On 1st May 2004, eight Central and Eastern European (CEE) countries - the Czech Republic, Estonia, Hungary, Latvia, Lithuania, Poland, Slovakia and Slovenia - joined the European Union (EU). The United Kingdom (UK) granted relatively unrestricted work and residency rights to nationals from the "Accession 8" (A8) and subsequently experienced a large influx of predominantly young economic migrants from these countries. It is estimated that over one million A8 nationals have migrated to the UK since accession [1, 2].
Romania and Bulgaria (A2) joined the EU on 1st January 2007. More stringent restrictions were imposed on A2 migrants which incorporate the requirement for job and person specific work permits. In spite of this, over 42,500 Romanians and 28,000 Bulgarians registered for National Insurance numbers between January 2007 and December 2008 . Throughout the rest of this paper, we refer to A8 and A2 migrants as simply CEE migrants.
The CEE migrant population in the UK is potentially vulnerable to sexual ill-health and reproductive morbidity. The 1990s saw huge increases in sexually transmitted infection (STI) and HIV rates across Central and Eastern Europe  and despite subsequent declines and variations across the region, STI and HIV rates remain high [5, 6]. In addition to the background prevalence of STIs and HIV, the demographic profile of CEE migrants indicates that they are likely to be sexually active and have reproductive ambitions (over 80% of those registered with WRS are aged 18-34) while the provision of sex education in their countries of origin is limited [7, 8].
CEE nationals have entitlement to NHS services and it is important to ensure that the health needs of these communities are met. However, the uptake of safer sex measures and patterns of health service use among CEE migrants in the UK are unknown. The SALLEE project (Sexual Attitudes and Lifestyles of London's Eastern Europeans) set out to address the lack of published research on sexual and reproductive health among CEE migrants in the UK.
There are a number of challenges to researching sexual behaviour among migrant communities. CEE nationals make up a small minority of the population resident in the UK with no sampling frame from which to select a probability sample. Furthermore, the information needed to design a convenience sampling strategy for the CEE migrant population is limited. Many members of the population are recent arrivals; they are also likely to be highly mobile and may not register to work through official channels, adding to the difficulty of estimating the socio-demographic and geographical distribution of the population. In addition, measuring self-reported sexual behaviour which is generally found to be problematic , may be compounded among people from a range of different cultural and linguistic backgrounds. This paper will describe the methods adopted by the SALLEE project to address these challenges.
The SALLEE project set out to establish an understanding of the sexual lifestyles, reproductive health risks and health service needs of the CEE communities in London in order to inform service planning and the development of culturally appropriate health promotion and HIV prevention material.
The specific research objectives were to:
conduct detailed social mapping of CEE community venues
describe the sexual behaviour and attitudes, sexual and reproductive health and health service use of this population
identify CEE migrants' specific sexual and reproductive health needs that are appropriate intervention targets through interdisciplinary qualitative research investigating culture, beliefs, practices, expectations and social, health and sexual behaviours, including aspects of relationships
evaluate the differences in population recruited by the different sampling methods
The project was funded by the UK Medical Research Council (2007 - 2009) and conducted by researchers from the Centre for Sexual Health and HIV Research and the School of Slavonic and Eastern European Studies at University College London. An Expert Advisory Group consisting of people with academic expertise in the areas of sexual health and migration was set up to advise on the design and development of the study. A Community Advisory Group consisting of representatives from each of the ten CEE countries was set up in order to review the development of the study and ensure that the study design was appropriate and acceptable to the target population.
The research protocol was approved by the Camden and Islington Research Ethics Committee.