Background <p>Depression is highly prevalent in people with HIV (PWH) in sub-Saharan Africa and affects their daily lives and the HIV care continuum. However, depression screening is not systematic in HIV services, limiting appropriate care. In the present study, we assessed the feasibility and acceptability of systematic screening for depression among PWH in Senegal.</p> Methods <p>Semi-structured individual interviews were conducted from April–July 2023 in Dakar with 18 health professionals (doctors, social workers, community health workers), including some who had experience screening for depression in HIV services, 3 representatives of PWH associations, 2 representatives of the health system, and 5 PWH suffering from depression. The interview guides explored perceptions of depression, as well as facilitators, barriers, and implementation needs at the individual, organizational and structural levels. The Consolidated Framework for Implementation Research (CFIR) conceptual framework was used to structure the study and guide the data analysis. Thematic analysis was conducted via MAXQDA analysis software.</p> Results <p>Both patients and healthcare professionals perceived depression screening well. Patients reported positive perceptions related to screening (i.e. relief, opportunity to express themselves). But specific needs were highlighted for its systematic implementation. Healthcare professionals first reported the importance of being trained in mental health. Organizational needs included the definition of a clear depression screening and care pathway adapted to patients (schedules, confidentiality, adapted tools). In addition, systemic barriers to screening were highlighted, especially due to social norms and stigma associated with mental health (i.e., depression is often linked to madness). The interviewed participants thus emphasized the need to improve mental health care literacy to fight stigmatization and the integration of mental health services in HIV care.</p> Conclusions <p>Systematic screening for depression appeared acceptable in Senegal, where task delegation is recommended, but its feasibility requires addressing several barriers and considering important needs, including formal integration into HIV services. The study results should help frame innovative and adapted approaches to implement systematic screening of depression through HIV services in sub-Saharan Africa.</p> Clinical trial number <p>Not applicable.</p>