{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:44:42Z","timestamp":1792176282265,"version":"4.4.0"},"reference-count":53,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T00:00:00Z","timestamp":1779753600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T00:00:00Z","timestamp":1779753600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100005615","name":"Beth Israel Deaconess Medical Center","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005615","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100011541","name":"Division of Cancer Epidemiology and Genetics","doi-asserted-by":"publisher","award":["1K08CA271949"],"award-info":[{"award-number":["1K08CA271949"]}],"id":[{"id":"10.13039\/100011541","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Cervical cancer is the leading cause of cancer deaths among women in Botswana, yet uptake of cervical screening remains suboptimal. Understanding knowledge and barriers to screening is essential to inform strategies to achieve cervical cancer elimination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted high\u2010risk human papillomavirus (hrHPV) testing and an accompanying cross\u2010sectional survey at health clinics and in the community in South East District, Botswana (February 2022\u2013July 2023). Eligible participants were women aged \u226525\u2009years with an intact cervix and no prior diagnosis of cervical cancer. Interviewer\u2010administered structured questionnaires assessed demographics, prior screening attendance, knowledge of cervical cancer, and perceived barriers to screening. Open\u2010ended responses were thematically categorized. Logistic regression was used to examine factors associated with knowledge and screening barriers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 3000 women screened, 2994 (99.8%) had known HIV status and were included. Median age was 43\u2009years (interquartile range [IQR] 36\u201351), and 1500 (50.1%) were women with HIV (WWH). Overall, 67.2% (2005\/2994) reported prior cervical cancer screening, with substantially higher uptake among WWH than women without HIV (80.0% vs 54.5%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). Knowledge of cervical cancer etiology was limited, with only 27.1% (788\/2905) correctly identifying hrHPV as the cause. Younger age, HIV\u2010positive status, higher education, formal employment, and prior screening attendance were independently associated with better knowledge. Among women who had never been screened, the most commonly reported barriers were lack of prioritization (38.3%; 376\/981), fear (17.0%; 167\/981), lack of awareness (17.0%; 167\/981) and service provision issues (12.0%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Despite relatively high screening uptake, important gaps in knowledge and persistent individual\u2010 and system\u2010level barriers remain. Strengthening cervical screening delivery through HPV self\u2010collection alongside targeted education, would address current barriers to cervical screening in Botswana.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.71089","type":"journal-article","created":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T12:59:07Z","timestamp":1779800347000},"page":"817-826","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Understanding barriers to cervical cancer screening in Botswana: Insights from a cross\u2010sectional study"],"prefix":"10.1002","volume":"175","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-8642-0526","authenticated-orcid":false,"given":"Jodie C.","family":"Russell","sequence":"first","affiliation":[{"name":"Botswana Harvard Health Partnership  Gaborone Botswana"},{"name":"Botswana Sexual and Reproductive Health Initiative  Gaborone Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salma","family":"Amin","sequence":"additional","affiliation":[{"name":"Botswana Harvard Health Partnership  Gaborone Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Racquel E.","family":"Kohler","sequence":"additional","affiliation":[{"name":"Botswana Harvard Health Partnership  Gaborone Botswana"},{"name":"Rutgers Cancer Institute  New Brunswick New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Kelly","sequence":"additional","affiliation":[{"name":"Department of Infectious and Tropical Diseases London School of Tropical Medicine &amp; Hygiene  London UK"},{"name":"School of Public Health, Physiotherapy and Sports Science University College Dublin  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chelsea","family":"Morroni","sequence":"additional","affiliation":[{"name":"Botswana Harvard Health Partnership  Gaborone Botswana"},{"name":"Botswana Sexual and Reproductive Health Initiative  Gaborone Botswana"},{"name":"Center for Reproductive Health University of Edinburgh  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mosepele","family":"Mosepele","sequence":"additional","affiliation":[{"name":"Botswana Harvard Health Partnership  Gaborone Botswana"},{"name":"Department of Medicine University of Botswana  Gaborone Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elysia","family":"Larson","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Beth Israel Deaconess Medical Center  Boston Massachusetts USA"},{"name":"Department of Obstetrics, Gynecology and Reproductive Biology Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorato","family":"Mochoba","sequence":"additional","affiliation":[{"name":"Botswana Harvard Health Partnership  Gaborone Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maduke","family":"Kula","sequence":"additional","affiliation":[{"name":"Harvard T.H. Chan School of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Makhema","sequence":"additional","affiliation":[{"name":"Botswana Harvard Health Partnership  Gaborone Botswana"},{"name":"School of Public Health, Physiotherapy and Sports Science University College Dublin  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthys H.","family":"Botha","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynecology Stellenbosch University  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger","family":"Shapiro","sequence":"additional","affiliation":[{"name":"Botswana Harvard Health Partnership  Gaborone Botswana"},{"name":"Department of Obstetrics, Gynecology and Reproductive Biology Harvard Medical School  Boston Massachusetts USA"},{"name":"Harvard T.H. Chan School of Public Health  Boston Massachusetts USA"},{"name":"Department of Obstetrics &amp; Gynecology University of Pretoria  Pretoria South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doreen","family":"Ramogola\u2010Masire","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynecology Stellenbosch University  Cape Town South Africa"},{"name":"Department of Obstetrics &amp; Gynecology University of Pretoria  Pretoria South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Luckett","sequence":"additional","affiliation":[{"name":"Botswana Harvard Health Partnership  Gaborone Botswana"},{"name":"Department of Obstetrics and Gynecology Beth Israel Deaconess Medical Center  Boston Massachusetts USA"},{"name":"Department of Obstetrics, Gynecology and Reproductive Biology Harvard Medical School  Boston Massachusetts USA"},{"name":"Harvard T.H. Chan School of Public Health  Boston Massachusetts USA"},{"name":"Department of Obstetrics &amp; Gynecology Stellenbosch University  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,26]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"FerlayJ ErvikM LamF et\u00a0al.Global Cancer Observatory: Cancer Today.2024https:\/\/gco.iarc.who.int\/today"},{"key":"e_1_2_10_3_1","doi-asserted-by":"crossref","unstructured":"UNAIDS.Country Factsheets. Botswana 2023.2023.https:\/\/www.unaids.org\/en\/regionscountries\/countries\/botswana","DOI":"10.5089\/9798400251474.002"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(20)30459-9"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199711063371903"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2020.02.051"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/QCO.0000000000000805"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0229086"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctarc.2023.100682"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.16758"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.25110"},{"key":"e_1_2_10_13_1","volume-title":"Global Strategy to Accelerate the Elimination of Cervical Cancer as a Public Health Problem","author":"World Health Organization","year":"2020"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2015.00239"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.3389\/fgwh.2023.1300788"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/IGC.0b013e318249470a"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-019-6638-z"},{"issue":"9","key":"e_1_2_10_18_1","first-page":"2445","article-title":"Knowledge and attitudes towards cervical cancer screening amongst University of Botswana Female Students","volume":"18","author":"Tapera R","year":"2017","journal-title":"Asian Pac J Cancer Prev"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12905-022-01777-z"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.13690"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12905-020-00927-5"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1080\/16549716.2017.1380361"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-024-13055-2"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.puhe.2021.04.014"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12905-025-03880-3"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0328103"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.15225"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2024.1424810"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-025-23143-y"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12905-024-03362-y"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-024-17842-1"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-021-12020-z"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2004.11.021"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-200303000-00013"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-72219-9"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1177\/0956462419868618"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.12963"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13027-021-00380-5"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13104-017-3045-3"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-019-7354-4"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph19010054"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2024.e32926"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.13579"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1158\/1940-6207.CAPR-19-0156"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph20116004"},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.xagr.2024.100414"},{"key":"e_1_2_10_47_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2024-017616"},{"key":"e_1_2_10_48_1","doi-asserted-by":"publisher","DOI":"10.2147\/IJWH.S50890"},{"issue":"4","key":"e_1_2_10_49_1","first-page":"1021","article-title":"Perceived benefits of cervical cancer screening among women attending Mahalapye District hospital, Botswana","volume":"11","author":"Ibekwe CM","year":"2010","journal-title":"Asian Pac J Cancer Prev"},{"key":"e_1_2_10_50_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1466-7657.2003.00195.x"},{"key":"e_1_2_10_51_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-023-11683-8"},{"key":"e_1_2_10_52_1","doi-asserted-by":"publisher","DOI":"10.1111\/jnu.12232"},{"key":"e_1_2_10_53_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0205425"},{"key":"e_1_2_10_54_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2023.107993"}],"container-title":["International Journal of Gynecology &amp; Obstetrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.71089","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ijgo.71089","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.71089","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T17:49:12Z","timestamp":1792172952000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/ijgo.71089"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,26]]},"references-count":53,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["10.1002\/ijgo.71089"],"URL":"https:\/\/doi.org\/10.1002\/ijgo.71089","archive":["Portico"],"relation":{},"ISSN":["0020-7292","1879-3479"],"issn-type":[{"value":"0020-7292","type":"print"},{"value":"1879-3479","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,26]]},"assertion":[{"value":"2026-03-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}