M. Reviewer Report For: Knowledge and uptake of contraceptive and other sexual reproductive health services among in-school adolescents in three South African townships: Baseline findings from the Girls Achieve Power (GAP Year) Trial [version 3; peer review: 2 approved, 2 approved with reservations] . Gates Open Res 2024, 6 :67 ( https://doi.org/10.21956/gatesopenres.14980.r33165 ) The direct URL for this report is: https://gatesopenresearch.org/articles/6-67/v2#referee-response-33165 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 11 Nov 2024 Alison Kutywayo , Wits Reproductive Health and HIV Institute (Wits RHI), Faculty of Health Sciences,, University of the Witwatersrand, Johannesburg, 2193, South Africa 11 Nov 2024 Author Response Thank you for your extensive review of our manuscript. We welcome this feedback for strengthening the paper and have addressed the comments as follows: General comments: Sentence added ... Continue reading Thank you for your extensive review of our manuscript. We welcome this feedback for strengthening the paper and have addressed the comments as follows: General comments: Sentence added to Introduction to clarify terminology and use of the word ‘’knowledge’’. Methods: A previous reviewer asked for more information on the GAP Year program however we have edited this section to streamline it further. The outcomes of the study were all powered for using a power of 0.8. However, given that there were small sample sizes in some of the variables, this is the reason why a number of variables were non-significant. An explanation of how the sample size was derived was provided on page 5. We have however indicated that it represents the actual sample of the trial. Results: The discrepancies in the data reported in the tables have been amended. Footnotes have been added to Table 2 to provide the reader clarity. We have removed p-values from Table 3 given the small sample size and non-significant differences. Discussion: The Discussion has been streamlined and revised in line with the key findings. The Limitations have been amended, in line with the reviewers comments. Thank you for your extensive review of our manuscript. We welcome this feedback for strengthening the paper and have addressed the comments as follows: General comments: Sentence added to Introduction to clarify terminology and use of the word ‘’knowledge’’. Methods: A previous reviewer asked for more information on the GAP Year program however we have edited this section to streamline it further. The outcomes of the study were all powered for using a power of 0.8. However, given that there were small sample sizes in some of the variables, this is the reason why a number of variables were non-significant. An explanation of how the sample size was derived was provided on page 5. We have however indicated that it represents the actual sample of the trial. Results: The discrepancies in the data reported in the tables have been amended. Footnotes have been added to Table 2 to provide the reader clarity. We have removed p-values from Table 3 given the small sample size and non-significant differences. Discussion: The Discussion has been streamlined and revised in line with the key findings. The Limitations have been amended, in line with the reviewers comments. Competing Interests: No competing interests were disclosed. Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 11 Nov 2024 Alison Kutywayo , Wits Reproductive Health and HIV Institute (Wits RHI), Faculty of Health Sciences,, University of the Witwatersrand, Johannesburg, 2193, South Africa 11 Nov 2024 Author Response Thank you for your extensive review of our manuscript. We welcome this feedback for strengthening the paper and have addressed the comments as follows: General comments: Sentence added ... Continue reading Thank you for your extensive review of our manuscript. We welcome this feedback for strengthening the paper and have addressed the comments as follows: General comments: Sentence added to Introduction to clarify terminology and use of the word ‘’knowledge’’. Methods: A previous reviewer asked for more information on the GAP Year program however we have edited this section to streamline it further. The outcomes of the study were all powered for using a power of 0.8. However, given that there were small sample sizes in some of the variables, this is the reason why a number of variables were non-significant. An explanation of how the sample size was derived was provided on page 5. We have however indicated that it represents the actual sample of the trial. Results: The discrepancies in the data reported in the tables have been amended. Footnotes have been added to Table 2 to provide the reader clarity. We have removed p-values from Table 3 given the small sample size and non-significant differences. Discussion: The Discussion has been streamlined and revised in line with the key findings. The Limitations have been amended, in line with the reviewers comments. Thank you for your extensive review of our manuscript. We welcome this feedback for strengthening the paper and have addressed the comments as follows: General comments: Sentence added to Introduction to clarify terminology and use of the word ‘’knowledge’’. Methods: A previous reviewer asked for more information on the GAP Year program however we have edited this section to streamline it further. The outcomes of the study were all powered for using a power of 0.8. However, given that there were small sample sizes in some of the variables, this is the reason why a number of variables were non-significant. An explanation of how the sample size was derived was provided on page 5. We have however indicated that it represents the actual sample of the trial. Results: The discrepancies in the data reported in the tables have been amended. Footnotes have been added to Table 2 to provide the reader clarity. We have removed p-values from Table 3 given the small sample size and non-significant differences. Discussion: The Discussion has been streamlined and revised in line with the key findings. The Limitations have been amended, in line with the reviewers comments. Competing Interests: No competing interests were disclosed. Close Report a concern COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Hernandez J. Reviewer Report For: Knowledge and uptake of contraceptive and other sexual reproductive health services among in-school adolescents in three South African townships: Baseline findings from the Girls Achieve Power (GAP Year) Trial [version 3; peer review: 2 approved, 2 approved with reservations] . Gates Open Res 2024, 6 :67 ( https://doi.org/10.21956/gatesopenres.14980.r33160 ) The direct URL for this report is: https://gatesopenresearch.org/articles/6-67/v2#referee-response-33160 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 25 May 2023 Julie Hernandez , Department of Health Management and Policy, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA Approved with Reservations VIEWS 0 https://doi.org/10.21956/gatesopenres.14980.r33160 Thank you for the opportunity to review this manuscript, which provides additional contributions to the literature on early adolescents’ SRH issues in South Africa. The study design and papers are overall clear and well developed. However, the reviewer thinks that ... Continue reading READ ALL Thank you for the opportunity to review this manuscript, which provides additional contributions to the literature on early adolescents’ SRH issues in South Africa. The study design and papers are overall clear and well developed. However, the reviewer thinks that some revisions are necessary to ensure the findings are rigorously presented and the recommendations align with the study results. Key cross-sectional issues include: The need to clarify between contraceptive use for pregnancy prevention vs. condom use for STI (including HIV) prevention. The authors mention “SRH and HIV” but the latter is included in the former. The results would benefit from clarifying the specific issues faced by young adolescents with regards to both contraceptive use and STI prevention. “Knowledge” is not well defined in the Methods section and as a result it is often unclear whether actual knowledge (e.g. including of how to use, possible side effects, etc.) or simply method awareness was recorded. In addition, the authors should clarify whether they recorded method awareness through direct “yes / no” questions (“Have you ever heard of method (x)?”) or by asking respondents to list the methods they knew? Method knowledge is not reported in any of the tables despite figuring prominently in the introduction, the key outcomes and the title for the study. Since participation was voluntary, what was the refusal rate / participation rate for each school, and does this introduce a potential for bias? Since the denominator for women who ever had sex dropped considerably (n = 157), could the authors comment on the power to run the association analysis presented in Table 3? Would it be possible to raise the significance threshold to counter the small denominator issue? Results are presented in details (p.9) and yet those specific samples are very small. Finally, as mentioned by another reviewer, the Discussion section still stretches the results considerably. Details are provided under suggestions for this specific section. I also suggest the following edits to each section: Introduction: Section 2: Adjust “SRH and HIV”. SRH includes HIV / AIDS / STI and contraceptive access and use. Section 3: “the prevalence of mostly unintended pregnancies” Suggest reformulating, unclear what “mostly” means here, nor what data supports it. Section 5: First sentence is circumvoluted, I suggest reformulating. Table 1: Significant difference for currently dating / ever had sex by girls might be indicative of reporting bias and needs to be discussed in Limitations. Literature consistently shows that adolescent girls underreport sexual activity. Table 2 Significant difference in “ever participated in an SRH program” for girls indicates that girls are much more frequently targeted by this kind of program and should be discussed in relevant section (esp. as authors advocate for gender-based interventions). It might also explain why girls are significantly more likely than boys to access youth clinics (because SRH programs may have made them aware of their availability). Table 2 presents knowledge of contraceptive services but not of contraceptive methods. Manuscript title, background and methods section should be adjusted to reflect this. Table 3: Is “Thigh sex” a traditional method? In that case it should be lumped with “Withdrawal” and other non-modern contraceptive methods. Discussion: I re-iterate the comment of a previous reviewer who found the discussion and conclusion too generic and not sufficiently aligned with the specific findings of the study. The first section does not reflect the specific findings presented in the previous section. For example, looking at the different age groups (since this is an important point highlighted by the authors in the recommendations) Table 1 and 2 suggest that older adolescents are more likely to have been exposed to SRH programs (which makes sense considering they have been alive / in the target demographic for a longer period of time), yet they are less comfortable asking SRH questions from service providers. Regardless of these differences in SRH exposure though, Table 3 indicates that there are no significant differences in use patterns between age groups. The authors do not discuss supply-side issues and barriers that may challenge their proposed recommendations. What factors could limit the feasibility of implementing those recommendations considering the resource-limited health provision environment of South African townships? Section 3 and 4 of the Discussion presents the GAP Year as a solution to the issues highlighted in the manuscript which might read as confirmation bias, particularly as the study uses only pre-intervention data. We suggest removing or reformulating to present how GAP Year specifically addresses these issues. The last three paragraphs of this section present conclusions that are not based on the study findings. For example, data about participants thinking that hormonal contraception can prevent STI / HIV is not mentioned in any of the previous sections. It might be more appropriate to talk about “respondents” rather than “learners” presuming that not all students participated in the survey? (Participation bias). The last section could also be construed as confirmation bias in advocating for ecological models such as the one used by GAP Year. Strengths and limitations: The sample of 26 schools was not selected in any representative way (or the randomization technique was not adequately presented in the Methods), therefore the results can NOT be generalized to other South African settings. (Large samples are not sufficient to generate external validity). Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Partly Are sufficient details of methods and analysis provided to allow replication by others? Partly If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? No Competing Interests: No competing interests were disclosed. Reviewer Expertise: International family planning I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Hernandez J. Reviewer Report For: Knowledge and uptake of contraceptive and other sexual reproductive health services among in-school adolescents in three South African townships: Baseline findings from the Girls Achieve Power (GAP Year) Trial [version 3; peer review: 2 approved, 2 approved with reservations] . Gates Open Res 2024, 6 :67 ( https://doi.org/10.21956/gatesopenres.14980.r33160 ) The direct URL for this report is: https://gatesopenresearch.org/articles/6-67/v2#referee-response-33160 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 11 Nov 2024 Alison Kutywayo , Wits Reproductive Health and HIV Institute (Wits RHI), Faculty of Health Sciences,, University of the Witwatersrand, Johannesburg, 2193, South Africa 11 Nov 2024 Author Response Thank you to the reviewer for this thoughtful and thorough review of our manuscript. There were a number of comments which have been addressed in the following ways: - The use ... Continue reading Thank you to the reviewer for this thoughtful and thorough review of our manuscript. There were a number of comments which have been addressed in the following ways: - The use of the term ''SRH and HIV'': In South Africa, and sub-Saharan Africa, the term SRH and HIV is commonly used as a package of distinct but interrelated interventions be it prevention, treatment, health promotion, advocacy etc. While there is an intersection, the two have separate policies and programmes in South Africa, and therefore we tend to refer to SRH and HIV. The introduction provides detail of the scope in this context. - Regarding the definition of knowledge: We wanted to probe their knowledge and uptake about SRH services broadly; and their utilisation and experience thereof. It was beyond the scope to probe detailed knowledge about each method. Sentence added to Introduction to clarify terminology and use of the word ‘’knowledge’’. - Based on reviewer feedback, the following limitations have been added: limited generalizability due to small school sample, refusal rate not collected leading to possible participation bias and some significant differences presented in the results may be attributed to under-reporting and AGYW targeting. - Power to run the study: Prior to commencing with our analysis, we set the statistical power to 0.8 (can also be specified as 80%) with an effect size of 5% and an alpha of 0.05 and this is usually considered to be the ideal power of a study. This was done with the purpose of lowering the risk of making a Type II error and thus given this instance, it was important to rather lean towards a Type I error which was as low as 0.05 or 0.01. We do however acknowledge that the sample size of young women who have ever had sex (n=157) was not sufficient enough to conduct inferential statistics with which affects the ability to comment on any significant differences between the two age groups. The n presented is lower (n=80) as it includes only information on the contraceptive users. We have therefore removed the P values which were non-significant and mentioned the descriptive presentation when the table is introduced. - Minor edits to the text have been amended, as per the reviewers suggestions. - Table 3: uptake of contraception methods is presented in Table 3. - Discussion: the Discussion has been edited and streamlined extensively aligning to the key findings, as suggested by the reviewer. - Discussion and Conclusion has been reviewed to ensure recommendations acknowledge the resource constrained context within which this research was conducted. - References made to the GAP Year intervention have been removed in the Discussion. - Throughout the manuscript we now talk about ''participants'', not learners. Please see the updated version of the manuscript for your review. Thank you to the reviewer for this thoughtful and thorough review of our manuscript. There were a number of comments which have been addressed in the following ways: - The use of the term ''SRH and HIV'': In South Africa, and sub-Saharan Africa, the term SRH and HIV is commonly used as a package of distinct but interrelated interventions be it prevention, treatment, health promotion, advocacy etc. While there is an intersection, the two have separate policies and programmes in South Africa, and therefore we tend to refer to SRH and HIV. The introduction provides detail of the scope in this context. - Regarding the definition of knowledge: We wanted to probe their knowledge and uptake about SRH services broadly; and their utilisation and experience thereof. It was beyond the scope to probe detailed knowledge about each method. Sentence added to Introduction to clarify terminology and use of the word ‘’knowledge’’. - Based on reviewer feedback, the following limitations have been added: limited generalizability due to small school sample, refusal rate not collected leading to possible participation bias and some significant differences presented in the results may be attributed to under-reporting and AGYW targeting. - Power to run the study: Prior to commencing with our analysis, we set the statistical power to 0.8 (can also be specified as 80%) with an effect size of 5% and an alpha of 0.05 and this is usually considered to be the ideal power of a study. This was done with the purpose of lowering the risk of making a Type II error and thus given this instance, it was important to rather lean towards a Type I error which was as low as 0.05 or 0.01. We do however acknowledge that the sample size of young women who have ever had sex (n=157) was not sufficient enough to conduct inferential statistics with which affects the ability to comment on any significant differences between the two age groups. The n presented is lower (n=80) as it includes only information on the contraceptive users. We have therefore removed the P values which were non-significant and mentioned the descriptive presentation when the table is introduced. - Minor edits to the text have been amended, as per the reviewers suggestions. - Table 3: uptake of contraception methods is presented in Table 3. - Discussion: the Discussion has been edited and streamlined extensively aligning to the key findings, as suggested by the reviewer. - Discussion and Conclusion has been reviewed to ensure recommendations acknowledge the resource constrained context within which this research was conducted. - References made to the GAP Year intervention have been removed in the Discussion. - Throughout the manuscript we now talk about ''participants'', not learners. Please see the updated version of the manuscript for your review. Competing Interests: No competing interests were disclosed. Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 11 Nov 2024 Alison Kutywayo , Wits Reproductive Health and HIV Institute (Wits RHI), Faculty of Health Sciences,, University of the Witwatersrand, Johannesburg, 2193, South Africa 11 Nov 2024 Author Response Thank you to the reviewer for this thoughtful and thorough review of our manuscript. There were a number of comments which have been addressed in the following ways: - The use ... Continue reading Thank you to the reviewer for this thoughtful and thorough review of our manuscript. There were a number of comments which have been addressed in the following ways: - The use of the term ''SRH and HIV'': In South Africa, and sub-Saharan Africa, the term SRH and HIV is commonly used as a package of distinct but interrelated interventions be it prevention, treatment, health promotion, advocacy etc. While there is an intersection, the two have separate policies and programmes in South Africa, and therefore we tend to refer to SRH and HIV. The introduction provides detail of the scope in this context. - Regarding the definition of knowledge: We wanted to probe their knowledge and uptake about SRH services broadly; and their utilisation and experience thereof. It was beyond the scope to probe detailed knowledge about each method. Sentence added to Introduction to clarify terminology and use of the word ‘’knowledge’’. - Based on reviewer feedback, the following limitations have been added: limited generalizability due to small school sample, refusal rate not collected leading to possible participation bias and some significant differences presented in the results may be attributed to under-reporting and AGYW targeting. - Power to run the study: Prior to commencing with our analysis, we set the statistical power to 0.8 (can also be specified as 80%) with an effect size of 5% and an alpha of 0.05 and this is usually considered to be the ideal power of a study. This was done with the purpose of lowering the risk of making a Type II error and thus given this instance, it was important to rather lean towards a Type I error which was as low as 0.05 or 0.01. We do however acknowledge that the sample size of young women who have ever had sex (n=157) was not sufficient enough to conduct inferential statistics with which affects the ability to comment on any significant differences between the two age groups. The n presented is lower (n=80) as it includes only information on the contraceptive users. We have therefore removed the P values which were non-significant and mentioned the descriptive presentation when the table is introduced. - Minor edits to the text have been amended, as per the reviewers suggestions. - Table 3: uptake of contraception methods is presented in Table 3. - Discussion: the Discussion has been edited and streamlined extensively aligning to the key findings, as suggested by the reviewer. - Discussion and Conclusion has been reviewed to ensure recommendations acknowledge the resource constrained context within which this research was conducted. - References made to the GAP Year intervention have been removed in the Discussion. - Throughout the manuscript we now talk about ''participants'', not learners. Please see the updated version of the manuscript for your review. Thank you to the reviewer for this thoughtful and thorough review of our manuscript. There were a number of comments which have been addressed in the following ways: - The use of the term ''SRH and HIV'': In South Africa, and sub-Saharan Africa, the term SRH and HIV is commonly used as a package of distinct but interrelated interventions be it prevention, treatment, health promotion, advocacy etc. While there is an intersection, the two have separate policies and programmes in South Africa, and therefore we tend to refer to SRH and HIV. The introduction provides detail of the scope in this context. - Regarding the definition of knowledge: We wanted to probe their knowledge and uptake about SRH services broadly; and their utilisation and experience thereof. It was beyond the scope to probe detailed knowledge about each method. Sentence added to Introduction to clarify terminology and use of the word ‘’knowledge’’. - Based on reviewer feedback, the following limitations have been added: limited generalizability due to small school sample, refusal rate not collected leading to possible participation bias and some significant differences presented in the results may be attributed to under-reporting and AGYW targeting. - Power to run the study: Prior to commencing with our analysis, we set the statistical power to 0.8 (can also be specified as 80%) with an effect size of 5% and an alpha of 0.05 and this is usually considered to be the ideal power of a study. This was done with the purpose of lowering the risk of making a Type II error and thus given this instance, it was important to rather lean towards a Type I error which was as low as 0.05 or 0.01. We do however acknowledge that the sample size of young women who have ever had sex (n=157) was not sufficient enough to conduct inferential statistics with which affects the ability to comment on any significant differences between the two age groups. The n presented is lower (n=80) as it includes only information on the contraceptive users. We have therefore removed the P values which were non-significant and mentioned the descriptive presentation when the table is introduced. - Minor edits to the text have been amended, as per the reviewers suggestions. - Table 3: uptake of contraception methods is presented in Table 3. - Discussion: the Discussion has been edited and streamlined extensively aligning to the key findings, as suggested by the reviewer. - Discussion and Conclusion has been reviewed to ensure recommendations acknowledge the resource constrained context within which this research was conducted. - References made to the GAP Year intervention have been removed in the Discussion. - Throughout the manuscript we now talk about ''participants'', not learners. Please see the updated version of the manuscript for your review. Competing Interests: No competing interests were disclosed. Close Report a concern COMMENT ON THIS REPORT Views 0 Cite How to cite this report: MacPhail C. Reviewer Report For: Knowledge and uptake of contraceptive and other sexual reproductive health services among in-school adolescents in three South African townships: Baseline findings from the Girls Achieve Power (GAP Year) Trial [version 3; peer review: 2 approved, 2 approved with reservations] . Gates Open Res 2024, 6 :67 ( https://doi.org/10.21956/gatesopenres.14980.r32262 ) The direct URL for this report is: https://gatesopenresearch.org/articles/6-67/v2#referee-response-32262 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 19 Jul 2022 Catherine MacPhail , School of Health and Society, University of Wollongong, Wollongong, NSW, Australia Approved VIEWS 0 https://doi.org/10.21956/gatesopenres.14980.r32262 I have no ... Continue reading READ ALL I have no further comments to make. Competing Interests: I was previously an employee of the Wits RHI (2003-2012) and have worked with both Melanie Pleaner and Mags Beksinska in the past. We have not worked with one another for more than 10 years and I do not believe that our relationship has impacted my decisions with regard to this manuscript. Reviewer Expertise: adolescent sexual and reproductive health, particularly HIV prevention I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT MacPhail C. Reviewer Report For: Knowledge and uptake of contraceptive and other sexual reproductive health services among in-school adolescents in three South African townships: Baseline findings from the Girls Achieve Power (GAP Year) Trial [version 3; peer review: 2 approved, 2 approved with reservations] . Gates Open Res 2024, 6 :67 ( https://doi.org/10.21956/gatesopenres.14980.r32262 ) The direct URL for this report is: https://gatesopenresearch.org/articles/6-67/v2#referee-response-32262 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Version 1 VERSION 1 PUBLISHED 25 May 2022 Views 0 Cite How to cite this report: MacPhail C. Reviewer Report For: Knowledge and uptake of contraceptive and other sexual reproductive health services among in-school adolescents in three South African townships: Baseline findings from the Girls Achieve Power (GAP Year) Trial [version 3; peer review: 2 approved, 2 approved with reservations] . Gates Open Res 2024, 6 :67 ( https://doi.org/10.21956/gatesopenres.14915.r32119 ) The direct URL for this report is: https://gatesopenresearch.org/articles/6-67/v1#referee-response-32119 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 20 Jun 2022 Catherine MacPhail , School of Health and Society, University of Wollongong, Wollongong, NSW, Australia Approved VIEWS 0 https://doi.org/10.21956/gatesopenres.14915.r32119 This paper reports on the baseline findings from an intervention programme to increase contraceptive knowledge and use among young South African adolescents in three township communities. Although the GAP Year intervention is included in the title of ... Continue reading READ ALL This paper reports on the baseline findings from an intervention programme to increase contraceptive knowledge and use among young South African adolescents in three township communities. Although the GAP Year intervention is included in the title of the paper, there is no real mention of the intervention in the paper. Would it be possible to include some details of the proposed intervention (likely completed already given the dates of this baseline data collection)? It seems that including some ideas of how the GAP Year intervention might address some of the issues outlined in the discussion would enhance the paper by reporting on how the findings might be addressed in the intervention. Abstract: Remove the apostrophe from Grade 8’s Introduction: Suggest adding a comma to “there are still multiple challenges in accessible SRH service provision for adolescents, resulting in poor health outcomes.” “limited information on contraception knowledge” seems to be convoluted language and might benefit from some additional editing Change “Knowledge about contraception and contraceptive options is low among South African youth,. . .” Methods: The recruitment of Grade 8 participants was undertaken across two school years. The authors might wish to comment on whether this was an intentional plan (and to what end) or to comment on any implications on this method in the limitations section. It is interesting that sensitive questions about sexuality, gender, and norms were included in the interviewer-administered questionnaire component and not in the ACASI component. I assume that this was because these were general questions and not specifically about the participant’s own identity? Please comment on the use of a Xhosa translation for the W Cape schools but no equivalent translation for the Gauteng schools. What was the reasoning behind this decision? This should potentially be further discussed in the limitations section if you believe that this might have impacted on the accuracy of information or completion. It would be useful here to see completion by province – given that quite a large number of students did not complete both parts of the survey, might language problems have contributed in the Gauteng cohort? Results: Table 2 results note that there is a significant difference in knowledge of right to accessing health care by gender (p<0.001), yet the reporting in the text says “Over two thirds of learners (66.8%, n=1557) perceived that they have a right to access health care without being discriminated or stigmatised by health workers: this was similar among males and females.” This doesn’t seem consistent. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? I cannot comment. A qualified statistician is required. Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests: I was employed by the Wits RHI from 2003-2012 and held an honorary position with this organisation after moving to Australia in 2012. I have not however worked with Melanie Pleaner or Mags Beksinska since before 2012. Previously working with the authors has not impacted my ability to provide an impartial review of this paper. Reviewer Expertise: adolescent sexual and reproductive health, particularly HIV prevention I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT MacPhail C. Reviewer Report For: Knowledge and uptake of contraceptive and other sexual reproductive health services among in-school adolescents in three South African townships: Baseline findings from the Girls Achieve Power (GAP Year) Trial [version 3; peer review: 2 approved, 2 approved with reservations] . Gates Open Res 2024, 6 :67 ( https://doi.org/10.21956/gatesopenres.14915.r32119 ) The direct URL for this report is: https://gatesopenresearch.org/articles/6-67/v1#referee-response-32119 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 18 Jul 2022 Alison Kutywayo , Wits Reproductive Health and HIV Institute (Wits RHI), Faculty of Health Sciences,, University of the Witwatersrand, Johannesburg, 2193, South Africa 18 Jul 2022 Author Response Thank you for your comments on our manuscript. We have noted your comments and have addressed them as follows: Although the GAP Year intervention is included in the ... Continue reading Thank you for your comments on our manuscript. We have noted your comments and have addressed them as follows: Although the GAP Year intervention is included in the title of the paper, there is no real mention of the intervention in the paper. Would it be possible to include some details of the proposed intervention (likely completed already given the dates of this baseline data collection)? It seems that including some ideas of how the GAP Year intervention might address some of the issues outlined in the discussion would enhance the paper by reporting on how the findings might be addressed in the intervention. Response : Added a sentence in the Methods section to elaborate on the GAP Year intervention and then also mentioned the intervention in the Discussion, in line with this comment. Abstract: Remove the apostrophe from Grade 8’s Response : Apostrophe removed. Introduction: Suggest adding a comma to “there are still multiple challenges in accessible SRH service provision for adolescents, resulting in poor health outcomes.” Response : Punctuation added. Intro: “limited information on contraception knowledge” seems to be convoluted language and might benefit from some additional editing Response : Punctuation added. Intro: Change “Knowledge about contraception and contraceptive options is low among South African youth… Response : Sentence amended. Methods: The recruitment of Grade 8 participants was undertaken across two school years. The authors might wish to comment on whether this was an intentional plan (and to what end) or to comment on any implications on this method in the limitations section Response : This section in the Methods has been amended and clarity provided. Methods: It is interesting that sensitive questions about sexuality, gender, and norms were included in the interviewer-administered questionnaire component and not in the ACASI component. I assume that this was because these were general questions and not specifically about the participant’s own identity? Response : This section of the Methods has been restructured to provide greater clarity on this query. Methods: Please comment on the use of a Xhosa translation for the W Cape schools but no equivalent translation for the Gauteng schools. What was the reasoning behind this decision? This should potentially be further discussed in the limitations section if you believe that this might have impacted on the accuracy of information or completion. It would be useful here to see completion by province – given that quite a large number of students did not complete both parts of the survey, might language problems have contributed in the Gauteng cohort? Response : This section in the Methods has been amended to provide clarity on the translation. Results: Table 2 results note that there is a significant difference in knowledge of right to accessing health care by gender (p<0.001), yet the reporting in the text says “Over two thirds of learners (66.8%, n=1557) perceived that they have a right to access health care without being discriminated or stigmatised by health workers: this was similar among males and females.” This doesn’t seem consistent Response : Although the difference between females (65.2% vs male 69.5%) table 2 appears to be a small percentage and similar, the large sample size indicates that statistically there is a real difference between the males and females in this variable. We have changed the text to make this more clear. Thank you for your comments on our manuscript. We have noted your comments and have addressed them as follows: Although the GAP Year intervention is included in the title of the paper, there is no real mention of the intervention in the paper. Would it be possible to include some details of the proposed intervention (likely completed already given the dates of this baseline data collection)? It seems that including some ideas of how the GAP Year intervention might address some of the issues outlined in the discussion would enhance the paper by reporting on how the findings might be addressed in the intervention. Response : Added a sentence in the Methods section to elaborate on the GAP Year intervention and then also mentioned the intervention in the Discussion, in line with this comment. Abstract: Remove the apostrophe from Grade 8’s Response : Apostrophe removed. Introduction: Suggest adding a comma to “there are still multiple challenges in accessible SRH service provision for adolescents, resulting in poor health outcomes.” Response : Punctuation added. Intro: “limited information on contraception knowledge” seems to be convoluted language and might benefit from some additional editing Response : Punctuation added. Intro: Change “Knowledge about contraception and contraceptive options is low among South African youth… Response : Sentence amended. Methods: The recruitment of Grade 8 participants was undertaken across two school years. The authors might wish to comment on whether this was an intentional plan (and to what end) or to comment on any implications on this method in the limitations section Response : This section in the Methods has been amended and clarity provided. Methods: It is interesting that sensitive questions about sexuality, gender, and norms were included in the interviewer-administered questionnaire component and not in the ACASI component. I assume that this was because these were general questions and not specifically about the participant’s own identity? Response : This section of the Methods has been restructured to provide greater clarity on this query. Methods: Please comment on the use of a Xhosa translation for the W Cape schools but no equivalent translation for the Gauteng schools. What was the reasoning behind this decision? This should potentially be further discussed in the limitations section if you believe that this might have impacted on the accuracy of information or completion. It would be useful here to see completion by province – given that quite a large number of students did not complete both parts of the survey, might language problems have contributed in the Gauteng cohort? Response : This section in the Methods has been amended to provide clarity on the translation. Results: Table 2 results note that there is a significant difference in knowledge of right to accessing health care by gender (p<0.001), yet the reporting in the text says “Over two thirds of learners (66.8%, n=1557) perceived that they have a right to access health care without being discriminated or stigmatised by health workers: this was similar among males and females.” This doesn’t seem consistent Response : Although the difference between females (65.2% vs male 69.5%) table 2 appears to be a small percentage and similar, the large sample size indicates that statistically there is a real difference between the males and females in this variable. We have changed the text to make this more clear. Competing Interests: None Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 18 Jul 2022 Alison Kutywayo , Wits Reproductive Health and HIV Institute (Wits RHI), Faculty of Health Sciences,, University of the Witwatersrand, Johannesburg, 2193, South Africa 18 Jul 2022 Author Response Thank you for your comments on our manuscript. We have noted your comments and have addressed them as follows: Although the GAP Year intervention is included in the ... Continue reading Thank you for your comments on our manuscript. We have noted your comments and have addressed them as follows: Although the GAP Year intervention is included in the title of the paper, there is no real mention of the intervention in the paper. Would it be possible to include some details of the proposed intervention (likely completed already given the dates of this baseline data collection)? It seems that including some ideas of how the GAP Year intervention might address some of the issues outlined in the discussion would enhance the paper by reporting on how the findings might be addressed in the intervention. Response : Added a sentence in the Methods section to elaborate on the GAP Year intervention and then also mentioned the intervention in the Discussion, in line with this comment. Abstract: Remove the apostrophe from Grade 8’s Response : Apostrophe removed. Introduction: Suggest adding a comma to “there are still multiple challenges in accessible SRH service provision for adolescents, resulting in poor health outcomes.” Response : Punctuation added. Intro: “limited information on contraception knowledge” seems to be convoluted language and might benefit from some additional editing Response : Punctuation added. Intro: Change “Knowledge about contraception and contraceptive options is low among South African youth… Response : Sentence amended. Methods: The recruitment of Grade 8 participants was undertaken across two school years. The authors might wish to comment on whether this was an intentional plan (and to what end) or to comment on any implications on this method in the limitations section Response : This section in the Methods has been amended and clarity provided. Methods: It is interesting that sensitive questions about sexuality, gender, and norms were included in the interviewer-administered questionnaire component and not in the ACASI component. I assume that this was because these were general questions and not specifically about the participant’s own identity? Response : This section of the Methods has been restructured to provide greater clarity on this query. Methods: Please comment on the use of a Xhosa translation for the W Cape schools but no equivalent translation for the Gauteng schools. What was the reasoning behind this decision? This should potentially be further discussed in the limitations section if you believe that this might have impacted on the accuracy of information or completion. It would be useful here to see completion by province – given that quite a large number of students did not complete both parts of the survey, might language problems have contributed in the Gauteng cohort? Response : This section in the Methods has been amended to provide clarity on the translation. Results: Table 2 results note that there is a significant difference in knowledge of right to accessing health care by gender (p<0.001), yet the reporting in the text says “Over two thirds of learners (66.8%, n=1557) perceived that they have a right to access health care without being discriminated or stigmatised by health workers: this was similar among males and females.” This doesn’t seem consistent Response : Although the difference between females (65.2% vs male 69.5%) table 2 appears to be a small percentage and similar, the large sample size indicates that statistically there is a real difference between the males and females in this variable. We have changed the text to make this more clear. Thank you for your comments on our manuscript. We have noted your comments and have addressed them as follows: Although the GAP Year intervention is included in the title of the paper, there is no real mention of the intervention in the paper. Would it be possible to include some details of the proposed intervention (likely completed already given the dates of this baseline data collection)? It seems that including some ideas of how the GAP Year intervention might address some of the issues outlined in the discussion would enhance the paper by reporting on how the findings might be addressed in the intervention. Response : Added a sentence in the Methods section to elaborate on the GAP Year intervention and then also mentioned the intervention in the Discussion, in line with this comment. Abstract: Remove the apostrophe from Grade 8’s Response : Apostrophe removed. Introduction: Suggest adding a comma to “there are still multiple challenges in accessible SRH service provision for adolescents, resulting in poor health outcomes.” Response : Punctuation added. Intro: “limited information on contraception knowledge” seems to be convoluted language and might benefit from some additional editing Response : Punctuation added. Intro: Change “Knowledge about contraception and contraceptive options is low among South African youth… Response : Sentence amended. Methods: The recruitment of Grade 8 participants was undertaken across two school years. The authors might wish to comment on whether this was an intentional plan (and to what end) or to comment on any implications on this method in the limitations section Response : This section in the Methods has been amended and clarity provided. Methods: It is interesting that sensitive questions about sexuality, gender, and norms were included in the interviewer-administered questionnaire component and not in the ACASI component. I assume that this was because these were general questions and not specifically about the participant’s own identity? Response : This section of the Methods has been restructured to provide greater clarity on this query. Methods: Please comment on the use of a Xhosa translation for the W Cape schools but no equivalent translation for the Gauteng schools. What was the reasoning behind this decision? This should potentially be further discussed in the limitations section if you believe that this might have impacted on the accuracy of information or completion. It would be useful here to see completion by province – given that quite a large number of students did not complete both parts of the survey, might language problems have contributed in the Gauteng cohort? Response : This section in the Methods has been amended to provide clarity on the translation. Results: Table 2 results note that there is a significant difference in knowledge of right to accessing health care by gender (p<0.001), yet the reporting in the text says “Over two thirds of learners (66.8%, n=1557) perceived that they have a right to access health care without being discriminated or stigmatised by health workers: this was similar among males and females.” This doesn’t seem consistent Response : Although the difference between females (65.2% vs male 69.5%) table 2 appears to be a small percentage and similar, the large sample size indicates that statistically there is a real difference between the males and females in this variable. We have changed the text to make this more clear. Competing Interests: None Close Report a concern COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Yimer B. Reviewer Report For: Knowledge and uptake of contraceptive and other sexual reproductive health services among in-school adolescents in three South African townships: Baseline findings from the Girls Achieve Power (GAP Year) Trial [version 3; peer review: 2 approved, 2 approved with reservations] . Gates Open Res 2024, 6 :67 ( https://doi.org/10.21956/gatesopenres.14915.r32124 ) The direct URL for this report is: https://gatesopenresearch.org/articles/6-67/v1#referee-response-32124 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 08 Jun 2022 Belete Yimer , Department of Human Nutrition, Debre Markos University, Debre Markos, Ethiopia Approved with Reservations VIEWS 0 https://doi.org/10.21956/gatesopenres.14915.r32124 The document makes important, relevant points, is timely and contains applicable references. I agree with much of the analysis, but think it needs strengthening. The title should be modified as: "Contraceptive knowledge ... Continue reading READ ALL The document makes important, relevant points, is timely and contains applicable references. I agree with much of the analysis, but think it needs strengthening. The title should be modified as: "Contraceptive knowledge and uptake among school adolescents in three South African townships...", in order to better convey the key features of the article. The authors used Chi-squared statistic tests for proportion comparison. To identify predictors of interest of knowledge, uptake and perceptions around SRH controlling for the confounding effects, multiple regression could be used. The recommendations need to be based on the findings of the study in question and not general observations and dissemination of knowledge. I suggest the authors to narrow down their recommendations and focus on what they found alone. I feel the study holds merit and may be of scientific interest. However I feel the above observations need to be addressed. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? No Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Partly Competing Interests: No competing interests were disclosed. Reviewer Expertise: Maternal and child health and nutrition I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Yimer B. Reviewer Report For: Knowledge and uptake of contraceptive and other sexual reproductive health services among in-school adolescents in three South African townships: Baseline findings from the Girls Achieve Power (GAP Year) Trial [version 3; peer review: 2 approved, 2 approved with reservations] . Gates Open Res 2024, 6 :67 ( https://doi.org/10.21956/gatesopenres.14915.r32124 ) The direct URL for this report is: https://gatesopenresearch.org/articles/6-67/v1#referee-response-32124 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 18 Jul 2022 Alison Kutywayo , Wits Reproductive Health and HIV Institute (Wits RHI), Faculty of Health Sciences,, University of the Witwatersrand, Johannesburg, 2193, South Africa 18 Jul 2022 Author Response The title should be modified as: "Contraceptive knowledge and uptake among school adolescents in three South African townships...", in order to better convey the key features of the article. ... Continue reading The title should be modified as: "Contraceptive knowledge and uptake among school adolescents in three South African townships...", in order to better convey the key features of the article. Response : The title has been amended as suggested. The authors used Chi-squared statistic tests for proportion comparison. To identify predictors of interest of knowledge, uptake and perceptions around SRH controlling for the confounding effects, multiple regression could be usedThe authors used Chi-squared statistic tests for proportion comparison. To identify predictors of interest of knowledge, uptake and perceptions around SRH controlling for the confounding effects, multiple regression could be used Response: The data presented is from the baseline- prior to any intervention. We were not expecting high levels of service uptake in this group of grade 8 learners. Grade 8 learners are usually aged 12-14 years but there were a significant proportion who were older (15-18) and these young people would have had to repeat school years due to exam failure or other social/financial/health reasons for school exclusion. In terms of their maturity, sexual experience and social circumstances they are a very different group and so we tried to focus on these as two separate and distinct age groups and not compare them too closely at baseline due to their different circumstances. In the 12 -14 age group although table 2 shows 10% of females had ever had sex - a much lower proportion had experienced sexual debut in the 12-14 age compared to the 15-18 year olds as expected. SRH service uptake was also extremely low in both age groups and in males and females which we expected at this age as few were sexually experienced. Only 11 girls aged 12-14 of 1504 had accessed HIV testing services for instance. Because of this low uptake, we felt that a descriptive analysis would be easier to present as numbers were too low for any meaningful multiple regression or other more complex analysis. The recommendations need to be based on the findings of the study in question and not general observations and dissemination of knowledge. I suggest the authors to narrow down their recommendations and focus on what they found alone. Response : In addressing this comment, we have removed the general observations in the Discussion and Conclusion to ensure it is inline with our findings. The title should be modified as: "Contraceptive knowledge and uptake among school adolescents in three South African townships...", in order to better convey the key features of the article. Response : The title has been amended as suggested. The authors used Chi-squared statistic tests for proportion comparison. To identify predictors of interest of knowledge, uptake and perceptions around SRH controlling for the confounding effects, multiple regression could be usedThe authors used Chi-squared statistic tests for proportion comparison. To identify predictors of interest of knowledge, uptake and perceptions around SRH controlling for the confounding effects, multiple regression could be used Response: The data presented is from the baseline- prior to any intervention. We were not expecting high levels of service uptake in this group of grade 8 learners. Grade 8 learners are usually aged 12-14 years but there were a significant proportion who were older (15-18) and these young people would have had to repeat school years due to exam failure or other social/financial/health reasons for school exclusion. In terms of their maturity, sexual experience and social circumstances they are a very different group and so we tried to focus on these as two separate and distinct age groups and not compare them too closely at baseline due to their different circumstances. In the 12 -14 age group although table 2 shows 10% of females had ever had sex - a much lower proportion had experienced sexual debut in the 12-14 age compared to the 15-18 year olds as expected. SRH service uptake was also extremely low in both age groups and in males and females which we expected at this age as few were sexually experienced. Only 11 girls aged 12-14 of 1504 had accessed HIV testing services for instance. Because of this low uptake, we felt that a descriptive analysis would be easier to present as numbers were too low for any meaningful multiple regression or other more complex analysis. The recommendations need to be based on the findings of the study in question and not general observations and dissemination of knowledge. I suggest the authors to narrow down their recommendations and focus on what they found alone. Response : In addressing this comment, we have removed the general observations in the Discussion and Conclusion to ensure it is inline with our findings. Competing Interests: None Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 18 Jul 2022 Alison Kutywayo , Wits Reproductive Health and HIV Institute (Wits RHI), Faculty of Health Sciences,, University of the Witwatersrand, Johannesburg, 2193, South Africa 18 Jul 2022 Author Response The title should be modified as: "Contraceptive knowledge and uptake among school adolescents in three South African townships...", in order to better convey the key features of the article. ... Continue reading The title should be modified as: "Contraceptive knowledge and uptake among school adolescents in three South African townships...", in order to better convey the key features of the article. Response : The title has been amended as suggested. The authors used Chi-squared statistic tests for proportion comparison. To identify predictors of interest of knowledge, uptake and perceptions around SRH controlling for the confounding effects, multiple regression could be usedThe authors used Chi-squared statistic tests for proportion comparison. To identify predictors of interest of knowledge, uptake and perceptions around SRH controlling for the confounding effects, multiple regression could be used Response: The data presented is from the baseline- prior to any intervention. We were not expecting high levels of service uptake in this group of grade 8 learners. Grade 8 learners are usually aged 12-14 years but there were a significant proportion who were older (15-18) and these young people would have had to repeat school years due to exam failure or other social/financial/health reasons for school exclusion. In terms of their maturity, sexual experience and social circumstances they are a very different group and so we tried to focus on these as two separate and distinct age groups and not compare them too closely at baseline due to their different circumstances. In the 12 -14 age group although table 2 shows 10% of females had ever had sex - a much lower proportion had experienced sexual debut in the 12-14 age compared to the 15-18 year olds as expected. SRH service uptake was also extremely low in both age groups and in males and females which we expected at this age as few were sexually experienced. Only 11 girls aged 12-14 of 1504 had accessed HIV testing services for instance. Because of this low uptake, we felt that a descriptive analysis would be easier to present as numbers were too low for any meaningful multiple regression or other more complex analysis. The recommendations need to be based on the findings of the study in question and not general observations and dissemination of knowledge. I suggest the authors to narrow down their recommendations and focus on what they found alone. Response : In addressing this comment, we have removed the general observations in the Discussion and Conclusion to ensure it is inline with our findings. The title should be modified as: "Contraceptive knowledge and uptake among school adolescents in three South African townships...", in order to better convey the key features of the article. Response : The title has been amended as suggested. The authors used Chi-squared statistic tests for proportion comparison. To identify predictors of interest of knowledge, uptake and perceptions around SRH controlling for the confounding effects, multiple regression could be usedThe authors used Chi-squared statistic tests for proportion comparison. To identify predictors of interest of knowledge, uptake and perceptions around SRH controlling for the confounding effects, multiple regression could be used Response: The data presented is from the baseline- prior to any intervention. We were not expecting high levels of service uptake in this group of grade 8 learners. Grade 8 learners are usually aged 12-14 years but there were a significant proportion who were older (15-18) and these young people would have had to repeat school years due to exam failure or other social/financial/health reasons for school exclusion. In terms of their maturity, sexual experience and social circumstances they are a very different group and so we tried to focus on these as two separate and distinct age groups and not compare them too closely at baseline due to their different circumstances. In the 12 -14 age group although table 2 shows 10% of females had ever had sex - a much lower proportion had experienced sexual debut in the 12-14 age compared to the 15-18 year olds as expected. SRH service uptake was also extremely low in both age groups and in males and females which we expected at this age as few were sexually experienced. Only 11 girls aged 12-14 of 1504 had accessed HIV testing services for instance. Because of this low uptake, we felt that a descriptive analysis would be easier to present as numbers were too low for any meaningful multiple regression or other more complex analysis. The recommendations need to be based on the findings of the study in question and not general observations and dissemination of knowledge. I suggest the authors to narrow down their recommendations and focus on what they found alone. Response : In addressing this comment, we have removed the general observations in the Discussion and Conclusion to ensure it is inline with our findings. Competing Interests: None Close Report a concern COMMENT ON THIS REPORT Comments on this article Comments (0) Version 3 VERSION 3 PUBLISHED 25 May 2022 ADD YOUR COMMENT Comment keyboard_arrow_left keyboard_arrow_right Open Peer Review Reviewer Status info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Reviewer Reports Invited Reviewers 1 2 3 4 Version 3 (revision) 11 Nov 24 read Version 2 (revision) 18 Jul 22 read read read Version 1 25 May 22 read read Belete Yimer , Debre Markos University, Debre Markos, Ethiopia Catherine MacPhail , University of Wollongong, Wollongong, Australia Julie Hernandez , Tulane University, New Orleans, USA Megan A Cohen , Emory University, Atlanta, USA Comments on this article All Comments (0) Add a comment Sign up for content alerts Sign Up You are now signed up to receive this alert keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2024 Hernandez J. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 05 Dec 2024 | for Version 3 Julie Hernandez , Department of Health Management and Policy, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA 0 Views copyright © 2024 Hernandez J. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions I reviewed and I approve the manuscript with the proposed revisions. Competing Interests No competing interests were disclosed. Reviewer Expertise International family planning I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (0) Hernandez J. Peer Review Report For: Knowledge and uptake of contraceptive and other sexual reproductive health services among in-school adolescents in three South African townships: Baseline findings from the Girls Achieve Power (GAP Year) Trial [version 3; peer review: 2 approved, 2 approved with reservations] . Gates Open Res 2024, 6 :67 ( https://doi.org/10.21956/gatesopenres.16764.r38445) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://gatesopenresearch.org/articles/6-67/v3#referee-response-38445 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2023 A Cohen M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 30 May 2023 | for Version 2 Megan A Cohen , Emory University, Atlanta, Georgia, USA 0 Views copyright © 2023 A Cohen M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions This is a cross-sectional baseline study on SRH knowledge and practices of grade 8 schoolchildren in South Africa. The information was gathered as part of a larger interventional study. Knowledge and practices are important topics and relevant to readers. However, several issues remain to be strengthened. There is now too much information on the GAP Year intervention trial included such that it is confusing. I do not see any information provided on knowledge of contraceptive methods. Was there any collected? I would definitely recommend including that if so. The discussion still appears to state conclusions and recommendations that are more editorializing and are not directly derived from the results. I really do not see where this was amended per the recommendation of a prior reviewer, except to add information on where the GAP Year trial aimed to address issues. For example, in the paragraph starting with "school teachers and mothers were noted as the most common source of SRH information," the authors then state that an important priority is "to equip parents with the knowledge and skills to communicate effectively with their children about sex," but no information in this study actually addressed whether the students felt that their parents lacked knowledge or that they felt they could not communicate with them; that is assumed by the authors. As another example, the authors mention in the discussion the need to promote availability of other contraceptive options such as the contraceptive implant and the IUD, but there is no actually information presented regarding knowledge on contraceptive methods. Therefore, it is unclear if the participants were aware of the implant as an option but chose another method instead, or if they were unaware of the methods. I have some concerns regarding discrepancies in the data reported in the tables, see below. Specific suggestions: Methods: Too much information is reported on the GAP Year trial which confuses what this study actually entails. I suggest editing information to a general, concise overview of the trial. Particularly I would remove information on randomization as that is irrelevant to this study. The sample size justification reflects that of the actual trial. I would clearly state that. Were the outcomes of this study powered for in any way? Results: Table 1– how does the 12-14 year old group have 14 people with sexual debut at 15-17? Table 2 – footnote a for “SRH services required” states multiple choice question not asked of males, but there are data provided for the male participants. Please explain. It would also be helpful to provide the n of the sample asked if it differs from the n=2337 listed above, but again it is not clear if this is actually a different subsample since data are presented for male participants. Table 2 – What is the n of participants who were asked the question “Requested contraceptive services at last visit?” There is an “*” on “Main Source of SRHR information” that does not correspond to any footnote I can see. However there are no male data presented – perhaps that was supposed to correspond to the note for footnote a “multiple choice question, not asked of males?” And please clarify "multiple choice" – it appears that means “select all that apply” such that the values may surpass 100%. I believe the correct terminology should be “multiple response” or “multiple answer” instead of “multiple choice.” Table 3 – please specify in the table that the question “contraceptive method ever used” is calculated based only on those who have used a contraceptive method as the denominator. For example I would consider putting the “n” in the table per age group in the same line as the heading, or list the total “n” before the footnote. Table 3, footnote a – again would recommend changing to “multiple response” or “multiple answer”. Table 3 “Current contraceptive method used” – it looks like this is also a multiple response question? Please clarify and specify if so. Table 3 - Why is there no p-value listed for “know that condoms can prevent HIV and STIs”? Table 3 - The numbers are not adding up correctly for “if no, who made the decision for you?” States n=80 but 60 answers and 100% in each group chose parents. I think it is because there are 18 missing responses, but this is confusing. In this case would change the n to be n=60. The text states that “65 females were current contraceptive users” but I do not see how that reflected anywhere in Table 3 and seems to conflict with the table, I would recommend adding it to Table 3 if it was asked as a question and it is accurate. All I see is that 80 had ever used contraception, and it appears that 36 answered the question regarding current contraception used. The authors state, “Of these 59% (n=36) reported current contraceptive use with two-thirds (69.4%, n=25) using the injection while a quarter (25.0%, n=9) using the condom” but the values stated for condom use directly conflict with the numbers stated in the table (58.3%, n=21). Discussion: I would recommend changing “experienced a lack of confidentiality” to “ perceived a lack of confidentiality”. I would recommend revising based on recommendations in the beginning. The authors state, "final study sample size was less than originally planned however the results maintain power to draw these conclusions," but again, I do not think these outcomes and sub-analyses were powered for at all? Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Partly Competing Interests No competing interests were disclosed. Reviewer Expertise sexual and reproductive health, global family planning, contraception I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (1) Author Response 11 Nov 2024 Alison Kutywayo, Wits Reproductive Health and HIV Institute (Wits RHI), Faculty of Health Sciences,, University of the Witwatersrand, Johannesburg, 2193, South Africa Thank you for your extensive review of our manuscript. We welcome this feedback for strengthening the paper and have addressed the comments as follows: General comments: Sentence added to Introduction to clarify terminology and use of the word ‘’knowledge’’. Methods: A previous reviewer asked for more information on the GAP Year program however we have edited this section to streamline it further. The outcomes of the study were all powered for using a power of 0.8. However, given that there were small sample sizes in some of the variables, this is the reason why a number of variables were non-significant. An explanation of how the sample size was derived was provided on page 5. We have however indicated that it represents the actual sample of the trial. Results: The discrepancies in the data reported in the tables have been amended. Footnotes have been added to Table 2 to provide the reader clarity. We have removed p-values from Table 3 given the small sample size and non-significant differences. Discussion: The Discussion has been streamlined and revised in line with the key findings. The Limitations have been amended, in line with the reviewers comments. View more View less Competing Interests No competing interests were disclosed. reply Respond Report a concern A Cohen M. Peer Review Report For: Knowledge and uptake of contraceptive and other sexual reproductive health services among in-school adolescents in three South African townships: Baseline findings from the Girls Achieve Power (GAP Year) Trial [version 3; peer review: 2 approved, 2 approved with reservations] . Gates Open Res 2024, 6 :67 ( https://doi.org/10.21956/gatesopenres.14980.r33165) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://gatesopenresearch.org/articles/6-67/v2#referee-response-33165 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2023 Hernandez J. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 25 May 2023 | for Version 2 Julie Hernandez , Department of Health Management and Policy, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA 0 Views copyright © 2023 Hernandez J. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Thank you for the opportunity to review this manuscript, which provides additional contributions to the literature on early adolescents’ SRH issues in South Africa. The study design and papers are overall clear and well developed. However, the reviewer thinks that some revisions are necessary to ensure the findings are rigorously presented and the recommendations align with the study results. Key cross-sectional issues include: The need to clarify between contraceptive use for pregnancy prevention vs. condom use for STI (including HIV) prevention. The authors mention “SRH and HIV” but the latter is included in the former. The results would benefit from clarifying the specific issues faced by young adolescents with regards to both contraceptive use and STI prevention. “Knowledge” is not well defined in the Methods section and as a result it is often unclear whether actual knowledge (e.g. including of how to use, possible side effects, etc.) or simply method awareness was recorded. In addition, the authors should clarify whether they recorded method awareness through direct “yes / no” questions (“Have you ever heard of method (x)?”) or by asking respondents to list the methods they knew? Method knowledge is not reported in any of the tables despite figuring prominently in the introduction, the key outcomes and the title for the study. Since participation was voluntary, what was the refusal rate / participation rate for each school, and does this introduce a potential for bias? Since the denominator for women who ever had sex dropped considerably (n = 157), could the authors comment on the power to run the association analysis presented in Table 3? Would it be possible to raise the significance threshold to counter the small denominator issue? Results are presented in details (p.9) and yet those specific samples are very small. Finally, as mentioned by another reviewer, the Discussion section still stretches the results considerably. Details are provided under suggestions for this specific section. I also suggest the following edits to each section: Introduction: Section 2: Adjust “SRH and HIV”. SRH includes HIV / AIDS / STI and contraceptive access and use. Section 3: “the prevalence of mostly unintended pregnancies” Suggest reformulating, unclear what “mostly” means here, nor what data supports it. Section 5: First sentence is circumvoluted, I suggest reformulating. Table 1: Significant difference for currently dating / ever had sex by girls might be indicative of reporting bias and needs to be discussed in Limitations. Literature consistently shows that adolescent girls underreport sexual activity. Table 2 Significant difference in “ever participated in an SRH program” for girls indicates that girls are much more frequently targeted by this kind of program and should be discussed in relevant section (esp. as authors advocate for gender-based interventions). It might also explain why girls are significantly more likely than boys to access youth clinics (because SRH programs may have made them aware of their availability). Table 2 presents knowledge of contraceptive services but not of contraceptive methods. Manuscript title, background and methods section should be adjusted to reflect this. Table 3: Is “Thigh sex” a traditional method? In that case it should be lumped with “Withdrawal” and other non-modern contraceptive methods. Discussion: I re-iterate the comment of a previous reviewer who found the discussion and conclusion too generic and not sufficiently aligned with the specific findings of the study. The first section does not reflect the specific findings presented in the previous section. For example, looking at the different age groups (since this is an important point highlighted by the authors in the recommendations) Table 1 and 2 suggest that older adolescents are more likely to have been exposed to SRH programs (which makes sense considering they have been alive / in the target demographic for a longer period of time), yet they are less comfortable asking SRH questions from service providers. Regardless of these differences in SRH exposure though, Table 3 indicates that there are no significant differences in use patterns between age groups. The authors do not discuss supply-side issues and barriers that may challenge their proposed recommendations. What factors could limit the feasibility of implementing those recommendations considering the resource-limited health provision environment of South African townships? Section 3 and 4 of the Discussion presents the GAP Year as a solution to the issues highlighted in the manuscript which might read as confirmation bias, particularly as the study uses only pre-intervention data. We suggest removing or reformulating to present how GAP Year specifically addresses these issues. The last three paragraphs of this section present conclusions that are not based on the study findings. For example, data about participants thinking that hormonal contraception can prevent STI / HIV is not mentioned in any of the previous sections. It might be more appropriate to talk about “respondents” rather than “learners” presuming that not all students participated in the survey? (Participation bias). The last section could also be construed as confirmation bias in advocating for ecological models such as the one used by GAP Year. Strengths and limitations: The sample of 26 schools was not selected in any representative way (or the randomization technique was not adequately presented in the Methods), therefore the results can NOT be generalized to other South African settings. (Large samples are not sufficient to generate external validity). Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Partly Are sufficient details of methods and analysis provided to allow replication by others? Partly If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? No Competing Interests No competing interests were disclosed. Reviewer Expertise International family planning I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (1) Author Response 11 Nov 2024 Alison Kutywayo, Wits Reproductive Health and HIV Institute (Wits RHI), Faculty of Health Sciences,, University of the Witwatersrand, Johannesburg, 2193, South Africa Thank you to the reviewer for this thoughtful and thorough review of our manuscript. There were a number of comments which have been addressed in the following ways: - The use of the term ''SRH and HIV'': In South Africa, and sub-Saharan Africa, the term SRH and HIV is commonly used as a package of distinct but interrelated interventions be it prevention, treatment, health promotion, advocacy etc. While there is an intersection, the two have separate policies and programmes in South Africa, and therefore we tend to refer to SRH and HIV. The introduction provides detail of the scope in this context. - Regarding the definition of knowledge: We wanted to probe their knowledge and uptake about SRH services broadly; and their utilisation and experience thereof. It was beyond the scope to probe detailed knowledge about each method. Sentence added to Introduction to clarify terminology and use of the word ‘’knowledge’’. - Based on reviewer feedback, the following limitations have been added: limited generalizability due to small school sample, refusal rate not collected leading to possible participation bias and some significant differences presented in the results may be attributed to under-reporting and AGYW targeting. - Power to run the study: Prior to commencing with our analysis, we set the statistical power to 0.8 (can also be specified as 80%) with an effect size of 5% and an alpha of 0.05 and this is usually considered to be the ideal power of a study. This was done with the purpose of lowering the risk of making a Type II error and thus given this instance, it was important to rather lean towards a Type I error which was as low as 0.05 or 0.01. We do however acknowledge that the sample size of young women who have ever had sex (n=157) was not sufficient enough to conduct inferential statistics with which affects the ability to comment on any significant differences between the two age groups. The n presented is lower (n=80) as it includes only information on the contraceptive users. We have therefore removed the P values which were non-significant and mentioned the descriptive presentation when the table is introduced. - Minor edits to the text have been amended, as per the reviewers suggestions. - Table 3: uptake of contraception methods is presented in Table 3. - Discussion: the Discussion has been edited and streamlined extensively aligning to the key findings, as suggested by the reviewer. - Discussion and Conclusion has been reviewed to ensure recommendations acknowledge the resource constrained context within which this research was conducted. - References made to the GAP Year intervention have been removed in the Discussion. - Throughout the manuscript we now talk about ''participants'', not learners. Please see the updated version of the manuscript for your review. View more View less Competing Interests No competing interests were disclosed. reply Respond Report a concern Hernandez J. Peer Review Report For: Knowledge and uptake of contraceptive and other sexual reproductive health services among in-school adolescents in three South African townships: Baseline findings from the Girls Achieve Power (GAP Year) Trial [version 3; peer review: 2 approved, 2 approved with reservations] . Gates Open Res 2024, 6 :67 ( https://doi.org/10.21956/gatesopenres.14980.r33160) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://gatesopenresearch.org/articles/6-67/v2#referee-response-33160 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2022 MacPhail C. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 19 Jul 2022 | for Version 2 Catherine MacPhail , School of Health and Society, University of Wollongong, Wollongong, NSW, Australia 0 Views copyright © 2022 MacPhail C. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions I have no further comments to make. Competing Interests I was previously an employee of the Wits RHI (2003-2012) and have worked with both Melanie Pleaner and Mags Beksinska in the past. We have not worked with one another for more than 10 years and I do not believe that our relationship has impacted my decisions with regard to this manuscript. Reviewer Expertise adolescent sexual and reproductive health, particularly HIV prevention I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (0) MacPhail C. Peer Review Report For: Knowledge and uptake of contraceptive and other sexual reproductive health services among in-school adolescents in three South African townships: Baseline findings from the Girls Achieve Power (GAP Year) Trial [version 3; peer review: 2 approved, 2 approved with reservations] . Gates Open Res 2024, 6 :67 ( https://doi.org/10.21956/gatesopenres.14980.r32262) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://gatesopenresearch.org/articles/6-67/v2#referee-response-32262 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2022 MacPhail C. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 20 Jun 2022 | for Version 1 Catherine MacPhail , School of Health and Society, University of Wollongong, Wollongong, NSW, Australia 0 Views copyright © 2022 MacPhail C. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions This paper reports on the baseline findings from an intervention programme to increase contraceptive knowledge and use among young South African adolescents in three township communities. Although the GAP Year intervention is included in the title of the paper, there is no real mention of the intervention in the paper. Would it be possible to include some details of the proposed intervention (likely completed already given the dates of this baseline data collection)? It seems that including some ideas of how the GAP Year intervention might address some of the issues outlined in the discussion would enhance the paper by reporting on how the findings might be addressed in the intervention. Abstract: Remove the apostrophe from Grade 8’s Introduction: Suggest adding a comma to “there are still multiple challenges in accessible SRH service provision for adolescents, resulting in poor health outcomes.” “limited information on contraception knowledge” seems to be convoluted language and might benefit from some additional editing Change “Knowledge about contraception and contraceptive options is low among South African youth,. . .” Methods: The recruitment of Grade 8 participants was undertaken across two school years. The authors might wish to comment on whether this was an intentional plan (and to what end) or to comment on any implications on this method in the limitations section. It is interesting that sensitive questions about sexuality, gender, and norms were included in the interviewer-administered questionnaire component and not in the ACASI component. I assume that this was because these were general questions and not specifically about the participant’s own identity? Please comment on the use of a Xhosa translation for the W Cape schools but no equivalent translation for the Gauteng schools. What was the reasoning behind this decision? This should potentially be further discussed in the limitations section if you believe that this might have impacted on the accuracy of information or completion. It would be useful here to see completion by province – given that quite a large number of students did not complete both parts of the survey, might language problems have contributed in the Gauteng cohort? Results: Table 2 results note that there is a significant difference in knowledge of right to accessing health care by gender (p<0.001), yet the reporting in the text says “Over two thirds of learners (66.8%, n=1557) perceived that they have a right to access health care without being discriminated or stigmatised by health workers: this was similar among males and females.” This doesn’t seem consistent. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? I cannot comment. A qualified statistician is required. Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests I was employed by the Wits RHI from 2003-2012 and held an honorary position with this organisation after moving to Australia in 2012. I have not however worked with Melanie Pleaner or Mags Beksinska since before 2012. Previously working with the authors has not impacted my ability to provide an impartial review of this paper. Reviewer Expertise adolescent sexual and reproductive health, particularly HIV prevention I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (1) Author Response 18 Jul 2022 Alison Kutywayo, Wits Reproductive Health and HIV Institute (Wits RHI), Faculty of Health Sciences,, University of the Witwatersrand, Johannesburg, 2193, South Africa Thank you for your comments on our manuscript. We have noted your comments and have addressed them as follows: Although the GAP Year intervention is included in the title of the paper, there is no real mention of the intervention in the paper. Would it be possible to include some details of the proposed intervention (likely completed already given the dates of this baseline data collection)? It seems that including some ideas of how the GAP Year intervention might address some of the issues outlined in the discussion would enhance the paper by reporting on how the findings might be addressed in the intervention. Response : Added a sentence in the Methods section to elaborate on the GAP Year intervention and then also mentioned the intervention in the Discussion, in line with this comment. Abstract: Remove the apostrophe from Grade 8’s Response : Apostrophe removed. Introduction: Suggest adding a comma to “there are still multiple challenges in accessible SRH service provision for adolescents, resulting in poor health outcomes.” Response : Punctuation added. Intro: “limited information on contraception knowledge” seems to be convoluted language and might benefit from some additional editing Response : Punctuation added. Intro: Change “Knowledge about contraception and contraceptive options is low among South African youth… Response : Sentence amended. Methods: The recruitment of Grade 8 participants was undertaken across two school years. The authors might wish to comment on whether this was an intentional plan (and to what end) or to comment on any implications on this method in the limitations section Response : This section in the Methods has been amended and clarity provided. Methods: It is interesting that sensitive questions about sexuality, gender, and norms were included in the interviewer-administered questionnaire component and not in the ACASI component. I assume that this was because these were general questions and not specifically about the participant’s own identity? Response : This section of the Methods has been restructured to provide greater clarity on this query. Methods: Please comment on the use of a Xhosa translation for the W Cape schools but no equivalent translation for the Gauteng schools. What was the reasoning behind this decision? This should potentially be further discussed in the limitations section if you believe that this might have impacted on the accuracy of information or completion. It would be useful here to see completion by province – given that quite a large number of students did not complete both parts of the survey, might language problems have contributed in the Gauteng cohort? Response : This section in the Methods has been amended to provide clarity on the translation. Results: Table 2 results note that there is a significant difference in knowledge of right to accessing health care by gender (p<0.001), yet the reporting in the text says “Over two thirds of learners (66.8%, n=1557) perceived that they have a right to access health care without being discriminated or stigmatised by health workers: this was similar among males and females.” This doesn’t seem consistent Response : Although the difference between females (65.2% vs male 69.5%) table 2 appears to be a small percentage and similar, the large sample size indicates that statistically there is a real difference between the males and females in this variable. We have changed the text to make this more clear. View more View less Competing Interests None reply Respond Report a concern MacPhail C. Peer Review Report For: Knowledge and uptake of contraceptive and other sexual reproductive health services among in-school adolescents in three South African townships: Baseline findings from the Girls Achieve Power (GAP Year) Trial [version 3; peer review: 2 approved, 2 approved with reservations] . Gates Open Res 2024, 6 :67 ( https://doi.org/10.21956/gatesopenres.14915.r32119) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://gatesopenresearch.org/articles/6-67/v1#referee-response-32119 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2022 Yimer B. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 08 Jun 2022 | for Version 1 Belete Yimer , Department of Human Nutrition, Debre Markos University, Debre Markos, Ethiopia 0 Views copyright © 2022 Yimer B. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions The document makes important, relevant points, is timely and contains applicable references. I agree with much of the analysis, but think it needs strengthening. The title should be modified as: "Contraceptive knowledge and uptake among school adolescents in three South African townships...", in order to better convey the key features of the article. The authors used Chi-squared statistic tests for proportion comparison. To identify predictors of interest of knowledge, uptake and perceptions around SRH controlling for the confounding effects, multiple regression could be used. The recommendations need to be based on the findings of the study in question and not general observations and dissemination of knowledge. I suggest the authors to narrow down their recommendations and focus on what they found alone. I feel the study holds merit and may be of scientific interest. However I feel the above observations need to be addressed. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? No Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Partly Competing Interests No competing interests were disclosed. Reviewer Expertise Maternal and child health and nutrition I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (1) Author Response 18 Jul 2022 Alison Kutywayo, Wits Reproductive Health and HIV Institute (Wits RHI), Faculty of Health Sciences,, University of the Witwatersrand, Johannesburg, 2193, South Africa The title should be modified as: "Contraceptive knowledge and uptake among school adolescents in three South African townships...", in order to better convey the key features of the article. Response : The title has been amended as suggested. The authors used Chi-squared statistic tests for proportion comparison. To identify predictors of interest of knowledge, uptake and perceptions around SRH controlling for the confounding effects, multiple regression could be usedThe authors used Chi-squared statistic tests for proportion comparison. To identify predictors of interest of knowledge, uptake and perceptions around SRH controlling for the confounding effects, multiple regression could be used Response: The data presented is from the baseline- prior to any intervention. We were not expecting high levels of service uptake in this group of grade 8 learners. Grade 8 learners are usually aged 12-14 years but there were a significant proportion who were older (15-18) and these young people would have had to repeat school years due to exam failure or other social/financial/health reasons for school exclusion. In terms of their maturity, sexual experience and social circumstances they are a very different group and so we tried to focus on these as two separate and distinct age groups and not compare them too closely at baseline due to their different circumstances. In the 12 -14 age group although table 2 shows 10% of females had ever had sex - a much lower proportion had experienced sexual debut in the 12-14 age compared to the 15-18 year olds as expected. SRH service uptake was also extremely low in both age groups and in males and females which we expected at this age as few were sexually experienced. Only 11 girls aged 12-14 of 1504 had accessed HIV testing services for instance. Because of this low uptake, we felt that a descriptive analysis would be easier to present as numbers were too low for any meaningful multiple regression or other more complex analysis. The recommendations need to be based on the findings of the study in question and not general observations and dissemination of knowledge. I suggest the authors to narrow down their recommendations and focus on what they found alone. Response : In addressing this comment, we have removed the general observations in the Discussion and Conclusion to ensure it is inline with our findings. View more View less Competing Interests None reply Respond Report a concern Yimer B. Peer Review Report For: Knowledge and uptake of contraceptive and other sexual reproductive health services among in-school adolescents in three South African townships: Baseline findings from the Girls Achieve Power (GAP Year) Trial [version 3; peer review: 2 approved, 2 approved with reservations] . Gates Open Res 2024, 6 :67 ( https://doi.org/10.21956/gatesopenres.14915.r32124) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://gatesopenresearch.org/articles/6-67/v1#referee-response-32124 Alongside their report, reviewers assign a status to the article: Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved - fundamental flaws in the paper seriously undermine the findings and conclusions Adjust parameters to alter display View on desktop for interactive features Includes Interactive Elements View on desktop for interactive features Competing Interests Policy Provide sufficient details of any financial or non-financial competing interests to enable users to assess whether your comments might lead a reasonable person to question your impartiality. Consider the following examples, but note that this is not an exhaustive list: Examples of 'Non-Financial Competing Interests' Within the past 4 years, you have held joint grants, published or collaborated with any of the authors of the selected paper. You have a close personal relationship (e.g. parent, spouse, sibling, or domestic partner) with any of the authors. You are a close professional associate of any of the authors (e.g. scientific mentor, recent student). You work at the same institute as any of the authors. You hope/expect to benefit (e.g. favour or employment) as a result of your submission. You are an Editor for the journal in which the article is published. Examples of 'Financial Competing Interests' You expect to receive, or in the past 4 years have received, any of the following from any commercial organisation that may gain financially from your submission: a salary, fees, funding, reimbursements. You expect to receive, or in the past 4 years have received, shared grant support or other funding with any of the authors. You hold, or are currently applying for, any patents or significant stocks/shares relating to the subject matter of the paper you are commenting on. Stay Updated Sign up for content alerts and receive a weekly or monthly email with all newly published articles Register with Gates Open Research Already registered? Sign in Not now, thanks close PLEASE NOTE If you are an AUTHOR of this article, please check that you signed in with the account associated with this article otherwise we cannot automatically identify your role as an author and your comment will be labelled as a “User Comment”. If you are a REVIEWER of this article, please check that you have signed in with the account associated with this article and then go to your account to submit your report, please do not post your review here. If you do not have access to your original account, please contact us . All commenters must hold a formal affiliation as per our Policies . The information that you give us will be displayed next to your comment. User comments must be in English, comprehensible and relevant to the article under discussion. We reserve the right to remove any comments that we consider to be inappropriate, offensive or otherwise in breach of the User Comment Terms and Conditions . Commenters must not use a comment for personal attacks. When criticisms of the article are based on unpublished data, the data should be made available. I accept the User Comment Terms and Conditions Please confirm that you accept the User Comment Terms and Conditions. Affiliation ✕ refresh Please enter your institution. Note: To add your institution or organisation, start typing the name and then select the correct name from the list. Where applicable, the name will appear in both the original language and in English. Do not paste in the name. If the name does not appear in the drop-down list, we will display the information you have entered. ✕ refresh Country/Region * USA UK Canada China France Germany Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory British Virgin Islands Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Cyprus Czech Republic Democratic Republic of the Congo Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Federated States of Micronesia Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and Mcdonald Islands Holy See (Vatican City State) Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kosovo (Serbia and Montenegro) Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Minor Outlying Islands of the United States Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea North Macedonia Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Helena Saint Kitts and Nevis Saint Lucia Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Is South Korea South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand The Gambia The Netherlands Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu UK USA Uganda Ukraine United Arab Emirates United States Virgin Islands Uruguay Uzbekistan Vanuatu Venezuela Vietnam Wallis and Futuna West Bank and Gaza Strip Western Sahara Yemen Zambia Zimbabwe Please select your country/region. You must enter a comment. Competing Interests Please disclose any competing interests that might be construed to influence your judgment of the article's or peer review report's validity or importance. Competing Interests Policy Provide sufficient details of any financial or non-financial competing interests to enable users to assess whether your comments might lead a reasonable person to question your impartiality. Consider the following examples, but note that this is not an exhaustive list: Examples of 'Non-Financial Competing Interests' Within the past 4 years, you have held joint grants, published or collaborated with any of the authors of the selected paper. You have a close personal relationship (e.g. parent, spouse, sibling, or domestic partner) with any of the authors. You are a close professional associate of any of the authors (e.g. scientific mentor, recent student). You work at the same institute as any of the authors. You hope/expect to benefit (e.g. favour or employment) as a result of your submission. You are an Editor for the journal in which the article is published. Examples of 'Financial Competing Interests' You expect to receive, or in the past 4 years have received, any of the following from any commercial organisation that may gain financially from your submission: a salary, fees, funding, reimbursements. You expect to receive, or in the past 4 years have received, shared grant support or other funding with any of the authors. You hold, or are currently applying for, any patents or significant stocks/shares relating to the subject matter of the paper you are commenting on. Please state your competing interests The comment has been saved. An error has occurred. Please try again. Cancel Post var lTitle = "Knowledge and uptake of contraceptive and...".replace("'", ''); var linkedInUrl = "http://www.linkedin.com/shareArticle?url=https://gatesopenresearch.org/articles/6-67/v3" + "&title=" + encodeURIComponent(lTitle) + "&summary=" + encodeURIComponent('Read the article by '); var deliciousUrl = "https://del.icio.us/post?url=https://gatesopenresearch.org/articles/6-67/v3&title=" + encodeURIComponent(lTitle); var redditUrl = "http://reddit.com/submit?url=https://gatesopenresearch.org/articles/6-67/v3" + "&title=" + encodeURIComponent(lTitle); linkedInUrl += encodeURIComponent('Pleaner M et al.'); var offsetTop = /chrome/i.test( navigator.userAgent ) ? 4 : -10; var addthis_config = { ui_offset_top: offsetTop, services_compact : "facebook,twitter,www.linkedin.com,www.mendeley.com,reddit.com", services_expanded : "facebook,twitter,www.linkedin.com,www.mendeley.com,reddit.com", services_custom : [ { name: "LinkedIn", url: linkedInUrl, icon:"/img/icon/at_linkedin.svg" }, { name: "Mendeley", url: "http://www.mendeley.com/import/?url=https://gatesopenresearch.org/articles/6-67/v3/mendeley", icon:"/img/icon/at_mendeley.svg" }, { name: "Reddit", url: redditUrl, icon:"/img/icon/at_reddit.svg" }, ] }; var addthis_share = { url: "https://gatesopenresearch.org/articles/6-67", templates : { twitter : "Knowledge and uptake of contraceptive and other sexual reproductive.... Pleaner M et al., published by " + "Gates Open Research" + ", https://gatesopenresearch.org/articles/6-67/v3" } }; if (typeof(addthis) != "undefined"){ addthis.addEventListener('addthis.ready', checkCount); addthis.addEventListener('addthis.menu.share', checkCount); } $(".f1r-shares-twitter").attr("href", "https://twitter.com/intent/tweet?text=" + addthis_share.templates.twitter); $(".f1r-shares-facebook").attr("href", "https://www.facebook.com/sharer/sharer.php?u=" + addthis_share.url); $(".f1r-shares-linkedin").attr("href", addthis_config.services_custom[0].url); $(".f1r-shares-reddit").attr("href", addthis_config.services_custom[2].url); $(".f1r-shares-mendelay").attr("href", addthis_config.services_custom[1].url); function checkCount(){ setTimeout(function(){ $(".addthis_button_expanded").each(function(){ var count = $(this).text(); if (count !== "" && count != "0") $(this).removeClass("is-hidden"); else $(this).addClass("is-hidden"); }); }, 1000); } close How to cite this report {{reportCitation}} Cancel Copy Citation Details $(function(){R.ui.buttonDropdowns('.dropdown-for-downloads');}); $(function(){R.ui.toolbarDropdowns('.toolbar-dropdown-for-downloads');}); $.get("/articles/acj/13636/16764") new F1000.Clipboard(); new F1000.ThesaurusTermsDisplay("articles", "article", "16764"); $(document).ready(function() { $( "#frame1" ).on('load', function() { var mydiv = $(this).contents().find("div"); var h = mydiv.height(); console.log(h) }); var tooltipLivingFigure = jQuery(".interactive-living-figure-label .icon-more-info"), titleLivingFigure = tooltipLivingFigure.attr("title"); tooltipLivingFigure.simpletip({ fixed: true, position: ["-115", "30"], baseClass: 'small-tooltip', content:titleLivingFigure + " " }); tooltipLivingFigure.removeAttr("title"); $("body").on("click", ".cite-living-figure", function(e) { e.preventDefault(); var ref = $(this).attr("data-ref"); $(this).closest(".living-figure-list-container").find("#" + ref).fadeIn(200); }); $("body").on("click", ".close-cite-living-figure", function(e) { e.preventDefault(); $(this).closest(".popup-window-wrapper").fadeOut(200); }); $(document).on("mouseup", function(e) { var metricsContainer = $(".article-metrics-popover-wrapper"); if (!metricsContainer.is(e.target) && metricsContainer.has(e.target).length === 0) { $(".article-metrics-close-button").click(); } }); var articleId = $('#articleId').val(); if($("#main-article-count-box").attachArticleMetrics) { $("#main-article-count-box").attachArticleMetrics(articleId, { articleMetricsView: true }); } }); var figshareWidget = $(".new_figshare_widget"); if (figshareWidget.length > 0) { window.figshare.load("f1000", function(Widget) { // Select a tag/tags defined in your page. In this tag we will place the widget. _.map(figshareWidget, function(el){ var widget = new Widget({ articleId: $(el).attr("figshare_articleId") //height:300 // this is the height of the viewer part. [Default: 550] }); widget.initialize(); // initialize the widget widget.mount(el); // mount it in a tag that's on your page // this will save the widget on the global scope for later use from // your JS scripts. This line is optional. //window.widget = widget; }); }); } close Error Close Add Reset F1000.MICROSERVICES.AFFILIATION = ''; $(document).ready(function () { $('.js-affiliations-form').each((index, form) => { new AffiliationForm({ formId: form.id, institutionErrorSelector: '.comment-enter-institution', departmentErrorSelector: '.comment-enter-department', placeSelector: '.js-add-comment-place', stateSelector: '.js-add-comment-state', zipCodeSelector: '.js-add-comment-zipcode', countrySelector: '.js-add-comment-country', countryErrorSelector: '.comment-enter-country', }); }); }); $(document).ready(function () { var reportIds = { "33156": 0, "32261": 0, "33157": 0, "32262": 17, "33158": 0, "33159": 0, "33160": 23, "33161": 0, "33162": 0, "33163": 0, "33164": 0, "33165": 22, "32220": 0, "32221": 0, "32223": 0, "38694": 0, "38695": 0, "38696": 0, "38697": 0, "38698": 0, "38699": 0, "38700": 0, "38444": 0, "38445": 7, "38701": 0, "38702": 0, "38446": 0, "38703": 0, "38447": 0, "32119": 19, "32120": 0, "32121": 0, "32122": 0, "32123": 0, "32124": 48, }; $(".referee-response-container,.js-referee-report").each(function(index, el) { var reportId = $(el).attr("data-reportid"), reportCount = reportIds[reportId] || 0; $(el).find(".comments-count-container,.js-referee-report-views").html(reportCount); }); var uuidInput = $("#article_uuid"), oldUUId = uuidInput.val(), newUUId = "e540e8bf-2db4-49a0-a29e-a85f161572a0"; uuidInput.val(newUUId); $("a[href*='article_uuid=']").each(function(index, el) { var newHref = $(el).attr("href").replace(oldUUId, newUUId); $(el).attr("href", newHref); }); }); Are you a Gates-funded researcher? If you are a previous or current Gates grant holder, sign up for information about developments, publishing and publications from Gates Open Research. First Name * You must provide your first name Last Name * You must provide your last name Email * You must provide a valid email address Institution You must provide an institution. Submit Thank you! We'll keep you updated on any major new updates to Gates Open Research Gates Open Research Browse Gateways How to Publish About Contact Legal For Developers Cookie Notice Privacy Notice RSS Submit via VeriXiv © F1000 Research Limited and its licensors ISSN 2572-4754 var F1000platform = new F1000.Platform({ name: "gates", displayName: "Gates Open Research", hostName: "gatesopenresearch.org", id: "3", editorialEmail: "[email protected]", infoEmail: "[email protected]", usePmcStats: true }); Sign In Remember me Forgotten your password? Sign In Cancel Email or password not correct. Please try again Please wait... $(function(){ // Note: All the setup needs to run against a name attribute and *not* the id due the clonish // nature of facebox... $("a[id=googleSignInButton]").click(function(event){ event.preventDefault(); $("input[id=oAuthSystem]").val("GOOGLE"); $("form[id=oAuthForm]").submit(); }); $("a[id=facebookSignInButton]").click(function(event){ event.preventDefault(); $("input[id=oAuthSystem]").val("FACEBOOK"); $("form[id=oAuthForm]").submit(); }); $("a[id=orcidSignInButton]").click(function(event){ event.preventDefault(); $("input[id=oAuthSystem]").val("ORCID"); $("form[id=oAuthForm]").submit(); }); }); If you've forgotten your password, please enter your email address below and we'll send you instructions on how to reset your password. The email address should be the one you originally registered with F1000. Email address not valid, please try again You registered with F1000 via Google, so we cannot reset your password. To sign in, please click here . If you still need help with your Google account password, please click here . You registered with F1000 via Facebook, so we cannot reset your password. To sign in, please click here . If you still need help with your Facebook account password, please click here . Code not correct, please try again Reset password Cancel Email us for further assistance. Server error, please try again. If your email address is registered with us, we will email you instructions to reset your password. If you think you should have received this email but it has not arrived, please check your spam filters and/or contact for further assistance. Please wait... Register $(document).ready(function () { signIn.createSignInAsRow($("#sign-in-form-gfb-popup")); $(".target-field").each(function () { var uris = $(this).val().split("/"); if (uris.pop() === "login") { $(this).val(uris.toString().replace(",","/")); } }); });