The average American has just a 1 percent risk of ever being infected with the AIDS virus, but gay and bisexual black men have a 50 percent risk, according to new federal data.
A quarter of Latino gay and bisexual men will be infected over their lifetimes, the new analysis from the Centers for Disease Control and Prevention finds.
And by region, the South, from Texas to Florida, has a higher rate of HIV infection than the rest of the country.
"Gay and bisexual men continue to be most affected by HIV in the U.S. At current rates, one in six men who have sex with men (MSM) will be diagnosed with HIV in their lifetime, making them 79 times more likely than heterosexual men to be diagnosed with HIV in their lifetimes," the CDC team led by Kristen Hess reported.
"People who inject drugs are also at increased risk."
The report, released at the Conference on Retroviruses and Opportunistic Infections in Boston, is the first to take a look at any given person's lifetime risk of becoming infected with the human immunodeficiency virus (HIV) that causes AIDS.
"Overall, the estimated lifetime risk of being diagnosed with HIV was 1.05 percent, meaning that approximately 3 million Americans (or 1 in 99 people) will be diagnosed with HIV in their lifetime," CDC said in a statement.
"Among males the estimated risk was one in 62, and among females it was one in 221. At every age, males had a higher estimated lifetime risk than females."
In many other parts of the world the sexually transmitted infection hits young women the hardest. HIV is also spread in blood, from mothers to their babies and in shared needles.
African-Americans are at highest risk in the U.S. One in 19 American black men will be infected with HIV over a lifetime and one in 46 black women will be. And when someone's black and gay, the risk skyrockets.
"At current rates, 1 in 2 African American men who have sex with men (MSM) and 1 in 4 Hispanic MSM will be diagnosed with HIV in their lifetime, compared with 1 in 11 white MSM," CDC said.
States where risk is greatest include Maryland, where one 1 in 49 people will become infected, Georgia, with a one in 51 HIV infection rate, Florida (1 in 54), and Louisiana (1 in 56). "The highest lifetime risk was in Washington D.C. (1 in 13), an urban district," CDC said.
The CDC has been warning for years that people most at risk of HIV are not getting tested for it nearly often enough. People who know they are infected can take drug cocktails that will not only keep them healthy, but greatly reduce the risk that they will infect someone else.
In addition, people at high risk can take a once-a-day pill in a regimen called pre-exposure prophylaxis or PrEP can reduce the risk of catching HIV by 90 percent if people use it consistently. It's been on the market since 2012 and has been recommended by the CDC since 2014.
Researchers reported Monday that actor Charlie Sheen's admission he was HIV positive had sparked strong interest in HIV prevention.