Integrating Depression Care Into HIV Services for Older People With HIV Using a Stepped Care, Task-Sharing Approach.

Depression levels will be compared using PHQ-9 in the Treatment as Usual arm(TAU) VS intervention arm to see if the stepped care intervention is effective in treating depression. The main questions it aims to answer are: * Needs assessment of stepped-care integration versus usual care for treating depression in older adults living with HIV? * How effective will the stepped care task-sharing (SCT) model in reducing depressive symptoms and improving HIV treatment outcomes in older PLHIV in Nigeria? Participants who screen positive for depression PHQ-9 ≥10 will be randomized into 2 arms for treatment using a systemized ballot system: TAU arm and Intervention arm. TAU arm will receive current treatment available for depression at the HIV center. Intervention arm will receive the stepped-care intervention in stages based on their symptom severity. Follow-up assessments at (6 weeks, 3months, 6 months, 9 months and 12 months) will be conducted by assessors who would be blinded to the different groups (TAU arm VS intervention arm).

Inclusion Criteria: * Consenting individuals living with HIV * People living with HIV who are 50 years and above (PLHIV aged ≥50 years) * Those with a score of ≥10 on the 9-item patient-health questionnaire (PHQ-9). Exclusion Criteria: * • Older PLHIV will be assessed for the imminent risk of suicide and if there is an high risk, participant will be excluded. * Older PLHIV with severe cognitive impairment or diagnosed dementia that limits their ability to provide informed consent or complete study visits will be excluded. * Participants with comorbidities that can preclude the use of sertraline should be excluded.