The incidence of vascular events in HIV-infected individuals is increasing. We investigated whether there is a higher prevalence of vascular risk factors in the adult US population with HIV compared to uninfected controls that could explain some of the increased vascular events. We obtained prevalence estimates of vascular risk factors, stratified by the HIV status, in sampled adults aged 20-49 years from the 1999 to 2008 National Health and Nutrition Examination Survey. Estimates were weighted to account for oversampling and nonresponse. Logistic regression models with adjustment for demographic and socioeconomic status were created to adjust for confounders. The analysis included 12,339 US adults, 76 with HIV infection. The weighted seroprevalence of HIV was 0.48% (95% CI 0.33-0.65). In univariate analysis, HIV infection was more prevalent in non-Hispanic blacks (odds ratio [OR] 7.4, 95% CI 3.6-15.2), men (OR 2.6, 95% CI 1.42-4.89), the physically inactive (OR 1.8, 95% CI 1.0-3.0), and current smokers (OR 2.4, 95% CI 1.3-4.4). Increased waist circumference (OR 0.5, 95% CI 0.3-1.0) was less common in HIV-infected individuals, although controlling for sex and ethnicity differences, this difference became nonsignificant (OR 0.6, 95% CI 0.3-1.2). Further controlling for differences in income and education rendered the associations with smoking and physical inactivity nonsignificant, but revealed associations of HIV infection with hypertension (OR 2.4, 95% CI 1.0-6.0) and diabetes (OR 4.1, 95% CI 1.1-16.1). These results underscore the need to further investigate the role of cardiovascular risk factors in the growing HIV population.