Introduction: Dyslipidemia is a key modifiable cardiovascular risk factor and a major clinical feature in the patients infected with the human immunodeficiency virus (HIV) in the current era of highly active antiretroviral therapy. Peanuts could reduce the risk of cardiovascular diseases as an abundant source of fiber, α-tocopherol, copper, arginine, magnesium, folate, and resveratrol. The present study aimed to evaluate the impact of supplementing peanut and counseling in the form of a healthy diet on the fasting lipid profile of HIV-infected adults. Methods: This randomized crossover clinical trial was conducted on the eligible participants who were randomly assigned to a two-arm study. In treatment I, the participants consumed 80 grams of peanuts plus their regular diet. In treatment II, the participants were provided with nutrition counseling on a healthy diet and consumed 80 grams of peanuts. Each treatment continued for eight weeks with a six-week washout interval. Results: A 3.07% reduction was observed in the total cholesterol of the subjects receiving treatment I, while the reduction rate was 5.39% in treatment II. In addition, a 12.8% decrease was observed in the triglycerides of the subjects receiving treatment 1I, as well as a 17% reduction in treatment II. A significant increase was reported in the high-density lipoprotein cholesterol in treatments I and II, with the rate estimated at 7.38% and 5.1%, respectively. Furthermore, low-density lipoprotein cholesterol decreased by 5.56% in treatment I and 4.32% in treatment II. The estimated 10-year risk of contracting coronary heart disease reduced significantly between the baseline and end of the study (P=0.03). Conclusion: According to the results, regular consumption of peanuts could improve the fasting lipid profile of HIV-infected patients and reduce the risk of coronary heart disease.