Given the high prevalence of depression in PHC, the use of depression screening instruments has often been recommended. The aim of this study was to construct and validate a visual depression screening instrument in a setting of low literacy and a high burden of HIV/AIDS. We engaged the help of a fine artist to draw pictures depicting DSM-IV-TR criteria for a depressive episode. We then validated this instrument named the Akena's visual depression inventory (AVIDI), in 92 persons living with HIV/AIDS in Uganda. The performance of the AVIDI in those with high and low education levels was determined. The area under curve (AUC) score of the AVIDI was 0.82. There was no difference between the AUC scores in persons with lower versus higher education levels. The AVIDI demonstrated a good psychometric property and can therefore be used to screen for depression in settings with higher rates of illiteracy.