The Text Me! Flash Me! Helpline uses cell phone technology to provide most-at-risk populations (MARP) with friendly and accessible HIV and AIDS information, referrals, and counseling services from qualified providers. It is a creation of the Ghana SHARP project (Strengthening HIV/AIDS Response Partnerships), which is managed by AED (Academy for Educational Development), through collaboration with the Ghana National AIDS Control Program, the Ghana Health Services (GHS), and 9 local non-governmental organisation (NGO) Implementing Partners, and with funding by the United States Agency for International Development (USAID). The Helpline was launched in September 2008 through a pilot focusing on men who have sex with men (MSM) exclusively, and then was expanded in February 2009 to include female sex workers (FSW).

Conducted in February-March 2009, this evaluation included the review of 1,169 Helpline Client Session Report Forms completed by the 12 Helpline Counselors, a telephone survey of 135 randomly selected MSM Helpline clients, and focus group discussions (FGDs) with Helpline Counselors and MSM Peer Educators, as well as interviews with key national government officials.

Thirty-three percent of survey respondents heard about the Helpline from a peer educator, 21% heard about it through a text message, 16% were informed by a Helpline Counselor, 27% cited "other" (mainly through a friend), and 2% heard about it from a paper flier.

The number of callers disclosing their sexual orientation to a Helpline counselor increased each month. In addition,

• 86.9% of survey respondents said that after their Helpline call session they shared the information they received with others;
• 40% of respondents forwarded the texts they received to others, and sent to an average of 8.6 other people;
• Respondents who forwarded texts said their reason for doing so was either to educate others, or because they wanted them to have the same information;
• Only 13.1% of clients said they did not share the information with anyone.

The evaluation findings revealed that the Helpline increased clients' knowledge of and intention to use condoms and lubricants.

Of the survey respondents who were referred for services by a Helpline counselor:

• 47% reported that they followed up and went for these services.
• 77% said they intended to go for counseling and testing (CT) services.
• 23% said they did not intend to, mainly because they said were "already aware of my HIV status" or had "already taken the HIV test".

The sum total of CT service uptake in October 2008 was higher than the uptake numbers in the previous 5 months combined at the MSM drop-in center at one of SHARP's local NGO Implementing Partners: 69 clients from May to Sept. 2008, as compared to 76 clients in Oct. 2008.

CT uptake following referrals increased after the launch of the Helpline:

• 16% effective referrals over the period of April-August 2008;
• 39% effective referrals over the period of September 2008-January 2009.

Prior to the Helpline, only 1% of MSM referred to the MSM drop-in centre at one of SHARP's local NGO Implementing Partners for sexually transmitted infection (STI) services actually went and received STI services. Following the launch of the Helpline Pilot, that number increased to 11%.

PowerPoint presentation, sent from Lydia Clemmons to The Communication Initiative on May 6 2009, titled "Preliminary Findings: Helpline Pilot Evaluation: Review & Dissemination Meeting for Implementing Partners, March 23, 2009" - by Lydia Clemmons, Joe Limage, Anika Pyle, and Rebecca Ledsky; and emails from Lydia Clemmons to The Communication Initiative on May 8 2009, May 9 2009, and July 9 2009.