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 overlooked 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.