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As HIV transitions into a manageable chronic condition, optimizing lifestyle behaviors is key to achieving long-term health outcomes. This study aims to explore lifestyle behaviors in people with HIV (ODHIV) who participate in peer support groups as well as identify socioeconomic and clinical predictors of healthy lifestyle engagement. The research design was a cross-cutting analysis involving 250 ODHIV registered in a community support group. Lifestyle behavior was measured using  a modified Health-Promoting Lifestyle Profile II (HPLP-II) instrument. Multivariate logistic regression analysis was used to determine independent predictors, with Nagelkerke R² and Hosmer–Lemeshow tests  to assess model suitability. The results showed that 56.2% of respondents had a healthy lifestyle. Factors of higher education (OR = 2.77; p = 0.006), older age (OR = 2.32; p = 0.015), employment status (OR = 2.00; p = 0.029), and longer duration of ART therapy (OR = 1.17 per year; p = 0.003) were significant predictors. The model explains 32% of lifestyle variations, with ART compliance and substance control as the strongest behavioral domains. These findings confirm the role of peer support groups as a behavioural reinforcement environment, but socioeconomic disparities remain influential. The integration of theory-based lifestyle interventions into community-based HIV services is necessary to optimize chronic disease outcomes.

Peer Support Groups have a meaningful role in the life of an ODHIV. ODHIV who received a peer support had a significant effect on changes in HIV identity, HIV knowledge, access to HIV services, HIV prevention behaviors and positive activities compared to ODHIV who did not receive peer support. The purpose of this study is to find out the process of peer support group program activities. This study was carried out using descriptive qualitative research methods, using data collection with interview, observation and documentation techniques. The results of the study show that this peer support group program has been running and implemented optimally and the ODHIV members have shown an increase in self-change through activities that have been planned according to the needs of the ODHIV, namely family groups, socialization, counseling, self-help groups, capacity building and also mobile visiting.