Loop electrosurgical excision procedure: safety and tolerability among human immunodeficiency virus-positive Kenyan women.


Journal Article

OBJECTIVES: To estimate the safety, tolerability, and acceptability of loop electrosurgical excision procedure (LEEP) for cervical intraepithelial neoplasia (CIN 2 or 3) in human immunodeficiency virus (HIV)-positive women performed by nonphysician health care providers in an HIV care and treatment clinic. METHODS: We performed a prospective cohort study among women undergoing LEEP for biopsy-confirmed CIN 2 or 3 at the Family Acquired Immunodeficiency Syndrome Care and Education Services Clinic in Kisumu, Kenya. Women were followed-up 4 weeks after the procedure and questioned for abstinence as well as presence and severity of side effects after the procedure. The results were analyzed using descriptive statistics and univariable and multivariable analysis. RESULTS: Among the 180 (91%) women who returned for a 4-week follow up after LEEP, 52% reported at least one postprocedure symptom, including bleeding, discharge, or pain. Using a Likert scale for severity of symptoms, 179 (99%) reported very mild to mild symptoms, whereas one (1%) participant described the symptoms as moderate. No participants reported severe symptoms. Mean CD4 count was significantly higher among women who reported any symptoms compared with women who reported no symptoms after LEEP (419 cells/mm compared with 349 cells/mm, P<.05), an association that remained significant after adjustment for antiretroviral treatment. The presence or severity of postprocedure symptoms did not differ among women who reported sexual activity (16%) less than 4 weeks after the procedure. CONCLUSION: LEEP performed by clinical officers was well-accepted by HIV-positive women and appears safe, resulting in minimal side effects, even among women with early resumption of intercourse. LEVEL OF EVIDENCE: II.

Full Text

Duke Authors

Cited Authors

  • Woo, VG; Cohen, CR; Bukusi, EA; Huchko, MJ

Published Date

  • September 2011

Published In

Volume / Issue

  • 118 / 3

Start / End Page

  • 554 - 559

PubMed ID

  • 21860283

Pubmed Central ID

  • 21860283

Electronic International Standard Serial Number (EISSN)

  • 1873-233X

Digital Object Identifier (DOI)

  • 10.1097/AOG.0b013e31822b0991


  • eng

Conference Location

  • United States