# Riverine Women’s Perceptions of the Pap Smear Test in Light of Health Literacy

## TL;DR

This study explores how riverine women in the Brazilian Amazon perceive Pap smear tests, highlighting how limited health knowledge affects their use of cervical cancer screening.

## Contribution

The study provides new insights into the relationship between health literacy and adherence to Pap smear exams among riverine women in a specific geographic and cultural context.

## Key findings

- Limited knowledge about the Pap smear test was linked to low health literacy among participants.
- Health literacy and access to information were found to influence self-care behaviors and exam adherence.
- Geographic and cultural barriers were identified as significant challenges to accessing health services.

## Abstract

Background: Women living in riverine communities are affected by factors such as geographical and cultural distance that hinder access to and use of health services. In this context, access to the Pap smear is crucial for the early detection of cellular changes that may progress to cervical cancer, which underlines the importance of understanding riverine women’s subjective perceptions of this exam. Objectives: To analyze the perceptions of riverine women regarding cervical cancer screening through the lens of health literacy. Methods: Descriptive qualitative study conducted with 42 riverine women residents of the Brazilian Amazon who were registered at the Basic Health Unit on Cotijuba Island, Pará, Brazil. Data were collected through semi-structured individual interviews from January to May 2024 and analyzed using IRaMuTeQ software version 0.7 alpha 2. Results: Data were grouped into similar classes, yielding the following thematic axes: knowledge, feelings and perceptions about the Pap smear test; how health literacy and access to information affect self-care; access to health services. The study showed that limited participant knowledge about the Pap smear was reflected in low health literacy, which directly affected adherence to the exam. Conclusions: The study demonstrated that the riverine woman’s limited knowledge regarding the Pap smear was reflected in their poorly developed health literacy, which directly contributed to non-adherence to the exam.