Great product, but Has a hissing noise during charging
Like the reviewer above I am getting a high pitched noise when the ipod starts charging. This usually occurs a few seconds after the song begains to play. I called USA-Spec and they were suprised that I could hear this noise. They sent me a replacement, but it was the wrong model !!! I am disappointed in them and at this point I would not recommend buying this because of poor customeer support.

Easy to install and works like its supposed to
Having bought an 08 TL, it was disappointing that car did not come with a built in ipod interface. Using an FM transmitter give you very low audio quality and I pretty much like having my ipod hidden away like i did in my previous car. The USA Spec is very easy to install, took me about 2 hours and I am not a stereo installer. I just researched carefully on the internet and found installation diagrams. Once installed you get ipod controls on you vehicles factory stereo via CD Changer emulation. You car detects the ipod as a CD Changer. The only thing that you don't get from this adapter is text on your screen. I highly recommend this adapter and suggest you do the installation yourself and save a few bucks.

Awesome product, few setbacks
Let me start by saying this is an amazing product, but I have to give it 3 stars because the first unit I received was defective and only played audio through the left channel... so the build quality is less than perfect. However, the merchant I purchased it from gladly replaced it, and it works fine now (luckly he was also located in so. cal. so i could just drive to his place instead of paying extra shipping charges). Also, anyone installing this in a 2003 Honda Accord will have remove the ENTIRE stereo to access the cable in the back to plug into the y-connector (my car has a navigation system, im not sure if this is the case for all 2003 accords). This was a huge pain for me, and added a few extra hours to my project. As for the 2004 and up models, installation is much easier as you can access the cord at the bottom of the stereo by simply removing the bin. There are multiple online guides that can guide you with pictures and everything (google: "install ipod accord pictures").
Also, this product works fine with the ipod touch. They have also "unlocked" the device when its playing in playlist mode so that you can access other features (ie safari, youtube, etc) while music is still playing through the "ipod" function of your itouch... I dont recommend this while driving (duh). Audio quality is excellent, on the itouch, i can still use the equalizer in the ipod or the one on the navigation screen, which is a nice feature if you like fine-tuning audio like I do.
It would have been nice if they supported a text display on the navigation screen, but i'll settle for the track and playlist number. Also, there is a slight lag between pressing buttons on the steering wheel/radio and getting a response from the ipod.
I have taken multiple pictures of the installation process and would happily share them if anyone needs help installing their own usa spec in their 2003 accord. I dont know if amazon supports a PM feature, but if it doesn't, facebook message (USC) me and I'll see what I can do.

Probably the best 120 bucks I've ever spent on my car.

High pitched background noise USA SPEC pa11HON2y
I had the USA SPEC pa11h2y professionally installed on my 2006 Acura RL. When I play the ipod there is a high pitched background noise. I spoke with USA SPEC and they told me that from my description of the problem it appears that I am getting this noise as a result of the charging of my ipod. The noise is only present when I play the ipod on the radio but not from the XM, CD, Radio. And the noise goes away for a few moments after I press the next track from the steering wheel button and then returns. Crutchfield had me do a couple of attempts at a fix but to no avail. USA SPEC will be sending me a unit that they will disable the ipod charging and they believe that this will fix my problem. I will post a follow up when I get the new unit in the car and see if it fixes it. The sound quality is very diminished with this feedback noise so if this does not fix the problem I will not be able to use this unit. I saw a few posts elsewhere with this same problem so I figured I'd post it right here.USA SPEC PA11-HON2y - iPod to 2003-2006 Honda Factory Radio Interface w/ Auxiliary Audio input

Awesome
Works really really well. You can control your ipod from the steering wheel or directly on the ipod itself without having to change any switches. It charges the ipod while its plugged in and its a direct input vs. a headphone jack. So sound quality is much better. If you have an audio input that isn't an ipod, you can still listen to it cuz it has a regular headphone jack input too. But you'll need to switch a dip switch on the device. I love it.