Date of Graduation

Summer 8-16-2017

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Behavioral Health (MSBH)


School of Nursing and Health Professions

First Advisor

Dr. Kathleen Raffel

Second Advisor

Dr. Kelly L'Engle



San Francisco Suicide Prevention’s HIV Nightline provides emotional support to those living with human immunodeficiency virus (HIV) as well as support and basic medical information around relative risk and testing for who may have been exposed to HIV. Nightline counselors use a harm-reduction model, active listening, reflection of emotions, and encouragement to promote health maintenance and mental health self-care behaviors. Until now, there has been no process to assess whether callers had disproportionate anxiety about HIV given their actual risk level. Consequently, HIV(-) anxious callers could receive inconsistent information. The goal of this improvement study was to develop a call structure that could be used to take a sexual health history and assess whether callers were suffering from symptoms consistent with health anxiety or simply searching for health information. Methods. Over two Plan-Do-Study-Act cycles (34 calls), counselors tested an adapted version of the Centers for Disease Control and Prevention’s sexual health assessment and asked callers questions from two scales designed to assess illness anxiety. Counselors provided feedback on the assessments, individual anxiety assessment questions, their comfort level using the assessments, and their perception of the caller’s response to each question. Results. Counselors felt questions helped maintain or improve rapport with callers, accurately assess callers’ needs, and guide provision of appropriate information. The new sexual health and illness anxiety questions will become incorporated in the regular call structure and counselor training. Implications. The assessment questions may help other counselors more accurately assess the needs of those concerned about HIV exposure.