Sin Vergüenza (Without Shame)

Sin Vergüenza webseries encourages people - including those who are married or over 50 - to get tested for HIV as a routine part of their medical care and to seek HIV medical care should they test positive. The drama tells the story of 3 generations of the Salazar family, a fictional Mexican-American family living in East Los Angeles and dealing with HIV/AIDS. The first 4 episodes (Season 1) of the series launched in March 2012, with a focus on increasing HIV knowledge and understanding of risk factors. As this first season unfolds, the viewer quickly learns that each member of the family is at risk of getting HIV, no matter the age, sexual orientation, or marital status. As the season comes to a close, the family discovers who is HIV positive and wonders if they can pull through this together. The 3 episodes of Season 2 launched in March 2016. Season 2 continues the focus on education and understanding, particularly for people living with HIV, and also covers mother-to child transmission of HIV and HIV medications, including Pre-exposure Prophylaxis (PrEP). Faced with the reality of an HIV diagnosis and having unknowingly infected his pregnant wife, Cesar is consumed with shame and guilt in Season 2. The family shares in their struggles as they try to come to terms with the truths that have forever changed their family and their lives. The videos address difficult issues families like this one face, but also portray the unconditional love and support that carries this family through such a challenging time. The episodes of the mini series are available for viewing in English or Spanish on the Sin Vergüenza website. The telenovela does not air (yet) on network television.

Around the world, soap operas like the one that Sin Vergüenza is modeled after have been channels for social change, linked, for example, to better HIV education and condom use in Tanzania, increased adult literacy in Mexico, and changing attitudes about dowries and female education in India. These daytime (and in many parts of the world, prime time) dramas use the "Sabino Method," developed by Mexican television producer Miguel Sabido -widely considered to be the father of entertainment-education.

The idea for the telenovela came about when AltaMed was training its employees to prepare them for universal HIV testing of all AltaMed patients. "We used a series of training videos on a range of topics designed to make sure that AltaMed employees were well-educated and felt confident implementing HIV testing," says AltaMed's Hilda Sandoval Sandoval. "Educating patients was just as important, but would require a different approach, and that's when we decided to create a telenovela that would be both educational and entertaining." Adds Natalie Sanchez, "We wanted the series to factor in the cultural nuances of the Latino population, but in a way to help people get informed and counteract some of the inaccurate info presented in other telenovelas, where HIV is often depicted as fatal."

The storylines are based on the real-life experiences of clients that Sanchez and Sandoval have worked with at AltaMed. Actors were chosen carefully, they say. "We wanted to make sure that we had actors who are fluent in both English and Spanish and could really do the project justice," explains Sanchez.

HIV/AIDS

Latinos are disproportionately affected by HIV and hepatitis C compared to other ethnic groups and races and, according the the Centers for Disease Control in Prevention (CDC), 7 in 10 new HIV diagnoses among Hispanics and Latinos occur in gay and bisexual men. The mass shooting that occurred on Latin night at the Pulse nightclub in Orlando, Florida (US) is a reminder that discrimination and stigma persist in the US with regard to Latinos, and especially Hispanic/Latino men who have sex with men.

AltaMed is the largest independent FQHC in the US, serving 930,000 people annually in the Southern California area through 43 locations.

Sanchez and Sandoval worked with the Council for La Raza at Cal State Long Beach to create a viewers' survey that gathered information on whether the project was effective in changing knowledge and behaviours. Results suggest that Season 1 was successful in changing views of condom use and HIV testing: "Regarding self-efficacy intention to test for HIV, use condoms, and negotiate use with partners, findings indicate that most participants plan on engaging in HIV risk reduction behaviors." Sin Vergüenza Telenovela, AltaMed Health Services Findings 2013. A viewer survey also accompanies the Season 2 episodes.

Sanchez and Sandoval would like to get Sin Vergüenza to network TV and mainstream audiences. They're seeking funding for a third season to continue to enhance knowledge and understanding of HIV. They're also interested in collaboration opportunities for reaching other populations through the series. "We recognize that there are some limitations to relying on the internet to air the series and could make Sin Vergüenza available through other methods," they add. "Our main goal is to address the high level of HIV infections in our communities and to find ways to reduce it."