Objective Few studies have examined psychiatric comorbidity among HIV positive injection drug users (IDUs) in resource-limiting settings. Results Of the 117 participants 33 (39) exhibited symptoms of depression 24 (28) reported using an illicit substance in the past month and 29% (34) were in methadone treatment. Depressive symptoms were significantly associated with recent substance use in the last 30 days (AOR 95 CI: Volitinib 5.3 1.9 to 15.4) and being on methadone (3.5 1.2 to 10). Older age (per year 0.9 0.8 to 1 1) full-time Volitinib employment (0.2 0.1 to 0.7) and living with parents (0.2 0.1 to 0.6) appeared to be protective. Conclusion The results suggest that depression is common among Indonesian IDUs even among patients enrolled in methadone treatment. HIV clinics and drug treatment programs need to recognize the risk/protective factors and also provide services to address this common comorbidity. (SD) were assessed using a shortened 9-item version of the Center for Epidemiologic Studies Depression Scale (CES-D) [26 27 CES-D has been validated and used widely across cultures including in Indonesia [28 29 The short version and the rating scheme used here have been psychometrically assessed to improve the effectiveness in identifying depressed individuals relative to the original CES-D Vax2 . Respondents were asked to rate how often over the past week they experienced the following nine situations: “I had been bothered by items that usually do not bother me; I experienced I could not shake off my blues even with help from my friends or family; I had developed problems keeping my mind on what I was performing; I felt stressed out; I experienced that everything I did was an effort; my sleep was restless; I had been happy; I loved life; I experienced unfortunate.” Response groups solicited for each item were “less than 1 day time 1 days 3 days to 5-7 days in the past week.” Using methods suggested by Santor and Coyne  we dichotomously coded reactions to each of the nine items. Responses of less than 1 or 1-2 days were obtained as “0”; reactions of 3 or more days were scored as “1.” Next scores were summed across all 9 items with a total score of 4 or more categorized mainly because symptomatic of major depression (SD) and 3 or less mainly because non-symptomatic (NSD).Level analysis yielded a Cronbach’s α value at 0.804 indicating that the level performed with satisfactory internal regularity. were selected on either epidemiologic plausibility or previously shown association with major depression in HIV-positive drug using populations [30-32]. These covariates included age (continuous) self-reported current employment (used full-time used part-time operating at informal jobs a student unemployed) and highest level of education (by no means attended school elementary junior high high school college). Use in the last 30 days was measured based on articipants’ self-reports of how regularly Volitinib they used one or more of the following drugs: alcohol cannabis heroin cocaine amphetamines or stimulants tranquilizers or downers additional narcotics or opiates and hallucinogens. Recent substance use for cocaine heroin Amphetamines/stimulants tranquilizers/downers additional narcotics or opiates and hallucinogens was coded as “1” based on having used one or more of these substances in the last 30 days; smaller or no reported use was coded as “0.”Alcohol and marijuana use which formed a separate coding category were coded while “1” if used at least once a week in the last 30 days and “0” for lesser or non-use. Enrollment in was measured initially by asking participants if they currently received MMT and then later confirmed through the patient’s medical record. to ARVs was approximated by inquiring about the time framework of the last missing of the medications. Six options (by no means skipped medication missed within the past week within the past two weeks within the past month more than a month ago and more than three months ago) were given. Responses subsequently were coded into two groups for analysis: By no means having missed a dose or not having missed a dose for over a month was coded as “0;” Having missed at least one dose in the last month was coded mainly because “1.” was Volitinib gauged by a series of questions regarding family involvement in HIV care possible financial assistance from family members and family living arrangements. The later on was measured by asking participants if they currently lived with their mother/stepmother father/stepfather or spouse. Multi-generational households are common in Indonesia. Anyone living with one or more parents actually if married was coded as “living with parent.” Three types of were.