Associations of demographic variables and the Health Belief Model constructs with Pap smear screening among urban women in Botswana

PURPOSE Papanicolaou (Pap) smear services are available in most urban areas in Botswana. Yet most women in such areas do not screen regularly for cancer of the cervix. The purpose of this article is to present findings on the associations of demographic variables and Health Belief Model constructs with Pap smear screening among urban women in Botswana. SAMPLE AND METHODS The study included a convenience sample of 353 asymptomatic women aged 30 years and older who were living in Gaborone, Botswana. Data were collected using a demographic questionnaire and items of the Health Belief Model. Data analysis included descriptive statistics for demographic variables and bivariate and ordinal (logit) regression to determine the associations of demographic variables. RESULTS Having health insurance and having a regular health care provider were significant predictors of whether or not women had a Pap smear. Women with health insurance were more likely to have had a Pap smear test than women without health insurance (91% vs 36%). Similarly, women who had a regular health care provider were more likely to have had a Pap smear test than women without a regular health care provider (94% vs 42%). Major barriers to screening included what was described as "laziness" for women who had ever had a Pap smear (57%) and limited information about Pap smear screening for women who had never had a Pap smear (44%). CONCLUSION There is a need for more information about the importance of the Pap smear test and for increased access to screening services in Botswana.