Experiences of women living with HIV who underwent long loop excision of the transformation zone (LLETZ) in selected hospitals of Vhembe district, Limpopo province, South Africa

Abstract

Background: Cervical cancer poses a significant health threat, especially for women living with HIV, who are at increased risk of developing premalignant cervical lesions. Large Loop Excision of the Transformation Zone (LLETZ) is a standard treatment for cervical intraepithelial neoplasia (CIN) to prevent progression to malignancy. This study explores the experiences of HIV-positive women who underwent LLETZ in Vhembe District, South Africa, where access to such specialized treatments remains limited. Methods: Using a qualitative, phenomenological approach, this study engaged seven HIV-positive women who underwent LLETZ, capturing their lived experiences through in-depth, unstructured interviews. Thematic analysis identified key themes and subthemes to elucidate their psychological, physical, and social encounters related to the procedure. Results: Analysis revealed eight central themes: psychological and physical experiences, psychosocial and financial support, misconceptions, education, recommendations, and time-related factors. Participants reported anxiety, fear, and initial stress about the procedure, coupled with resilience and acceptance over time. Physical effects such as pain and bleeding were common, though recovery experiences varied. Social support from family and community played a critical role in coping, while financial constraints impacted access to and continuity of care. Misunderstandings about the LLETZ procedure underscored the need for enhanced patient education. Participants emphasized timely screening and support systems to improve treatment outcomes and reduce psychological distress. Conclusions: The study highlights the multifaceted impact of LLETZ on HIV-positive women, including the psychological and financial burdens and the importance of clear communication and patient education. Improved support structures, timely result communication, and access to follow-up care are essential to enhance patient outcomes. Recommendations advocate for health system improvements, partner involvement, and proactive counselling to address the specific needs of HIV-positive women undergoing cervical cancer prevention treatments.