Modernization Brings both Healthy and Unhealthy Change to Members of the Tsimane

Jonathan Stieglitz, right, in Bolivia

UNM Depart­ment of Anthro­pol­ogy Research Assis­tant Pro­fes­sor Jonathan Stieglitz is lead author of a new paper pub­lished this week in PLoS ONE that exam­ines the changes as part of a long run­ning research project among Tsi­mane forager-farmers of the Boli­vian Amazon.

The paper, “Mod­ern­iza­tion, Sex­ual Risk-Taking, and Gyne­co­log­i­cal Mor­bid­ity among Boli­vian Forager-Horticulturalists” explores how sex­ual behav­ior changes with mod­ern­iza­tion for both men and women and the con­se­quence of these behav­ior changes for women’s repro­duc­tive health. The researchers were very inter­ested in under­stand­ing whether Tsi­mane who lived closer to the mar­ket town of San Borja are more likely to take sex­ual risks, and whether that in turn led to greater expo­sure to sex­u­ally trans­mit­ted infections.

The Tsi­mane are forager-farmers in a rural area of Bolivia that still main­tain their own small scale vil­lages com­posed of closely related kin. They speak an indige­nous lan­guage which is unre­lated to the Span­ish spo­ken in nearby towns. The Tsi­mane are in the early stages of mod­ern­iza­tion as they increas­ingly come into con­tact with a wider world. They lack mate­r­ial wealth, elec­tric­ity and run­ning water and their access to school­ing and mod­ern health­care, includ­ing con­tra­cep­tion, remains extremely limited. Tsimane men and some women are becom­ing a part of the local econ­omy as they travel to regional town mar­kets to sell wood, thatched roof pan­els and hor­ti­cul­tural products. Sporadically, men engage in itin­er­ant wage labor.

More than 500 sex­u­ally active women received gyne­co­log­i­cal exams and PAP smears as part of the Tsi­mane project’s rou­tine screen­ing for cer­vi­cal can­cer.  Forty-eight per­cent exhib­ited inflam­ma­tion of cer­vi­cal cells and most inflam­ma­tion is due to bac­te­r­ial vagi­nosis (35 per­cent). In 11 per­cent, how­ever, the inflam­ma­tion results from tri­chomo­ni­a­sis, a sex­u­ally trans­mit­ted infection.

The research group is cur­rently funded by the National Insti­tutes of Health (National Insti­tute of Aging) to learn both about the aging process under pre-modern con­di­tions and how mod­ern­iza­tion influ­ences phys­i­ol­ogy, behav­ior and social­ity over the lifespan. The project employs full-time Boli­vian physi­cians and bio­chemists to visit vil­lages annually. The project has also estab­lished a sta­tion­ary health clinic in San Borja. Regardless of their par­tic­i­pa­tion in research, all Tsi­mane receive free health care from project physicians.

Stieglitz ini­tially became inter­ested in the issue as part of his Ph.D. research into mar­i­tal con­flict and cooperation. 

“Peo­ple often think about mod­ern­iza­tion as being asso­ci­ated with improved health out­comes and greater access to schools,” says Stieglitz. “But for indige­nous, sub­sis­tence pop­u­la­tions in the early stages of mod­ern­iza­tion, where money is scarce and its acqui­si­tion highly vari­able over time, where peo­ple may lack knowl­edge of how infec­tions may be sex­u­ally trans­mit­ted and where peo­ple may be reluc­tant to com­mu­ni­cate with med­ical pro­fes­sion­als in town due to lin­guis­tic or geo­graph­i­cal bar­ri­ers, mis­trust, or prior dis­crim­i­na­tion, mod­ern­iza­tion may lead to a new increase in risk of repro­duc­tive morbidity.”

He says it is counter-intuitive that women who live near towns where there are hos­pi­tals are actu­ally more likely to have a sex­u­ally trans­mit­ted infec­tion, but that is one of their major findings.

Col­lab­o­ra­tors include Aaron Black­well, UC Santa Bar­bara; Raúl Quispe (Tsi­mane project;) Edhitt Cortez (Tsi­mane Project;) Michael Gur­ven, UC Santa Bar­bara and Hillard Kaplan, UNM.

Media con­tact: Karen Went­worth (505) 277‑5627; email: kwent2@unm.edu