Educating immigrant groups about the AIDS epidemic in the UK must be treated as a key public health priority, as Hazel Barrett explains

For many people, coming to the UK is a chance to lead a full and free life. The UK is widely regarded as a safe place to live and in most respects this is true. However, many migrants from sub-Saharan Africa have serious misconceptions about the AIDS epidemic in the UK.

Many of these migrants believe, incorrectly, that AIDS is not a health problem in the UK, that people's HIV status is checked along with passports at entry, and that there are treatments that can prevent people from being infectious if they have AIDS.

As these migrants come from a community where most people are affected by AIDS and where prolonged illness, death and drastically shortened life expectancy are normal, perhaps it is not surprising that they perceive the UK as a safe health environment.

However, such misconceptions present a serious public health challenge. Even after living in the UK for several years, people in African communities still have misconceptions about AIDS in the UK. As a result, the greatest increases in AIDS cases in this country are among these groups.

Getting the message across

Researchers at Coventry University have highlighted a breakdown in communications between immigrant groups from the Horn of Africa living in the West Midlands and the UK health authorities, with a lack of understanding on both sides.

This may be because public health messages about the threat of AIDS are being aimed at the general public rather than specific groups. But as global travel and migration continues to increase, there needs to be a far more tailored approach to discussing AIDS and assessing the knowledge, attitudes and behaviours of different groups.

While AIDS is preventable, changing people's sexual behaviour is difficult, especially as the cultural, economic and social environment in which sexual activity takes place is little understood, especially among migrant communities in the UK.

It is a difficult issue to deal with because of the risk of seeming to interfere with individual freedoms - and because the subject is embarrassing and sensitive. However, the sooner we begin to understand the nature of sexuality and sexual behaviour among different groups of the UK population, improve their knowledge of HIV and the UK epidemic, and target relevant public health messages at them in a meaningful way, the better chance we have of controlling the UK epidemic.