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Background  Cervical cancer is the leading cause of cancer among women in Swaziland; however, a low rate of cervical screening in this population has led to high rates of morbidity and mortality from cervical cancer.    Objective  To identify factors associated with lack of cervical screening among women in Swaziland.    Methods  A cross-sectional study was conducted among 300 women aged 18–69 years attending clinics in three regions of Swaziland from May to August of 2014. An investigator-administered questionnaire was used to collect data on socioeconomic factors, health-seeking behaviors, reproductive history, and cervical screening history and knowledge from the women.    Results  Adjusted multivariable logistic regression analysis revealed that women < 30 years of age were less likely to receive a cervical exam compared to women ≥30 years of age (Odds Ratio 0.06, 95% Confidence Interval 0.01–0.67). Women who had a tertiary education were almost 6 times more likely to receive a cervical screening (OR 5.83, 95% CI 1.11–30.50). Women who said that they did not know when to receive cervical screening were 73% less likely to have a cervical exam (OR 0.27, 95% CI 0.01–0.74).    Conclusions  Younger age, lower educational level, and lack of knowledge about when to receive a cervical screening affected whether women obtained a cervical screening. This indicates the need for educating women, particularly younger women, about the importance of cervical examinations. Addressing these barriers to screening should lead to a decrease in cervical lesions and cancer, especially in this high HIV-positive population.

Sociodemographic factors, health seeking behaviors, reproductive history, and knowledge of cervical screening among women in Swaziland