Shame, Fear, and the Husband's Word: A Qualitative Health Belief Model Study of VIA Screening in a Banjar Regency Village

Abstract

Background: Cervical cancer is largely preventable, yet in Indonesia coverage rather than availability remains the constraint. Quantitative studies identify Health Belief Model constructs associated with screening, but the reasoning within reported barriers is less clearly described.

Objective: To explore how women of reproductive age in a Banjar Regency village neighbourhood perceive visual inspection with acetic acid screening through the six Health Belief Model constructs.

Methods: An exploratory qualitative descriptive study was conducted in August 2026. Six purposively selected women varied in prior visual inspection with acetic acid experience. Semi-structured interviews and field notes were analysed through construct-directed thematic analysis. Reporting followed COREQ, sample adequacy was considered through information power, and no inferential statistics were used.

Results: Six married informants (median age, 37.0 years; range, 26-45; five unscreened) provided 10 quotations. Barriers were the only construct expressed by more than one informant: five women in five quotations. The barriers were shame at exposure, fear of the result, anticipated pain, unreadiness, and the husband's word. Each was raised by one informant. One woman described cervical cancer as dreadful, another considered herself healthy and therefore not at risk, and a previously screened woman described the procedure as painless.

Conclusion: Barriers, rather than lack of information, dominated these accounts. Counselling should address each barrier before the woman must raise it and should preserve her decision-making. Whether perceived severity and susceptibility diverge within individuals remains a hypothesis that this study cannot test.