We evaluated patient knowledge, attitudes, and beliefs regarding changes present with the Affordable Care Act (ACA). HIV-infected adults attending an academic medical center HIV clinic in Omaha, Nebraska were asked to complete a self-administered survey between November 2013 and March 2014. Information collected included demographics, knowledge regarding healthcare reform policies, as well as attitudes and beliefs regarding the potential impact of the ACA on patient access to healthcare. Basic descriptive statistics were used to assess demographic characteristics of respondents and outcomes of interest. Chi-square tests were used for comparisons of interest among participants; some trends were evaluated with Cochran-Armitage trend tests. Four hundred and six patients completed the questionnaire. Of the respondents 90% were between the ages of 27 and 64, 61% were white, 27% had no health insurance, and 21% reported that they felt they had or will eventually benefit from the ACA. The proportion who responded "I don't know" to this question decreased over the study period (p=0.036). Overall, 57% reported they do not believe that they are informed enough to make decisions about the ACA. In answering four knowledge-based questions, only 3% answered all of them correctly. Knowledge about the ACA was significantly associated with perception of benefit (p=0.018). HIV-infected patients are not well informed about the ACA and few perceive that they will benefit from healthcare reform. Targeted education and outreach are necessary to reduce the knowledge gap for this population that stands to benefit greatly from the ACA.