Background: The impact of highly active antiretroviral therapy (HAART) on the combined quantity and quality of life has not been studied for the HIV-infected women.

Objective: To evaluate the effectiveness of HAART on quality-adjusted life years (QALYs) by comparing HIV-infected HAART users with HAART naïve participants in the Women Interagency HIV Study (WIHS).

Methods: A one-to-one matching with equivalent (≤0.1%) propensity scores for predicting HAART initiation was carried out between the HAART using and HAART naïve groups and 458 pairs of women were obtained. Quality of life (QOL) was repeatedly measured using a shortened version of MOS-HIV form. QALYs were calculated as integrated survival-quality product, i.e., weighting the follow-up periods by utility coefficients derived from a QOL summary score. The effectiveness of HAART on QALYs was assessed using a lognormal model accounting for right censoring.

Results: After propensity score matching, the distributions of the baseline covariates between the HAART treatment groups were the same. The subjects had a mean age of 39 years at the matching visits and had been followed up till October 2004. Univariately, HAART using group had longer expected survival time than the HAART naïve group (5.8 years in overall survival time and 7.2 years in QALYs). After controlling for baseline age, number of CD4+ cell counts, calendar time, education level at study entry and race/ethnicity, HAART use resulted in 4.5 more expected overall survival years and 5.4 more expected QALYs.

Conclusions: Our study showed that HAART not only improved HIV-infected women’s survival time, but also enhanced their overall quality of life. Using HAART did not cause severe tradeoff between quantity and quality of life among the HIV-infected women.