The aims of this study were to determine the association between service utilization and subjective cognitive complaints among adults with HIV and to identify the predictors of cognitive complaints as a step forward in improving service utilization in this population. Participants were 385 adults with HIV who were receiving care from AIDS service organizations (ASOs) in Alabama. Trained staff administered a face-to-face questionnaire, which assessed cognitive complaints and diverse aspects of service utilization. Significant correlations were found between cognitive complaints and work status, financial difficulties, difficulty getting medical care, legal problems, medication compliance, emotional problems, housing difficulties, counseling for sexual issues, transportation difficulties, and difficulty getting food. Multiple regression analysis identified the following predictors of cognitive complaints: level of education, physical pain, and stress. Given the association between cognitive complaints and service utilization, interventions aimed at reducing cognitive complaints and improving neuropsychological functioning may enhance service utilization and everyday functioning among adults with HIV. © 2008 by The Haworth Press. All rights reserved.