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: Large Loop Electrosurgical removal of the Transformation Zone (LLETZ) is a mutually agreed intervention of choice by researchers in screening for and treatment of pre-malignant lesions and is therefore implemented worldwide. Several studies have been conducted globally, regionally and nationally on the concept of LLETZ and women living with Human Immunodeficiency Virus. Hardly any such study was conducted within Vhembe District, Limpopo Province, South Africa. Being a surgical procedure, it is associated with potential side effects for individuals undergoing it. Purpose: The study intended to explore and describe the experiences of women living with Human Immunodeficiency Virus who underwent LLETZ in selected hospitals of Vhembe District, Limpopo Province, South Africa. Methodology: The researcher conducted a scoping review guided by the methodology of the Joanna Briggs Institute (JBI) and searched for published articles related to LLETZ experiences of HIV-positive women from 2013 to 2023 in the English language only. Keywords for searching various databases included experiences, HIV, LLETZ, reproductive age and women. The review identified critical factors and characteristics associated with the topic as well as gaps in the knowledge base. The researcher embarked on a qualitative study, exploratory and descriptive in design, guided by a phenomenological approach cognitive framework. A purposive sampling technique was applied. The sample constituted seven (7) participants, including two (2) for pretest and one (1) for verifying data saturation. One-to-one in-depth, unstructured interviews were conducted. Approaches to data analysis included organizing, reading, coding, identifying categories/themes and representing and interpreting the data. The Tesch coding procedure was implemented as part of the thematic analysis. The study consists of two articles. Results: Eight main themes emerged, with four constituting sub-themes. The LLETZ intervention process involves several aspects, including outcomes, psychological experiences, physical experiences, psychosocial support, financial support, misconceptions and education, recommendations and reflections and the time factor. Women often experience unrealistic expectations from interventions due to misconceptions. Uncertainty emerged as a factor affecting psychological and psychosocial experiences as well as the screening test, intervention procedure and results turnaround time. Recommendations are made to patients, health professionals, educators and researchers. It is evident that there is still much work to be done with regard to this phenomenon to achieve the goals of the third millennium. Conclusion: The discussion of the study findings reflected on the reviewed literature. Uncertainty was identified as the dominant force behind women’s experiences. This implicates knowledge deficit as the main factor. Thus, all possible manners of information given to patients and their support system must be applied.