Creating Without Shame: Care Providers Turn Real-Life Stories Into an HIV-Focused Telenovela
A Conversation With Sin Vergüenza Producers and Creators Natalie Sanchez and Hilda Sandoval
March 6, 2013
Family secrets ... betrayed trust ... condom usage?
The classic, persistent themes of Spanish-language soap operas, also known as telenovelas, get a refreshing, enthralling update in Sin Vergüenza (Without Shame), the new telenovela that is taking the Internet by storm. Presented in English as well as Spanish, and imagined and realized by California's vast AltaMed health care network, the aim of the show is to "educate without being educational." The project is a unique endeavor -- it combines a fresh narrative format with the ability to tackle real-world issues such as HIV, stigma, lesbian/gay/bisexual/transgender (LGBT) issues, family issues, infidelity, shame, aging, dating and more.
Before you read, make sure to watch Episode 3 of Sin Vergüenza. Stay tuned for two more episodes in the coming weeks -- each accompanied by a conversation with key people involved in the production!
Mathew Rodriguez: Can you give an overview of what AltaMed does and what they offer?
Natalie Sanchez: AltaMed is the largest federally qualified health center in the nation, and we offer primary health care at 22 clinics. But, altogether, we have 43 sites. We serve about 150,000 clients in a year. We have been providing HIV services for over 20 years.
Hilda Sandoval: Of the 22 sites that provide medical services, three of them focus on HIV care. Recently we implemented universal testing at all of our sites, and when a patient is identified as HIV positive, the referral is sent over to us, whether it's at East L.A., Pico Rivera or El Monte, which are the sites that have specialized care for HIV patients.
Mathew Rodriguez: Does AltaMed serve a particularly large Latino population?
Natalie Sanchez: Yes, actually, we are centralized in L.A. County and Orange County, and the focus of the care that we provide is really targeting Latinos. We have a rather large number of patients who come in who are monolingual Spanish-speaking, uninsured, and also undocumented. We really take great pride in saying that we do not discriminate -- anybody gets treated, and the same applies to our general medical sites. Because we are a federally qualified health program, we have the luxury to provide care to all individuals who come in through our doors. And a good number of them are Latino.
Hilda Sandoval: We definitely take great pride in serving those who are underrepresented in the community. So the fact that we do this work is a rewarding experience for most of our employees.
Mathew Rodriguez: What made you both want to pursue this project as part of the HIV services that AltaMed offers?
"It's taken us some time to change the culture and to prepare providers, as well as clinic staff and clients, to accept HIV as a routine part of care, because there's this perception that HIV only affects certain populations. We've had to do a lot of training." -- Natalie Sanchez
Natalie Sanchez: The primary reason that we wanted to do this telenovela series was to raise awareness about HIV and the importance of routine HIV testing. We've incorporated routine HIV testing into all 22 of our clinics. It's taken us some time to change the culture and to prepare providers, as well as clinic staff and clients, to accept HIV as a routine part of care, because there's this perception that HIV only affects certain populations. We've had to do a lot of training. But now we're looking at doing a lot more training with our clients who perceive that they're not at risk for HIV.
Hilda Sandoval: About a year and a half ago, we had the opportunity of developing a series of videos for staff, and the focus of that project was really to get AltaMed staff as a whole, not only in HIV services but everyone else, at one level of understanding some of the important components of working with our community. Natalie and I were both involved in the development and the writing of those modules. We created an HIV 101, Universal HIV Testing, Delivering a Positive Result, LGBT Cultural Sensitivity, and Linguistic Services Accessibility.
It was really a wonderful project, because we were able to connect all of the missing pieces that we have as an organization. Yes, we talk about HIV all the time, but that's the work that we do. In our general medicine departments, treating a client who's identified with an HIV diagnosis, there were times in which our medical staff didn't have the appropriate tools to address their needs. With the implementation of universal testing, it gave us the opportunity to begin that dialogue.
When we had the opportunity to have additional funding this past year, we said, "We need to do more, but now we need to connect to the community." Internally we were working to develop a better understanding on the effects of HIV on our population, but now we needed to reach those individuals in the community who do not think they are at risk. We were brainstorming on an idea. We knew we needed to educate the community, but we needed to do it in a way that was not educational. We needed to do it in a way that had some type of a story, something that was suspenseful, something that had intrigue. And that led to the telenovela.
We were at a table, just talking about this project, and we were sitting with John Reynolds, who is part of the production team that we had worked with on the first project. Natalie, John, Tom, our director [at AltaMed] and a few other individuals were there, and we were saying, "OK, what do we need to do?" We threw out a lot of ideas and Natalie said, "I'd love to see a grandmother in a story." And from there it kind of evolved: "Oh, we need a young, gay man in the story"; and "We need a closeted older gay man." It morphed into this wonderful family. I say "morphed" because each family member represents a patient that we've seen over the last 20 years. The stories, many times, overlap. Many times, we hear one story, and we say, "That sounds like So-and-so's story." Because it's a repeated story, that means it's a continuing issue, and that means we're not talking about it. That's why we found it so relevant to address in this format.
Natalie Sanchez: Another reason we said that we didn't want to do the traditional education is because people ignore it. [laughs] We've been in the field for so long, for over 10 years, and we do it on a day-to-day basis where we're educating the community, doing HIV 101, but people just don't connect. And, yes, they'll hear you, but they'll think, "Oh, that's somebody else's story. That doesn't affect me. That doesn't apply to me." By doing these storylines, we're addressing not only HIV risk, but some of the generational traditions that have been passed on.
If you look at the different generations in the series, the grandmother, the mother, and the daughter, you'll see some of the traditions that are being past on and the struggle of Christina, the young one, to kind of break out of those traditions, in dealing with her own relationship in today's generation and being able to make choices and be assertive in requesting to use a condom with her partner.
We also wanted to address different marital statuses. In our clinics, as we're doing routine HIV testing, we get a lot of comebacks where patients say, "Well, I'm not at risk for HIV, I don't think I should get at test, because I've been married for over 10 years, and I know I'm not with anybody else." So we wanted to address that by having family members who are in relationships, as well as family members who had been married, and those that are not married.
"[T]he stories are intended to ignite some discussions, or to hit a nerve here and there. When we start talking about these transgenerational issues, we're also taking about those family secrets, those issues of infidelity, that we all know take place, but nobody wants to come to light." -- Hilda Sandoval
Hilda Sandoval: I'd like to add that the stories are intended to ignite some discussions, or to hit a nerve here and there. When we start talking about these transgenerational issues, we're also taking about those family secrets, those issues of infidelity, that we all know take place, but nobody wants to come to light. And then we brought in another layer, another big taboo, which is to talk about homosexuality. I think addressing the challenges and the stigma that still exist in our community as it relates to someone who is gay identified, or questioning, or struggling with their sexual identity, is one of those things that we don't have the tools as a community to really start talking about.
We've gotten some feedback from some viewers who said, "Wow, you normally don't see a condom being pulled out"; "You normally don't see the disapproval taking place between a father and a gay son"; "You normally don't see the issue of infidelity hit on so many levels." The daughter seeing the mom in distress because she suspects her father is being unfaithful; the daughter not knowing how to respond to her father, but putting a condom in his pocket, but, at the same time, still struggling to talk about it to him, like, "Dad, why are you doing this to mom?" And then, going back to her own relationship and saying, "There is this pattern that I want to stop." These are the things that we normally see in a very vague tone in normal novelas, but Sin Vergüenza really just pushes the envelope.
It's the elephants in the room that nobody wants to talk about, but they're constantly being shoved in their faces. And that's what HIV is: You need to talk about it.
This article was provided by TheBody.
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