No abstract

Migrant black African communities bear the brunt of heterosexual HIV/AIDS epidemic in the UK. This study confirms the close links that exist between UK resident black Africans and their countries of origin. A total of 43% of men and 46% of women visited their home countries within the last five years. While there, men were more likely than women to have acquired a new sexual partner. Previous diagnosis with a sexually transmitted disease, and the use of condoms at last intercourse were independently associated with this practice. This represents a potential risk of HIV transmission, and highlights an area for targeted health promotion within these communities.

The National Institute for Health and Clinical Excellence guidance is that a pregnant woman should see a midwife within the first 13 weeks into her pregnancy, in what is known as the 'booking appointment' or the 'full assessment' where she discusses with the midwife her care plan, medical and family histories and social circumstances. Significant numbers of black African women present after 13 weeks into the pregnancy. This study explores why black African women access the booking appointment after 13 weeks of pregnancy in a London borough. The study took a qualitative approach and used semi-structured interviews with 23 women who self-identified as black African migrants born in a sub-Saharan African country, and had experience of using ante-natal services in the borough. Participants discussed how their cultural understandings of pregnancy influenced timing of the booking appointment. The data was analysed using the thematic approach. Cultural, economic and political contexts within which they experienced pregnancy influenced the timing. Whilst acknowledging the benefits of early booking, this was said to be at odds with their cultural beliefs where pregnancy disclosure within 13 weeks was considered inappropriate. Lack of information about the booking appointment and unresolved immigration issues led to perceptions that they were being brought under the Immigration Department's radar through the booking appointment. Whilst most health promotion information regarding the booking appointment is designed in a top-down fashion, health planners should also recognize ethnic diversities so as to market the booking appointment using downstream approaches that take account of the cultural, political and economic contexts in which migrants/ethnic minority populations live.

Many issues that affect the food choice of people who move to the UK are common within different ethnic groups. The idea of a practical intervention based on improving cooking skills was popular with all the groups.