Kiko has a classic and conservative sense of style that’s reflected in his quaint three-bedroom house in Denver. It's filled with framed Salvador Dali and Pablo Picasso prints and antiques like the large, hand-carved wooden bar in the formal dining room.
“The father of my friend was in World War II in Japan, and he brought this piece to America,” Kiko said.
For Kiko, who was born in Puerto Rico and raised in Mexico City, this house is his temple. A place where the 69-year-old can relax with his dog Rita, a chihuahua miniature pinscher mix, pray and just be himself.
This is important to Kiko, as he was diagnosed with HIV in 1998.
“(If) I have tranquility in my house, of course my HIV will be healthy,” he said.
Kiko, which is a nickname to protect his privacy, said he is successfully managing the disease and wants to help others. Two years ago, he decided to participate in a pilot study for Hispanics and Latinos at the University of Colorado College of Nursing. HIV disproportionately impacts these communities, so the study focused on providing information and strategies to help people manage the disease.
The study, ViviendoPositivos, was released earlier this year, and it created an intervention approach modeled after Latin American soap operas, also known as telenovelas.
“They are a huge topic for entertainment among the Latino community,” said lead researcher Evelyn Iriarte Parra, a registered nurse and an assistant professor at the University of Colorado College of Nursing. “Also, we know that they can have an impact on some other health outcomes, including mental health, substance use, (and) some other preventative behaviors.”
The study started in 2023, and it was conducted in two phases. In the first phase, six participants developed 10-minute episodes based on their experiences living with HIV. Their work highlights the importance of mental health, and the main storyline reflects that, Iriarte Parra said.
“The main storyline behind the telenovela is that all these people affected by HIV, they are going to a weekly social support group,” she said. “They share their stories.”
Phase two expanded to 24 participants who attended table reads for the scripts and gave feedback on the content. Participants thought the messages were clear, the stories were realistic and they liked the short length. They also wanted to see some topics reinforced even more – like HIV medications and prevention.
Then, with the scripts ready, filming began. The telenovela, also called Viviendo Positivos, was recorded in Spanish with English subtitles. The five episodes cover topics ranging from self-management and telling a partner about a diagnosis to navigating a healthy sex life and aging with HIV.
Viviendo Positivos means “living positive” in English, which Iriate Parra says is analogous to living with HIV.
“Being HIV positive usually has a very challenging meaning,” she said. “So we wanted to use this name just to put the good side of having this diagnosis and also living with the disease.”
The use of telenovelas to disseminate health information is not a new concept. This type of intervention falls under a broad term called entertainment education, which involves incorporating educational messages into content, like a TV show.
“It's all based on a very simple idea that, you know, we as humans, we can learn vicariously,” said Nathan Walter, an associate professor at Northwestern University’s School of Communication and co-director of Northwestern’s Center of Media Psychology & Social Influence. He and his team help design and then evaluate entertainment education interventions.
For example, they looked at the popular Mexican telenovela “Vencer el Miedo.” The show was created to address social issues like teen pregnancy, STDs and gang violence. The intervention was effective on several levels, Walter said. They found heavy viewership led to adolescents seeking information about contraception.
“The telenovela was able to encourage parents and teens to talk about reproductive health, because the telenovela models that behavior,” he said. “That's why we often call telenovelas or entertainment education the Trojan horse of persuasion,” he said.
There are downsides to using telenovelas. It’s an indirect way to disseminate health information because viewers might miss the message, he said. He’s conducted experiments comparing exposure to telenovelas to traditional public service announcements or health brochures.
“When you take all these studies together, there's not a necessary advantage to telenovelas,” he said.
According to Walter, telenovelas are more effective for people who are less likely to search for health information or don’t have a doctor they feel comfortable talking to. To be successful, he said this type of intervention must have one key thing – a character the viewer can identify with.
Representation is one of the reasons why Karla Monter participated in phase two of the CU College of Nursing study. Monter, 35, is a transgender woman and immigrant from Mexico City who moved to Denver six years ago for love. But when she got her HIV diagnosis, her husband wasn’t supportive. Monter didn’t speak English at the time. She also didn't haveinsurance or know how to navigate the health care system. She became depressed and lonely.
Monter wanted her journey living with HIV to be reflected in the Viviendo Positivos telenovela.
“I (am) hoping someone watch that telenovela and feel empathy and feel like I could be that person,” Monter said.
While the goal was to help others, being a part of the study has also helped her come to terms with her own diagnosis. Monter said she feels strong and powerful now.
“If someone is living like this, they're not alone,” she said. “There's someone helping others no matter what's going on. No matter a legal status or no matter what language we can speak. It's about like empathy, about love and about like resources.”
In June, the ViviendoPositivos study was published in PLOS One, a peer reviewed journal. Iriarte Parra plans to use the telenovela for her next study. It will create a website to host the videos so participants can watch them. She and her team will test the impact of the content on viewers' health outcomes related to HIV including self care, stigma, medication adherence and knowledge. That study will last two to three years.
