Measuring Phases of Employment Decision-Making and the Need for Vocational Services as a Social Determinant of the Health of Employed People Living with HIV

Round 1

Reviewer 1 Report

This manuscript points out the importance of employment and the type of mental/psychological security that different types of employment hold in the general population, but more specifically in a very fragile group of the population that are PLHIV.

The manuscript succeeds in proving the thesis that employment has positive effects on the health and quality of life of PLHIV.

The instrument used seems to have been well constructed and validated, presenting data that confirm its behavioral predictive possibilities, and improvements to other authors' existing scales have been advanced.

Basically, the decision process is presented as non-linear and complex, in this case related to factors such as keeping the job or moving to a new job. In this decision process, the existence and access to local and national services (with coordination that can be complemented) will be determinant. This manuscript thus contributes in a very interesting and assertive way to encouraging the creation and or expansion of these counseling services, as well as enabling HIV-positive citizens to access information about work. It is assumed that there will exist in the link between vocation and psychological comfort found via being employed and via the type of work the person has.

The theoretical foundation is sufficient, and has been well explored, with improvement factors presented in existing methodological frameworks.

Although the data survey reports on 2018-2019 - National Working Positive 147 Coalition (NWPC) Vocational Development and Employment Needs survey- They can be perfectly used.

The fact that it is reported that this was a voluntary sample (which turns out to be convenient) is not compromising of results, since the school conditions of the sample members are explicit. Appropriate considerations are made about the limits to the generalization of the results obtained.

Basically, the study intends to be one more contribution to a national policy, with a logic of networking and partnership, involving both sectors (public and private) in order to assure the quality of life in this very fragile population group, through counseling in the area of employment.

Should be taken into account some spelling recommendations, which follow in the attached file.

 

Comments for author File: Comments.pdf

Author Response

Thank you for your thoughtful review. We have fixed the three typographical errors.

Reviewer 2 Report

COMMENT

The work is interesting in terms of the corresponding social value because it addresses an issue related to social determinants and in this case employment in people who are informed of an HIV diagnosis.

From the methodological point of view, the study proposed a factor analysis with several rotations. However, there are some doubts that can surely be explained by the authors.

With factorial rotation, even if the factorial matrix changes, the communalities are not altered; however, the variance explained by each factor changes.

There are several rotation methods that we can group into two main types: orthogonal and oblique. The most recommendable is the orthogonal rotation, although in case there are reasons to think that the factors are correlated then we will use the oblique rotation, one or the other. Among the orthogonal rotations the most used is the varimax while in the oblique ones it is the oblimin. In oblique rotation, the factorial weights do not coincide with the correlations between the factor and the variable, since the factors are correlated with each other. That is why when we do oblique rotation, the non-rotated factorial matrix becomes two different matrices: the weighting matrix (which is the one used in the interpretation) and the correlation matrix between factors and variables. Therefore, we would obtain another matrix of correlations between factors.

The question would be, explain the statistical strategy behind the use of various rotations and whether they could produce different results with different interpretations. In addition, although the Crombach's Alpha is adequate, there is no reference to the KMO, Kaiser-Meyer-Olkin Measure, which is useful to know the adequacy of sampling and indicates the proportion of variance in the variables that can be caused by underlying factors. High values ​​close to 1 indicate that with this amount of rate, factor analysis would be useful. If the value is less than 0.50, the results of the factor analysis will probably not be very useful.

Author Response

Thank you for your feedback on our paper and for pointing out the Kaiser-Meyer-Olkin measure. We have run the method and now report a KMO of 0.88. 

With regard to the factor analysis itself, our aim was to be transparent in how the rotation was selected.

With the addition of the KMO test, two references have been added; in-text citation numbers have been updated to reflect this addition.