Enhancing scientific rigor: Reflections on the study of perceived stress and its influencing factors among persons living with HIV/AIDS (PLHA) in Kannur district, Kerala, India

Sir, This is regarding the article titled “Perceived stress and its influencing factors among persons living with HIV/AIDS (PLHA) in Kannur district, Kerala, India”[1] published in your esteemed journal in the April 2024 issue (p 1219-1222). The authors have done an extremely good job of addressing one of the crucial aspects of the lives of people living with HIV/AIDS (PLHA), which is stress. The study suggests that occupation, gender, marital status, monthly income, and number of dependents are factors that contribute to the perceived stress of PLHA. Sample selection through simple random sampling was indeed a good approach to selecting the participants. There are some aspects of the study that I would like to address. First, the sample size calculation is crucial for any research study. It seems arbitrary that the authors chose to study 210 participants. The mode of data collection is also unclear; whether the researchers used any online data collection tools like Google Forms or KOBO Toolbox, or conducted one-on-one interviews. Second, the software used for data analysis and the statistical tests need to be clearly specified in the methodology or results section (where applicable). Odds ratio (with Haldane-Anscombe correction[2] where applicable) and adjusted OR through binary logistic regression could provide further insights into the factors. It is unclear whether the authors used the corrected Chi-square test and Fisher’s test to check for the independence of attributes in antiretroviral therapy (ART) and education, respectively. In Tables 4 and 5, even though the authors mentioned that a specific group perceived higher stress than others, conducting a posthoc test following a one-way ANOVA would have been affirmative. Despite minor oversights, the study identifies some of the factors that cause higher perceived stress among PLHA. Such studies are important to identify factors and address them to improve the quality of life of PLHA. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.