Background: Despite recommendations for routine mental health screening in human immunodeficiency virus (HIV) care settings, screening uptake remains low. The brief Patient Health Questionnaire (PHQ-2) and Generalized Anxiety Disorder-2 (GAD-2) are validated screeners for depression and anxiety symptoms with potential for integration into HIV primary care.

Objective: This study aimed to identify the optimal cut-off points for the PHQ-2 and GAD-2 among people with HIV at risk for mental health disorders (MHD) in comparison to the PHQ-8 and GAD-7.

Methods: Participants (N = 300) enrolled in a study evaluating a collaborative care intervention for substance use disorder and MHD care completed the PHQ-8 and GAD-7 at baseline. Sensitivity, specificity, and Youden's index were obtained for the PHQ-2 and GAD-2 at different scoring cut-off points against the PHQ-8 and GAD-7, which served as reference standards using recommended cut-off points of ≥10.

Results: A cut-off point of ≥3 on the PHQ-2 demonstrated a sensitivity of 0.79 and a specificity of 0.88, while a cut-off point of ≥2 had a sensitivity of 0.95 and a specificity of 0.68. A cut-off point of ≥3 on the GAD-2 had a sensitivity of 0.87 and a specificity of 0.92.

Conclusions: In the context of HIV care provision in busy clinical settings, our findings indicate that implementation of the PHQ-2 (cut point ≥ 2 or ≥3) and GAD-2 (cut point ≥ 3) detect depression and anxiety symptoms. The implementation of these brief screeners in routine health care settings has the potential for simplified detection of people with HIV who would benefit most from further evaluation for MHD.