Integrated Use of Video-Based Improvisation and Focus Group Discussion to Develop an HIV/STI Prevention Telenovela for Men Who Have Sex with Men (MSM) and Transgender Women (TW) in Lima, Peru

Background:  Video-based interventions have been effective in improving HIV/AIDS knowledge and reducing risk behavior. We used a combination of focus-groups and videotaped role-playing exercises to develop content for an HIV/STI prevention telenovela (Spanish soap opera) for MSM/TW in Peru

Methods:  We conducted 15 workshops between June-July 2012 with three groups of purposively sampled MSM/TW (low income MSM, n=9; middle/high income MSM, n=6 and TW, n=8). During the first workshop, each group created three main characters that provided the basis for subsequent improvisations.  Each workshop included a focus group discussion (1 hour) followed by role playing/scene improvisation and follow-up discussion (1 hour).  Qualitative data analysis compared audio and video recordings of focus groups and scene improvisations.

Results: Participant-generated protagonists reflected each group’s predominant sexual orientation, sexual role (e.g., activo, pasivo, moderno), social context (employment, family structure), and support systems (family, friends, health promoters). Substantial differences emerged between understandings of key HIV/STI prevention topics articulated in focus group discussions with those enacted in scene-based improvisations.  Focus group discussions reflected idealized norms of condom use, HIV/STI testing practices, serostatus disclosure, partner notification, and sexual identities/roles.  Scenic improvisations demonstrated imperfect and inconsistent patterns of behavior described in post-improvisation discussions as more reflective of participants’ lived realities. 

Conclusions:  Integration of focus-group discussions with scenic improvisation encouraged participants to explore multiple dimensions of vulnerability, health awareness, and modifiable barriers to HIV/STI prevention. Use of combined methods allowed for an iterative data collection process, probed for divergent themes between diverse MSM/TGW subpopulations, and informed development of a telenovela intervention.