This study aimed to assess the prevalence and clinical and psychosocial correlates of psychiatric symptoms in a sample of HIV patients in the Gambia. Data from 44 HIV-positive outpatients were collected at a Genito-Urinary Medicine clinic in Fajara, the Gambia. Translated versions of the Impact of Event Scale Revised and the Centre for Epidemiologic Studies Short Depression Scale were used to assess posttraumatic stress disorder (PTSD) symptoms and depressive symptoms, respectively. The Pictorial Representation of Illness and Self Measure revised was used to assess illness perception (IP). All other data (e.g., CD4 counts) were retrieved from medical charts or through standardised questions. The prevalence of PTSD symptoms (43.2%) and depressive symptoms (40.9%) was high. Not having an independent income and having a CD4 count under 200 cells/µl were independent correlates of depressive symptoms. Only IP was an independent correlate of PTSD symptoms. Finally, IP tended to moderate the relationship between CD4 cell counts and depressive symptoms. These findings indicate that routine screening for psychiatric symptoms is both necessary and feasible among HIV patients in the Gambia. In addition, any intervention targeting these symptoms should take IP into account.