Warning:

This document is being maintained for historical purposes, but is now out of date. To view current guidelines please visit:

• HIV/AIDS Guidelines and Recommendations   at http://www.cdc.gov/hiv/guidelines/index.html

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Guidelines for Health Education and Risk Reduction Activities

April 1995
                
Centers for Disease Control and Prevention
Atlanta, Georgia

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                                Hotlines

Because many people are uncomfortable discussing subjects that involve
sexual issues and behaviors, accessing a hotline for HIV/AIDS/STD
information is a viable, anonymous option.  However, hotlines may not be
appropriate for satisfying every program need.  Information generated
through a needs assessment can be used to determine whether a hotline is
appropriate; provide indicators for needed hours of operation, number of
staff, specialty services (e.g., for Spanish-speaking, the deaf); ascertain
appropriate venues for publicizing the hotline number; identify which
population(s) should be targeted; and indicate specific information needs.

If the establishment of a local hotline is not a viable option, the CDC
National AIDS Hotline and the CDC National STD Hotline can be publicized.

Why Establish A Hotline?

A Hotline can do the following:

  - Provide easy and immediate access for persons/populations who may not
    be reached by other methods, e.g., women at risk for HIV infection in
    rural communities.

  - Provide an opportunity for a person to frame a question and have
    anonymous human contact.

  - Provide information in a confidential manner, maintaining the privacy
    of the caller.

  - Provide information in appropriate language level and style and permit
    discussion of issues caller does not understand.

  - Afford the caller up-to-date, accurate information.

  - Provide referrals for counseling and testing, treatment services, and
    various support systems.

  - Serve as a monitoring mechanism for impact of public information
    activities, e.g., PSAs that publicize the hotline number.

  - Permit pre-screening of "worried well" to decrease unnecessary HIV
    testing.

Quality Assurance

A quality assurance plan should be developed as part of the process of
establishing a hotline.  This plan should address the following minimum
requirements:

  - Description of staff recruitment process and necessary qualifications
    for specialists.

  - Information and timeliness for monitoring the specialists for accurate
    information dissemination, appropriateness of referrals, and proper
    call management skills.

  - Performance appraisal based on whether persons are able to achieve
    standards; remedial activities for elevating performance; volunteers
    and paid staff judged according to the same expectations; and
    volunteers should understand that this is a "job" and conform to hours,
    vacation rules, confidentiality, etc.).

  - Information on publicizing the hotline (in all languages the hotline
    offers) and methods for documenting calls.

  - Explanation of data collection procedures and reporting forms, e.g.,
    collection of information about callers -- who is being reached and
    what they are asking.

  - Description of management techniques for referral information, e.g., a
    regular review of database or written materials.
 
Guidelines for Establishing A Hotline

  - The hotline should not impose any financial difficulties/barriers on
    prospective callers (e.g., should be free for the caller).

  - Days and hours of operation should meet the needs of the target
    audience (e.g., not just during business hours, when employed callers
    could not be assured of privacy for calls).

  - The CDC National STD and the CDC National AIDS Hotline numbers should
    be provided on a taped message for calls received after normal
    operating hours in order to provide access to callers having immediate
    needs.

  - Physical space should accommodate future staff expansion and additional
    phone lines.

  - Telecommunications equipment should be up-to-date and of sufficient
    capacity.

  - Venues should be available for publicizing the hotline and should be
    appropriate for targeted audiences.

  - Consideration should be given to phone lines that may be needed for
    special audiences, e.g., non-English speaking people and people who are
    deaf or hard of hearing.

Also consider offering an auto-attendant system to operate during off-hours
and weekends.  Such a system can offer a menu of pre-recorded messages for
callers who do not need to speak with a counselor, but who want quick and
anonymous access to information.
 
Staff Characteristics for Hotlines

Hotlines are staffed by information specialists who may be paid personnel
or volunteers, depending upon available financial resources.  If volunteers
are used, the organization should commit at least one paid staff person for
management purposes.  A paid staff member is  needed to ensure consistency
and  continuity of services because of the high turn over of staff commonly
experienced among volunteers, the need to ensure quality services, and the
need to maintain consistency in the implementation of policies and
procedures.  The manager should maintain and regularly update a
comprehensive list of HIV/AIDS/STD services and organizations.  A hard copy
and/or computer-based list should be used by information specialists during
work hours.

Information specialists provide information over the telephone; therefore,
they require unique skills and abilities.  They should always be prepared
for the unexpected and act accordingly.

The successful information specialist should possess the following
attributes:

  - Be knowledgeable about HIV/AIDS/STDs.

  - Understand the importance of anonymity and confidentiality.

  - Have the ability to speak at various levels that are consistent with
    the language needs of the callers, e.g., physicians, lay persons who
    are or are not AIDS-knowledgeable.

  - Exhibit active listening skills and be courteous, patient,
    understanding, and compassionate.

  - Display a sensitive and non-judgmental attitude when callers describe
    concerns, sexual activities, drug use, and/or symptoms.

  - Refrain from giving advice during crisis-oriented calls, but
    appropriately refer to organizations adept in crisis intervention.

  - Refer callers to appropriate resources in a timely, efficient manner by
    using proper call management skills.

  - Demonstrate resourcefulness and ingenuity in providing referrals and
    finding answers to questions.

Once the information specialists have been recruited, they should be
comprehensively trained to meet the challenges of their positions. 
Consider teaming new information specialists with more experienced staff
until the new person is comfortable handling calls independently.

A training plan should address the following minimum requirements:

  - Measurable goals and objectives for the training.

  - Basic medical knowledge about HIV/AIDS/STD, including modes of
    transmission, disease-causing organisms, signs and symptoms, disease
    epidemiology, diagnostic methods, disease progression and
    complications, and treatment.

  - Knowledge about common myths and misconceptions about HIV/AIDS/STD and
    correct information to dispel myths and misconceptions.

  - Skills-building exercises in active listening and effective information
    dissemination (including crisis intervention).

  - Interpersonal and multi-cultural communication skills-building.

  - In-service training and updates on a continual basis to remain current
    on issues surrounding HIV/AIDS/STD.

For additional information, consult the training bulletins that the CDC
National AIDS Hotline distributes to state health departments and others.

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