This project is to analyze the dysbiosis of fecal microbiome in HIV-1 infected individuals in Ghana. Gut microbiome dysbiosis has been correlated to the progression of non-AIDS diseases such as cardiovascular and metabolic disorders. Because the microbiome composition is different among races and countries, analyses of the composition in different regions is important to understand the pathogenesis unique to specific regions. In the present study, we examined fecal microbiome compositions in HIV-1 infected individuals in Ghana. In a cross-sectional case-control study, age- and gender-matched HIV-1 infected Ghanaian adults (HIV-1 [+]; n = 55) and seronegative controls (HIV-1 [-]; n = 55) were enrolled. Alpha diversity of fecal microbiome in HIV-1 (+) was significantly reduced compared to HIV-1 (-) and associated with CD4 counts. HIV-1 (+) showed reduction in varieties of bacteria including most abundant Faecalibacterium but enrichment of Proteobacteria. It should be noted that Ghanaian HIV-1 (+) exhibited enrichment of Dorea and Blautia, whose depletion has been reported in HIV-1 infected in most of other cohorts. Prevotella has been indicated to be enriched in HIV-1-infected MSM (men having sex with men) but was depleted in HIV-1 (+) of our cohort. The present study revealed the characteristic of dysbiotic fecal microbiome in HIV-1 infected Ghanaians, a representative of West African populations.