TV Soap Operas in HIV Education: Reaching out with Popular Entertainment

This peer-reviewed report discusses soap operas as vehicles for HIV/AIDS education, offering case studies of three examples and lessons learned from their production and broadcast. The cases reviewed, all of which receive German financial support, are: 1) "Love as a Test" in Kyrgyzstan; 2) "Amor de Batey" in Dominican Republic; and 3) "SIDA dans la Cité" in Côte d’Ivoire.

1. "Love as a Test" in Kyrgyzstan - Kyrgyzstan has an estimated 50,000 to 81,000 injecting drug users (IDUs) and 4,200 people living with HIV (2009). At the date of publication, three-quarters of all people living with HIV are IDUs. In 2002, the United Nations Development Programme (UNDP) Joint Programme on the Expanded Response to HIV/AIDS in Kyrgyzstan (UNDP JP) agreed to develop mass media strategies for prevention of HIV, which include four 52-minute episodes of this soap opera. It was written and produced through the following steps: a workshop training local writers in the art of script writing; a competition for the best script; training and support for the winners as they developed the script further; and training and support for the production crew and cast and for marketing and distribution. The episodes are being shown repeatedly in the Russian- and Kyrgyz-language versions. A 2007 evaluation found that 17 percent of people in Bishkek, Kyrgyzstan’s capital, and 41 and 49 percent of people in two villages had seen it. On a scale of 0 (worst) to 3 (best), adolescents and young adults gave it an average score of 2.7 for usefulness.
   
2. "Amor de Batey" in Dominican Republic - The Dominican Republic (DR) has HIV rates of 0.8 percent among all adults (15-49), but 3.2 percent among adults who live in bateys, informal settlements on sugar plantations occupied mainly by ethnic Haitians. In 2005, the Pan Caribbean Partnership against AIDS (PANCAP) launched Caribbean Social Marketing to Prevent HIV and AIDS (CARISMA) and Germany, through German bank KfW, became a financial partner. In the DR, CARISMA is administered by Population Service International (PSI). In 2006, it launched production of five 20-minute episodes of a soap opera and took research and development steps broadly similar to those outlined for "Love as a Test". The storyline is about a teenage single mother, Lucy, victim of rape, and the older married man she dates. Both contract AIDS, and, while the male character dies, Lucy joins a support group, encouraged by a peer counsellor, and begins literacy classes. A 2008 survey found that 27 percent of batey residents had seen the drama, and, of those, 43 percent had seen it two or more times. PSI credits it with increased sales of the low-cost but reliable Pantè condoms distributed by CARISMA. PSI also reports that non-governmental organisations (NGOs) working in bateys are finding that a 12-chapter educational version and related behaviour change communication (BCC) guide provide them with the tools they need for successful group counselling and for education and training in classrooms, meetings, and workshops.
   
3. "SIDA dans la Cité" in Côte d’Ivoire - Côte d’Ivoire has HIV prevalence rates of 6.4 percent among women (15-49) and 2.7 percent among men (15-49). Contributing factors include multiple and concurrent sexual relationships where women are often much younger than their male partners and have little knowledge about HIV and how to prevent it. Also, wealthier, better educated women with more knowledge about HIV reportedly take the most risks and often fail to use condoms even though they know they should. At first, in partnership with PSI, and now on its own, the Agence Ivorienne de Marketing Social (AIMAS) has been running the Côte d’Ivoire Social Marketing Programme since 1991. Germany, through KfW, has been a financial partner since 1996. In 1994, the programme launched production of eleven 15-minute soap opera episodes, which, together with debates and condom ads, filled half-hour television slots. In 1995, "'SIDA dans la Cité'... became the most popular television programme in Côte d’Ivoire and a hit throughout francophone West and Central Africa. The Burkina Faso Social Marketing Program joined in partnership to produce a second series of twenty 26-minute episodes, first broadcast in late 1996/early 1997. A third series with 16 episodes was broadcast in 2004." The three series cover a range of situations, attitudes and behaviours likely to result in HIV infection or to stop people from getting tested and treated. "An evaluation of the second series of 'SIDA dans la Cité' surveyed adults in a selection of communities with electricity (and, therefore, access to TV) and found that 68 percent of women and 62 percent of men had watched at least one episode; 42 percent of women and 27 percent of men had watched ten or more episodes. The most frequent watchers were wealthier and better educated young adults who often engaged in high-risk sex. The greatest impacts, in terms of increased use of condoms during high-risk sex, were on those who watched the most episodes and, in those same terms, its impacts on men were far greater than on women."

Among the lessons learned from the entertainment-education projects are the following:

• "Know your epidemic. To know who is at risk, where they live, and the attitudes and behaviours that put them at risk is to know your target audience and the messages you need to get through to them. 
• Make it professional. Effective "edutainment" puts special demands on a creative team. Most of the team should be country nationals, but it is vitally important that members include experts in soap opera production and also experts in HIV and education.
  
• Make it local and realistic. The target audience should be able recognize and identify with the characters and to put themselves in the situations portrayed in a soap opera.....
  
• Take care in developing supplementary material. Burdening a soap opera with too much information will destroy its capacity to hold and engage viewers. At the same time, it can predispose them to want to learn more. Possibilities include information spots to go with each episode, supplements in newspapers during the broadcast period, and teaching guides for use in education settings.
  
• Anticipate bi-products. Edited and repacked as a feature film or the chapters of an educational DVD, a series of television soap operas can be put to other uses. It is best to anticipate these during the production process. It may be appropriate, for example, to extend some scenes with more material for an educational DVD but to leave that material out of the broadcast version.
  
• Anticipate the need to evaluate impacts. Consider, for example, surveys and focus groups discussions before and after broadcasts in order to measure changes in knowledge, attitudes and behaviour.
  
• Sustain the effort. Successful HIV prevention requires a continual stream of HIV information and BCC. Rebroadcast of old episodes and broadcast of new episodes can be effective ways of reminding people of key messages (e.g., always carry condoms in your wallet or purse) and keeping those messages current with changing lifestyles and emerging situations.”