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Background: The full-scale Russian invasion of Ukraine in 2022 triggered the largest displacement crisis in Europe in recent decades. Displacement may affect both clinical outcomes and mental health among people living with HIV (PLHIV). Evidence comparing displaced PLHIV with host-country patients within the same healthcare system remains limited. This study aimed to compare epidemiological characteristics, clinical staging, and mental health outcomes between war-displaced Ukrainian PLHIV and Slovak PLHIV receiving care in the same clinical setting, with particular attention to sex-specific differences. Methods: This cross-sectional study included 137 PLHIV receiving care at the HIV/AIDS Centre, University Hospital Bratislava, Slovakia (69 from Ukraine and 68 from Slovakia). Anxiety and depressive symptoms were assessed using the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) scales. Scores were categorized into three severity groups (0-4, 5-9, ≥10). Results: Age distribution was comparable between cohorts (p = 0.2438). Transmission patterns differed substantially: heterosexual transmission predominated among Ukrainian participants, whereas men who have sex with men (MSM) transmission predominated among Slovak men (p < 0.001). Ukrainian patients were more frequently classified in CDC stage C, while Slovak patients more often presented in stage A. The combined antiretroviral therapy coverage was 100% in both cohorts and viral suppression rates were high (HIV RNA < 200 copies/mL: 91.3% in Ukraine vs. 94.1% in Slovakia). Overall anxiety and depressive symptom severity did not differ significantly between cohorts (GAD-7 p = 0.4145; PHQ-9 p = 0.7661). However, within the Ukrainian cohort, women demonstrated higher depressive symptom severity compared with men (p = 0.0478). Conclusions: War-displaced Ukrainian PLHIV achieved comparable biomedical outcomes to host-country patients within a structured healthcare system. However, depressive vulnerability emerged at the intersection of gender and displacement. These findings highlight the importance of integrating gender-sensitive mental health screening and psychosocial support into routine HIV care for displaced populations.