Acquired immune deficiency syndrome (AIDS) remains a leading cause of death for African-American women from 25 to 34 years of age. Depressive symptoms are commonly associated with the diagnosis of AIDS. Highly active antiretroviral therapy (HAART) is needed for optimal treatment; however, African-American women who are infected with the human immunodeficiency virus (HIV) and who experience depressive symptoms have low and/or inconsistent use of HAART. Additionally, behaviors associated with untreated depressive symptoms increase the chances for HIV transmission. Clinicians, therefore, need to recognize both the individual and the contextual factors that influence those seeking treatment for depressive symptoms. The purpose of this article is to gain a better understanding of the factors that shape treatment seeking for depressive symptoms among HIV-positive African-American women, an important variable in secondary HIV prevention. Multi-contextual underpinnings shape this phenomenon; therefore, Bronfenbrenner's ecological framework was used to organize this literature review. Knowledge gained from this paper can support the promotion of health and can prevent or manage depressive symptoms among this vulnerable group.