Background. Approximately 30% of new HIV infections in Germany occur among immigrants. HIV prevention thus needs to be better tailored to immigrant communities.Methods. A survey of the 118 members of the national association of AIDS service organizations (Deutsche AIDS-Hilfe e.V.) was conducted to assess their experiences in providing HIV prevention services to immigrants. The survey is part of a participatory research project (PaKoMi). The analysis focuses on the challenges described by the AIDS service organization (ASO).Results. A total of 90 ASO participated in the survey (return rate 76%). The great majority (89%) provide HIV prevention services to immigrants. More than half (53%) state a need for further action to improve prevention services to immigrants in their locality. Only a small minority (10%) are satisfied with the level of communal cooperation among local actors on this issue. Major challenges in providing HIV prevention services to immigrants include: intercultural challenges in dealing with cultural differences and taboos, lack of resources, limited access of ASOs to immigrant communities, language barriers, stigmatization processes, and practical and conceptual challenges resulting from the complex needs and multilayered problems of those immigrant groups who are most at risk for HIV/AIDS.Conclusions. To better manage the challenges described by the ASOs, the participation of immigrant communities in HIV prevention and the cooperation of health and social service providers with community-based immigrant organizations should be improved. Given the social structural factors and legal issues which contribute to the specific vulnerability and increased HIV risks of immigrants, the concept of "structural prevention" seems appropriate which conceptualizes HIV prevention as health promotion in the broader social context. © Springer-Verlag 2010.

Participation Immigrant Health promotion Structural prevention HIV prevention

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