Sexual Attitudes and Lifestyles of London's Eastern Europeans: SALLEE

Lead Research Organisation: University College London
Department Name: Primary Care and Population Sciences


On the 1st May 2004 eight central and eastern Europe countries -the Czech Republic, Estonia, Hungary, Latvia, Lithuania, Poland, Slovakia and Slovenia (the A8) joined the European Union (EU)1. It is estimated that over 600,000 A8 nationals have migrated to the UK in the past three years. This is a population at risk of sexual and reproductive ill health: the youthfulness of the A8 migrant population indicates that they are likely to be sexually active and to have reproductive ambitions; there is a high background prevalence of sexually transmitted infection (STI) and HIV in their countries of origin; and their uptake of safer sex measures and patterns of health service use are unknown.

All nationals of the A8 now have entitlement to NHS services and we have a responsibility to ensure that the health needs of these communities are being met. Romania and Bulgaria will join the EU in 2007. As both countries have low levels of GDP and are characterised by high levels of inequality, high poverty rates and underdeveloped social welfare systems, it is likely that comparable migratory influxes will occur following their accession. There is currently no published research in the UK on the sexual and reproductive health needs of east Europeans migrants. The proposed study aims to survey and interview migrants from the A8, Romania and Bulgaria (the ?A8+2?) to establish an understanding of the sexual lifestyles, reproductive health risks and health service needs of these communities. The health implications of this study lie in its potential to inform health service planning and policy recommendations for future service development, including health promotion and HIV prevention strategies. The study will consist of three components: a detailed social mapping exercise; a questionnaire based quantitative study; and an interview based qualitative study. Language matched A8+2 field workers will recruit participants.

Technical Summary

The proposed study aims to evaluate and understand the sexual and reproductive health, behaviours, and service utilisation of migrants‘ from Central & Eastern Europe (CEE) in order to inform service planning and the development of culturally appropriate health promotion and HIV prevention material.
Specific objectives:
1) Conduct detailed social mapping of CEE community venues.
2) Describe the sexual behaviour, sexual partnerships and networks, sexual health and health service use of this population.
3) Identify CEE migrants? specific sexual and reproductive health needs that are appropriate intervention targets through qualitative research investigating culture, beliefs, practices and social and sexual behaviours.
4) Facilitate discussion among CEE migrants‘, community and statutory stakeholders about what is needed to improve the sexual and reproductive health options of CEE migrants.
5) Evaluate different sampling methods for migrant populations.
6) Foster a strong community/researcher partnership aimed at improving CEE migrants‘ sexual and reproductive health options.
The study population will be adults aged 18 to 44 years self-identifying as migrants from CEE and arriving in the UK since 2000. The project will consist of a quantitative and qualitative study implemented over 2 years: i) A cross-sectional survey of CEE migrants‘, and ii) A qualitative study amongst a purposively selected sample employing in-depth interviewing techniques. Both studies will be preceded by a detailed social mapping exercise to ensure the sample is as representative as possible in the absence of a sampling frame. Language-matched fieldworkers and researchers will recruit participants using three different sampling strategies: clinic-based; a community convenience sample; and respondent driven sampling. A community advisory group will be set up to oversee all stages of the study. The study outputs will include: observational and comparative data that explores the sexual and reproductive heath, risk behaviours and service use of CEE migrants; Detailed information on factors associated with sexual health, risk behaviour, and health service utilisation; A methodological critique of the different sampling methods employed; and an evaluation of health service utilisation and policy recommendations for future service development.
Description North Central London Research Consortium (NoCLoR) Grant enhancement scheme
Amount £27,000 (GBP)
Organisation University College London 
Sector Academic/University
Country United Kingdom
Start 11/2009 
End 02/2010
Description EuroCoord Migrant workpackage 
Organisation Institute of Health Carlos III
Country Spain 
Sector Public 
PI Contribution The migrant work package within EuroCoord (a network of excellence involving five of the largest HIV cohorts in Europe) is jointly led by Dr Fiona Burns (UCL) and Dr Julia del Amo (ISC III). Dr Burns is leading on the pan-European survey component to explore barriers to HIV prevention, treatment & Care, as well as country of HIV acquisition.
Collaborator Contribution The migrant work package within EuroCoord (a network of excellence involving five of the largest HIV cohorts in Europe) is jointly led by Dr Fiona Burns (UCL) and Dr Julia del Amo (ISC III). Dr del Amois leading on the analysis of existing cohort data, which will explore HIV related outcomes among migrants.
Impact So far only conference abstracts and presentations have arisen.
Start Year 2011
Description Conference day to NHS service providers and commisioners 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? Yes
Geographic Reach Regional
Primary Audience Health professionals
Results and Impact Our team presented a poster detailing uptake and usage of NHS services by study participants. Also made oral presentation about risk behaviours of study population and need to adapt services to meet these needs.

Raised awareness of potential future health risks of this new population and how service providers need to start planning appropriate services.
Year(s) Of Engagement Activity 2009
Description Symposium on CEE migrants at LSHTM 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact An afternoons symposium to present inform practitioners and policy makers of the findings of several research projects focusing on Central & eastern European migrants health needs.

Apologies but I can not remember details of any outcomes potentially arising from this meeting,
Year(s) Of Engagement Activity 2010