It is well known that screening enhances the detection, and management of patients with anxiety and depression (1–6), the validation of the important psychometric properties of the practical tools concerning the performance is considerable (7–12). Recently, there is emerging evidence that indicates the association between delaying the screening of patients and the development of common mental disorders like anxiety and depression (13). Thus, the introduction of an appropriate and sound tool for screening depression among high-risk groups would minimize their missing opportunity and drop-out from proper interventions.
Despite, the provider-client interaction would improve the opportunity for screening (14, 15), one of the main barriers include the absence of a reliable and culturally contextualized measurement tools in some health facilities in low-income countries (16). The other possible negative consequence of failure to examine the emotional stability of chronic patients and detect depression in early stages includes lack of getting standard treatment or defaulting the medications.
Despite, many health sectors identify depression screening practice as an important component of the service (17), yet it not practiced in most of the health institution resource-constrained regions. This is one of the main gaps often observed in service entry points of most health facilities where depression remains unnoticed and not detected (18). Some of the gaps are associated with the readiness and practice of the providers, but most importantly the availability of validated tools exists to be a barrier. Based on these challenges on the ground, the limited patient screening service is known to intensify failure to enrol a large proportion of PLHIV to mental health and hence suffer from emotional and psychological disturbance. In such circumstances, numerous low-income countries were well-known for their lack of depression screening in HIV care set-up. As reported in one of the studies in Malawi (19) which identified the absence of depression screening in WLHIV as a prominent challenge to health delivery. Moreover, the issue is far more upsetting for the patients when different health providers have a different approach to the extent that some of these health providers choose to assess their patients with un-established emotional questions. In Ethiopia, screening of depression should be part of the comprehensive care (20), and an is recommended the use of tested and validated mental health screening tools (21). Furthermore, the World Health Organization suggests that depression screening and management should be one of the elements in HIV care (22). Nevertheless, this service is conditioned with the attendance of a skilled practitioner and the readiness of validated tools.
The lack of a validated depression screening tool has caused a number of some HIV patients not to receive medical treatment for depression (23). This is confirmed by a study on developing countries that documented such challenges. The study has reported that lack of screening tools and guidelines in these health facilities of the study settings in Uganda, Ethiopia, India, and Nepal was a major source for HIV clients to miss this diagnosis and treatment services (24).
Even though the importance of depression screening and management of HIV patients in health facilities has been long recognized, the need to develop the validated Somali version of HADS is thought to be crucial. HADS is a self-assessment tool that measures anxiety and depression and is mostly used in hospital settings. It is recorded to perform well in screening the severity of symptomatic depression and anxiety disorder in somatic and psychiatric patients and the general population. Even though, evidence show the screening gap and the necessity to develop a validated screening tool for WLHIV in Ethiopia (25). Yet, HADS has not been validated in the Somali language. This study is intended to assess the reliability and validity of HADS among WLHIV in two hospitals in Jijiga town in eastern Ethiopia.