Cervical Cancer Virus Linked to Promiscuity

A study of women with radically different sex lives--prostitutes and monogamous Indians--has found new evidence linking promiscuity to transmission of a virus that can cause cervical cancer.

Dr. Jose Azocar compared pap smear samples from the prostitutes with those of Piaroa women, part of a strictly monogamous group living in villages scattered in this South American nation’s Amazon jungle.

“With this study the relation between the HPV virus and cervical cancer is strengthened, as is the hypothesis that the mode of transmission is sexual,” said Azocar, a virologist with the Venezuelan Scientific Research Institute.

As early as the 1950s scientists observed that higher levels of cervical cancer seemed to be associated with promiscuity. A solid link between the human papilloma virus (HPV) and cervical cancer wasn’t made until the early 1980s by Harald Zur Hausen of Germany and Ralph Richart of Columbia University.

Using genetic engineering to manipulate infected DNA, they found that the viruses most related to cervical cancer were certain strains of HPV. Later research using genetic material from the viruses confirmed their results.

In 1985, Azocar began a similar study using viral genetic material in cell samples from Caracas hospitals and found that nearly 80% of cervical cancers in Venezuela were associated with HPV. Cancer is the No. 2 killer in Venezuela, and cervical cancer is the most common form in women.

“It is widely accepted among scientists that HPV causes cervical cancer, but it is thought that other factors are involved, including many births, early onset of sexual activity and promiscuity. I wanted to see to what point these other factors were involved,” Azocar said in a recent interview.

Further study required control groups at the extremes of sexual activity.

“It’s hard to find a control group of monogamous people, and with the Piaroa the girls are married off for life as soon as they get their first period,” Azocar said. “The only thing they required was that all the examinations be done by women gynecologists.”

Getting to the Piaroa, who had participated in an earlier AIDS study, was difficult. The 7,000-member tribe lives in an area the size of Austria roughly between the Parguaza River in southwest Bolivar State and the town of Tama-Tama in Amazonas Federal Territory.

Most still live in villages of less than 100. They fish, hunt small animals and birds and cultivate tubers and bananas, as they have for hundreds of years. Those in less remote villages may have outboard motors for their canoes and wear Western-style clothes, but their limited exposure to modern society ensures that their monogamous life style is intact.

Men of status may have two wives, but most have only one. There is no one from outside the village to fool around with, and tribal women are kicked out if they sleep with someone other than their husbands.

Azocar and his colleagues were flown by army helicopter to three villages near the Parguaza River, 290 miles south of Caracas, where they took samples from 125 women. No evidence of HPV or cervical cancer was found.

Promiscuous Group

Examining a promiscuous group was easier. He conducted a two-month campaign among prostitutes in several cities nearest Piaroa territory for a cervical screening program and free treatment. Police helped spread the word.

A team of gynecologists took pap smears from 130 prostitutes. Between 25% and 40%, depending on the city they lived in, had HPV, and among these there was a high incidence of different grades of precancerous tumors.

Both the Piaroa and prostitutes began having sex early, had multiple births, have similar blood lines, live in the same climate, eat similar foods and are exposed to roughly the same frontier-style living conditions.

“We showed that women who had many children and who started sex at an early age didn’t necessarily have HPV,” Azocar said. “This provides solid data that cervical cancer is a sexually transmitted disease--that the virus is the most important factor causing it and that promiscuity is the form of infection.”