Scanning electron micrograph of HIV-1 budding (in green) from cultured lymphocyte. (Photo: Creative Commons)

Gay and bisexual black men are at the highest risk for HIV and AIDS despite being a vast minority, according to a new report by the Black Aids Institute. While only one in 500 Americans is black and gay or bisexual, the group accounts for one in four new HIV infections, researchers said.

The report, titled "Back of the Line: The State of AIDS Among Gay Black Men in America 2012," found that a black gay male has a one in eight chance of becoming infected with HIV by age 20. By age 40, the likelihood is 60 percent.

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Black MSM continue to be first in line when it comes to need, but remain at the back of the line when it comes to assistance," Phill Wilson, founder and executive director of the Black AIDS Institute, told CNN. "This report not only highlights the gaps and why they still exist after 30 years, but it also provides a blueprint for how to close the gaps and move those most at risk up to the front."

HIV causes a failure of the immune system. Some people develop flulike symptoms within a few weeks of being infected, but most infected people show no symptoms, according to the Centers for Disease Control and Prevention. More than 1 million Americans live with HIV, and about 25 percent of seropositive people are unaware of their HIV status, according to the CDC.

No cure for HIV is known, but treatments include drug cocktails that inhibit formation of new HIV particles. If treatment begins early, life expectancy is 32 years, according to a 2006 study published in Med Care. Life expectancy shrinks as treatment is delayed.

Risk factors for HIV include having sex with multiple partners, having sex without a condom, and having sex with men who have sex with men, according to the National Institute of Allergy and Infection Diseases. 

The number of black men with HIV is twice that of white men in the United States, according to the report. In New York City, a black man is 488 times more like than other men and 325 more likely than other black men to become infected, researchers said.

The institute calls for more testing, better access to drugs and better education to help combat the virus.

"Current policies do not adequately address the unique needs of black MSM in America," Rep. Maxine Waters (D-California), told CNN. "Local and national leaders must remain vigilant in the fight against AIDS, especially in the black community, which continues to carry the heaviest burden. Unless we change the way we do business, we cannot reverse the epidemic. No one should be forced to the back of the line."