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While changes in microbiome composition have been associated with HIV, the effect of diet and its potential impact on inflammation remains unclear. Methods: Twenty-seven people living with HIV (PWH) on antiretroviral therapy (ART) were studied. A comprehensive dietary analysis was performed and two types of dietary patterns were determined. We explored the associations of each dietary pattern with gut microbiota and plasma inflammatory biomarkers. Results: We appreciated two dietary patterns, Mediterranean-like (MEL) and one Western-like (WEL). Compared to participants with the WEL pattern, participants with MEL pattern showed higher abundance of <i>Lachnospira</i> (<i>p</i>-value = 0.02) and lower levels of the inflammatory biomarkers D-dimer (<i>p</i>-value = 0.050) and soluble TNF-alpha receptor 2 (sTNFR2) (<i>p</i>-value = 0.049). Men who have sex with men (MSM) with MEL pattern had lower abundance of Erysipelotrichaceae (<i>p</i>-value < 0.001) and lower levels of D-dimer (<i>p</i>-value = 0.026) than MSM with WEL pattern. Conclusion: MEL pattern favours <i>Lachnospira</i> abundance, and protects against Erysipelotrichaceae abundance and higher levels of the inflammatory biomarkers D-dimer and sTNFR2, precursors of inflammatory processes in HIV-infected patients. Our study contributes to understanding the determinants of a healthier diet and its connections with gut microbiota and inflammation.