In the perilous age of HIV/AIDS and a host of sexually transmissible diseases, the prescription for a long life and good sexual health is safe sex - if you understand English, you could hardly have missed the constant warnings in the media.

Despite the fact that tens of thousands of people in Australia do not speak English as their first language, most women in ethnic communities are well aware of the risks, says Professor Sandy Gifford. Their problem is that other factors they share with women across different cultural backgrounds make it difficult for them to negotiate safe sex with their men.

For the past five years Professor Gifford's research team have been investigating how social influences such as culture and gender affect sexual health. Their bailiwick includes Melbourne's Turkish, Vietnamese and Chilean communities, second-generation Greeks and Anglo-Celts.

For the past three years she has also been involved in a community-based participatory with researchers from Melbourne's Macfarlane Burnet Centre for International Health, on prevention of HIV/AIDS and its impact on tribal women in Manipur, in north-eastern India. Now her team has recently turned its attention to other blood-borne illnesses, including hepatitis C.

Despite Australia's cultural diversity, says Professor Gifford, there are few culture-specific strategies for preventing HIV/AIDS and other sexually transmissible diseases - and even less attention has been given to the needs of ethnic communities in relation to the so-called "hidden epidemic" of hepatitis C.

There are no statistics that would suggest such diseases are any more prevalent in ethnic communities than in English-speaking communities. And that's just the problem: there are no reliable statistics, says Professor Gifford.

Not knowing the extent of any problem makes it difficult to develop culture-specific prevention strategies that are sensitive and effective in specific communities.

Different cultures vary in their beliefs, values and practices towards sexual health. In some communities, women who are merely seeking advice on sexual health risk being stigmatized or marginalised. For some women, even wanting to have information about sexual health can be seen as a threat to her relationship and family.

"One of the issues that has driven our research is the uncertain extent to which people of non-English speaking background understand the way hepatitis C is transmitted, and whether they understand the differences between hepatitis A, B, C and D.

"The viruses have different modes of transmission, so it has implications for prevention strategies. Hepatitis C is transmitted via blood. and, although much of the current infection is due to injecting drug use, many people who were infected previously, have contracted it through blood transfusions and also though immunizations carried out in their home countries before up to 20 years ago.

"Many of these people were infected because needles were re-used during childhood immunization programs. One of the big issues with hepatitis C is the stigma that is attached to infection, and the fact that there is no cure yet..

"Most people with hepatitis C are not diagnosed until three to five years after they become infected. If a woman was previously an intravenous drug user, but is now clean of drugs, the diagnosis raises the stigma of her past life.

"It not only has implications for her role as a mother, the evidence suggests that if her employer finds out, it can jeopardize her job. It's the reason why both men and women with hepatitis C are so loath to disclose their status.

In the past, says Professor Gifford many people from Egypt and the Middle East were accidentally infected by shared needles during mass-immunization campaigns in the late 1970s and early 1980s, before emigrating to Australia.

They are now in middle age, and some have lived with the disease - and the stigma - for nearly two decades.

The Deakin researchers have been interviewing women including those from non-English speaking communities who are living with hepatitis C, as a preliminary to developing ethno-specific prevention strategies.

The team's research into sexually-transmissible diseases in ethnic communities has found that gender may be more important than cultural influences in determining the way people think about sexual health and prevention.

The effect is most pronounced in men, says Professor Gifford - irrespective of cultural differences, men share a sense of being immune to STDs, including HIV AIDS, and tend to behave accordingly.

The reciprocal of that attitude is that women, irrespective of their cultural differences, share a belief that they are at risk, because they lack the power to negotiate safe sex, whether they are married or unmarried.

"All women we have interviewed had fairly high levels of knowledge about STDs. The problem is their ability to put their knowledge into practice.

"Another finding that reinforces the need for gender-specific prevention strategies is that all groups saw general practitioners as very important, and the first point of contact for their concerns about sexual health and prevention of STDs.

"But women from some communities - particularly Turkish and Vietnamese - will not visit a specialized sexual health clinic.

"It's not so much an issue for the men, who are more inclined to go to sexual health or STD specific services, even though also prefer to see a general practitioner. It means that we have to ensure that our primary care sector is up to date on being able to deal with this sensitive and often stigmatised health issues with people from different cultural backgrounds.

"This is why we are strongly advocating that women's sexual health services in some communities need to be embedded in general practice and primary healthcare services."