Knowledge and beliefs about HIV/AIDS among perimenopausal women: Are there urban–rural differences?

Introduction: HIV/AIDS remains a major public health issue, with social and cultural dimensions often underestimated. Middle-aged women, particularly in rural settings, represent a vulnerable and frequently over-looked population in prevention strategies, despite remaining sexually active during this life stage. Material and methods: A quantitative, cross-sectional, and analytical study was conducted using data from Peru’s 2024 Demographic and Health Survey (ENDES). A total of 6,314 women aged 40 to 49 years with complete data were included: 4,176 from urban areas and 2,138 from rural areas. An additive index of adequate HIV/ AIDS knowledge and beliefs was constructed (range: 0–9), along with sociodemographic and health information access variables. Statistical analysis was performed using Stata v17, and geographic visualization using RStudio. Results: Rural women reported lower exposure to HIV/AIDS information and less awareness of vertical transmission and asymptomatic HIV transmission (p < 0.001). Preventive beliefs were more frequent in urban areas, while misbeliefs, such as mosquito transmission, were more common in rural areas. Geographic analysis revealed a clear territorial gap, with higher index scores in urban zones. Nevertheless, some rural regions exhibited unexpectedly high scores. Discussion: Findings highlight informational and cultural disparities that hinder HIV prevention among rural women. These disparities underscore the need for tailored interventions that consider sociocultural and territorial specificities. Conclusions: Middle-aged women should be explicitly targeted by sexual health strategies. Regionalized interventions are essential to address territorial and sociocultural inequities in HIV/AIDS knowledge and beliefs.