Background: Depression is the most common preventable mental illness among people living withrnhuman immunoivirus (PLHA) with the rates of two to four times higher than those found in generalrnpopulations. Nowadays depression is estimated to affect 350 million people in the world. This studyrnaims to assess the magnitude and predictors of depression among PLHA in eastern part of Oromiarnregional state, Ethiopia. rnObjective: To assess the prevalence and associated factors of depression among PLHA takingrnAntiretroviral drug at Adama Hospital Medical College. rnMethods: We employed an institutional based cross-sectional study from April 01 to September 30,rn2021 in Adama Hospital Medical College, Oromia regional state, Ethiopia. A total of 420 PLHA agedrn18 years and above were recruited using a systematic random sampling technique. We collected therndata through a face-to-face interview, observation and document review. We entered the data into EPIinfornVersionrn7rnandrnanalyzedrnusingrnSPSSrnversionrn21.rnBinaryrnlogisticrnregressionrnanalysisrnwasrnconductedrnrntorndeterminernthernassociationrnbetweenrnexplanatoryrnvariablesrnonrnthernoutcomernvariable.rnFactorsrnwithrnarnpvaluernofrnlessrnthanrn0.25rninrnthernbivariablernanalysisrnwerernfurtherrnenteredrnintornthernmultivariablernanalysisrntornrncontrolrnforrnpotentialrnconfounders.rnAdjustedrnOddsrnRatiorn(AOR)rnwithrn95%rnCIrnwasrnusedrnasrnarnmeasurernofrnrnassociationrnandrnp-valuernless than 0.05 wasrntakenrnasrnstatisticallyrnsignificant.rnrnResults: A total of 420 PLHA taking ART were participated in this study. The prevalence ofrndepressive symptoms as assessed by PHQ-9 was 52.4% (95% CI= 47.6-57.1). Multivariable binaryrnlogistic regression analysis revealed that employment status [AOR=0.22(95% CI= 0.13-0.36)],rnpatients most recent CD4 count [AOR=6.99 (95% CI=2.81-17.38)], months on ART [AOR=5.05 (95%rnCI =2.38-10.74)] and chronic non-communicable diseases [AOR=7.90 (95% CI = 4.21-14.85)] werernsignificantly associated with depression among HIV positive patients. rnConclusion: Significant proportion of HIV positive patients taking ART drug had depressivernsymptoms. Employment was found to be preventive while low CD4 count, starting ART therapyrnrecently, and presence of chronic non-communicable diseases (CNCDs) were found with increasedrnodds of depression among HIV positive patients taking ART.