Abstract
Background: Cervical cancer is the most common cancer in Botswana. Little is known about women's use of Papanicolaou (Pap) cervical smear tests. Aim: The study is to explore knowledge and beliefs of 30 women about cervical cancer and Pap smear tests using the Health Belief Model. Method: Women were recruited from all income levels using network sampling. Data were collected using a demographic questionnaire and semi-structured interview guide. Data analysis included descriptive statistics for demographic data and content analysis for interview data. Findings: Knowledge of cervical cancer and the Pap smear test was inadequate among women with low incomes. Pap smear utilization was also limited among low-income women. Of the 18 women who had at least one Pap smear test in their lifetime, eight (44%) had opportunistic testing as a result of having gynaecological symptoms. Twelve women (40%) had never had Pap smear tests. Major barriers to Pap smear screening included inadequate knowledge about Pap smear testing, providers’ negative attitudes, and limited access to doctors. Conclusion: The study has implications for health education and health policy and for nurses’ involvement in both.