Background/Objective—It is well documented that people with human immunodeficiency virus (HIV) have nearly twice the risk of incident acute myocardial infarction compared to the general population. The elevated risk stems from a multi-layered interplay of factors such as persistent immune activation inherent to HIV infection and higher prevalence of traditional risk factors associated with nutritional needs. A large proportion of people living with HIV (PWH) reside in Sub-Saharan African countries such as Tanzania; however, there is a dearth of data on nutrition, particularly fruit and vegetable (F&V) intake, a key factor in the prevention of cardiovascular disease (CVD). This study aimed to contribute to the growing literature on CVD prevention for PWH globally. Methods—We conducted secondary analysis of data collected using the World Health Organization (WHO) STEPS survey among PWH and the general population in Mwanza City between December 2018 and May 2019. Approval for the parent study had been obtained from Bugando Medical Center. Multinomial logistic regression analysis examined F&V intake and associated factors between PWH and people living without HIV (PWoH) using sex, employment, and BMI. Results—A total of 537 participants (277 PWoH and 260 PWH) were included in the analysis. PWH were more likely to consume fruits > 4 days per week than PWoH (38% vs. 25%, p = 0.002), whereas vegetable intake did not differ significantly between groups. Fruit intake was higher in males (OR = 5.63; 95% CI: 2.48-12.79) and employed individuals (OR = 3.85; 95% CI: 1.82-8.14). Conclusions—PWH were more likely to consume more fruits than PWoH in this study, a phenomenon that is more novel than previous research. These findings are encouraging to support nutrition-based interventions for PWH who are at a higher risk of CVD.