People living with HIV in sub-Saharan Africa bear a disproportionate burden of mental and behavioral health disorders compared with the general population. Several health care systems throughout the region have made efforts to integrate HIV and mental health care, but these systems have met challenges in long-term sustainability due to limited care continuity and insufficient attention to social determinants of health. In this commentary, we propose evidence-based recommendations for integrating HIV and mental health care that may overcome these barriers. These strategies include mental health screenings and referrals during routine HIV clinic visits, community-based mobile clinics and telemedicine to expand access to mental health services, concurrent mental health and HIV education within schools, and models for future health care innovation. These approaches have the potential to offer an entire continuum of care for people living with HIV and co-occurring mental health disorders, mitigating the dual burden of these conditions in sub-Saharan Africa.