BACKGROUND: Psychological treatments improve depressive symptoms in people living with HIV/AIDS (PLWHA). Adaptation of treatments should be based on explanatory models of depression and other elements within the given context. AIM: This study aimed to examine explanatory models of depression and acceptable approaches for implementation of group IPT in Northwest Ethiopia. METHODS: Qualitative data were collected from April to May 2019 from case managers, adherence supporters and service users using focus group discussion and analysed thematically. RESULTS: PLWHA attributed depression to psychosocial problems, spiritual factors and biological factors. Depression had several impacts at individual and family level. Group-based interpersonal therapy (IPT) was acceptable if provided by trained peer counselors. CONCLUSION: The current study findings informed how to conduct feasibility and acceptability trials of group IPT in the HIV population in Ethiopia.