Rates of depression are high among individuals living with HIV. Accurate assessment of depressive symptoms among this population is important for ensuring proper diagnosis and treatment. The Beck Depression Inventory-II (BDI-II) is a widely used measure for assessing depression, however its psychometric properties have not yet been investigated for use with HIV-positive populations in the U.S. The current study was the first to assess the psychometric properties of the BDI-II among a large cohort of HIV-positive participants sampled at multiple sites across the U.S. as part of the CNS HIV Antiretroviral Therapy Effects Research (CHARTER) study. The BDI-II test scores showed good internal consistency (α = 0.93) and adequate test-retest reliability (ICC = 0.83) over a 6-month period. Using a ‘gold standard’ of major depressive disorder determined by the Composite International Diagnostic Interview (CIDI), sensitivity and specificity were maximized at a total cut-off score of 17 and a Receiver Operating Characteristic (ROC) analysis confirmed that the BDI-II is an adequate diagnostic measure for the sample (AUC = 0.83). The sensitivity and specificity of each score are provided graphically. Confirmatory factor analyses confirmed the best fit for a 3-factor model over 1-factor and 2-factor models and models with a higher-order factor included. The results suggest that the BDI-II is an adequate measure for assessing depressive symptoms among U.S. HIV-positive patients. Cut-off scores should be adjusted to enhance sensitivity or specificity as needed and the measure can be differentiated into cognitive, affective, and somatic depressive symptoms
