Nicole Angotti
Biographic Data
| ID | 219850 |
|---|---|
| NAME | Nicole Angotti |
| GIVEN NAMES | Nicole |
| FAMILY NAME | Angotti |
| SIGNATURE | ANGOTTI N |
| AFFILIATIONS | American University |
| ORCID | 0000-0002-9206-5914 |
| VERIFIED | Yes |
| TOTAL WORKS | 35 |
| TOTAL CITATIONS | 142 |
| AUTHOR COUNT | 35 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2008 |
| LATEST PUBLICATION YEAR | 2025 |
| H-INDEX | 8 |
The Strength of Long-Distance Ties for Aging Healthy With HIV: The Case of Rural South Africa
Objectives In lower-income settings with limited government-funded care, personal social networks are often the primary means by which older persons access resources and support. We tested the association between long-distance ties—ties that span greater geographical and network distances—and HIV treatment outcomes in a rural South African community with one of the largest aging populations with HIV. Methods We used data from the “Health and Agin…
Unpacking the black box of latent class analysis using qualitative life history interviews: A data-linked explanatory approach examining sexual behavior in rural South Africa
BACKGROUNDSexual behaviors are determined by present-day factors and past/future considerations.Previous work utilizing latent class analysis on a population-based cross-sectional survey of rural South Africans aged 15-plus showed how sexual behaviors cluster in distinct population subgroups (Class 1: Single with consistent protective behaviors; Class 2: Risky behaviors; Class 3: In union with lack of protective behaviors) and their associations …
Mortality variability and differentials by age and causes of death in rural South Africa, 1994–2018
INTRODUCTION: Understanding mortality variability by age and cause is critical to identifying intervention and prevention actions to support disadvantaged populations. We assessed mortality changes in two rural South African populations over 25 years covering pre-AIDS and peak AIDS epidemic and subsequent antiretroviral therapy (ART) availability. METHODS: Using population surveillance data from the Agincourt Health and Socio-Demographic Surveill…
Understanding Household Dynamics From the Ground Up: A Longitudinal Study From a Rural South African Setting
Investigations into household structure in low- and middle-income countries (LMICs) provide important insight into how families manage domestic life in response to resource allocation and caregiving needs during periods of rapid sociopolitical and health-related challenges. Recent evidence on household structure in many LMICs contrasts with long-standing viewpoints of worldwide convergence to a Western nuclearized household model. Here, we adopt …
The Missing Millions: Uncovering the Burden of Covid‐19 Cases and Deaths in the African Region
Early in 2020, experts warned of the devastating toll that COVID‐19 would have on African countries. By the close of 2021, however, Africa remained one of the least affected regions in the world, leading commentators to speculate about a so‐called “Africa paradox”. This review evaluates current research and data to establish the burden of COVID‐19 infections and mortality in the African region. Despite claims that African countries were spared fr…
Biomedical bargains: Negotiating "safe sex" on antiretroviral treatment in rural South Africa
Twin epidemics: The effects of HIV and systolic blood pressure on mortality risk in rural South Africa, 2010-2019
Our results indicate that HIV and elevated blood pressure are acting as separate, non-interacting epidemics affecting high proportions of the older adult population. PLWH with unsuppressed viral load were at higher mortality risk compared to those uninfected. Systolic blood pressure was a mortality risk factor independent of HIV status. As antiretroviral therapy becomes more widespread, further longitudinal follow-up is needed to understand how t…
The Meaning of Health in Rural South Africa: Gender, the Life Course, and the Socioepidemiological Context
This article examines the meaning of health among middle-aged and older adults in a rural South African setting, where 72 percent of adults aged 40 and over are living with a major chronic condition, and 81 percent report good or very good health. We draw on a unique mixed-methods dataset that includes a population-based survey with disease biomarkers (hypertension, diabetes, HIV), self-assessments of health including self-rated health, functiona…
Making Sense of Troubled Livelihoods: Gendered Expectations and Poor Health Narratives in Rural South Africa
When men and women cannot attain idealized gendered forms of economic provision and dependence, how do they make sense of this perceived failure? In this article, we posit that poor health narratives serve as a gendered tool to make sense of inadequate livelihoods, even when that inadequacy is attributable to structural conditions. We draw on survey and life-history interview data from middle-aged and older rural South Africans. The survey data s…
From “Secret” to “Sensitive Issue”: Shifting Ideas About HIV Disclosure Among Middle-Aged and Older Rural South Africans in the Era of Antiretroviral Treatment
Particularly as the epidemic ages in South Africa and globally, tracing changes in older persons' views on disclosure is an important step in developing messaging that could enhance treatment as prevention and ART adherence
A Nowadays Disease: HIV/Aids and Social Change in a Rural South African Community
Why do some people adapt successfully to change while others do not? We examine this question in the context of a severe HIV/AIDS epidemic in South Africa, where adapting (or not) to social change has borne life and death consequences. Applying an age-period-cohort lens to the analysis of qualitative life history interviews among middle-aged and older adults, we consider the role of the life course and gendered sexuality in informing Africans' st…
The end of Aids? HIV and the new landscape of illness in rural South Africa
The global HIV/AIDS scientific community has begun to hail the dawn of 'the End of AIDS' with widespread anti-retroviral therapy (ART) and dramatic declines in AIDS-related mortality. Drawing on community focus groups and in-depth individual interviews conducted in rural South Africa, we examine the complex unfolding of the end of AIDS in a hard-hit setting. We find that while widespread ART has led to declines in AIDS-related deaths, stigma pers…
Clusters of HIV Risk and Protective Sexual Behaviors in Agincourt, Rural South Africa: Findings from the Ha Nakekela Population-Based Study of Ages 15 and Older
Lgbt Visibility and Anti-Gay Backlash
Throughout the 2000s, donor organizations successfully argued for the inclusion of men who have sex with men (msm) in the global response to HIV/AIDS. These efforts have had unintended consequences for msm and lesbian, gay, bisexual, and transgender (lgbt) populations in sub-Saharan Africa. Focusing on Malawi and Senegal, we find that donors’ emphasis on msm provided new urgency and sources of support for nascent lgbt- and msm-identified groups t…
Sometimes it is not about men’: Gendered and generational discourses of caregiving HIV transmission in a rural South African setting
In this paper, we examine a prominent interpretation of HIV risk in a rural South African setting experiencing a severe HIV epidemic well into older ages: the discourse of caregiving HIV transmission. By caregiving transmission, we refer to HIV infection resulting from caring for family members who are living with HIV and may be sick with AIDS-related illnesses. We draw on individual life history and community focus group interviews with men and …
Sexual behavior and HIV risk across the life course in rural South Africa: Trends and comparisons
There is limited information about sexual behavior among older Africans, which is problematic given high HIV rates among older adults. We use a population-based survey among people aged 15-80+ to examine the prevalence of sexual risk and protective behaviors in the context of a severe HIV epidemic. We focus on variation across the life course, gender and HIV serostatus to compare the similarities and differences of young, middle aged, and older a…
Taking care’ in the age of Aids: Older rural South Africans’ strategies for surviving the HIV epidemic
Older adults have been largely overlooked in community studies of HIV in highly endemic African countries. In our rural study site in Mpumalanga Province, South Africa, HIV prevalence among those aged 50 and older is 16.5%, suggesting that older adults are at risk of both acquiring and transmitting HIV. This paper utilises community-based focus-group interviews with older rural South African men and women to better understand the normative enviro…
How to “Live a Good Life”: Aging and HIV Testing in Rural South Africa
We conclude with recommendations to increase HIV testing uptake among older adults including home testing, couples testing, and HIV testing concurrently with noncommunicable diseases
Ready Rhetorics: Political Homophobia and Activist Discourses in Malawi, Nigeria, and Uganda
They are looking just the same: Antiretroviral treatment as social danger in rural Malawi
Let's Talk about Sex, Maybe: Interviewers, Respondents, and Sexual Behavior Reporting in Rural South Africa
Researchers are often skeptical of sexual behavior surveys: Respondents may lie or forget details of their intimate lives, and interviewers may exercise authority in how they capture responses. We use data from a 2010-2011 cross-sectional sexual behavior survey in rural South Africa to explore who says what to whom about their sexual lives. Results show an effect of fieldworker age across outcomes: Respondents report "safer," more "responsible" s…
Reconsidering Gendered Sexualities in a Generalized Aids Epidemic
Using the threat of a severe AIDS epidemic in a collection of rural villages in South Africa, we illustrate how men and women reconsider gendered sexualities through conversations and interactions in everyday life. We draw from data collected by local ethnographers and focus on the processes through which men and women collectively respond to the threat posed by AIDS to relationships, families, and communities. Whereas previous research has shown…
Making meaning in the time of Aids: Longitudinal narratives from the Malawi Journals Project
The Malawi Journals Project is one of the longest-running observational field studies in rural sub-Saharan Africa, ongoing since 1999. The journals provide real-time accounts of the unfolding epidemic, from the days when AIDS was considered by rural Malawians to be a death sentence, through the advent of international AIDS organisations bearing advice on avoiding infections by self-control, and then the turn to institutionally-based efforts to co…
Cardiometabolic disease risk and HIV status in rural South Africa: Establishing a baseline
Sub-Saharan Africa is facing intersecting epidemics of HIV and hypertension. In this setting, around half the adult population require long-term care for at least one of HIV, hypertension or diabetes. Together with the adverse effects that HIV and its treatment have on lipids, this may have serious implications for the South African health care system. Monitoring of the interaction of HIV, ART use, and cardiometabolic disease is needed at both in…
HIV after 40 in rural South Africa: A life course approach to HIV vulnerability among middle aged and older adults
Increasing the acceptability of HIV counseling and testing with three C's: Convenience, confidentiality and credibility
Ready Rhetorics: Political Homophobia and Activist Discourses in Malawi, Nigeria, and Uganda
Working outside of the box: How HIV counselors in Sub-Saharan Africa adapt Western HIV testing norms
HIV after 40 in rural South Africa: A life course approach to HIV vulnerability among middle aged and older adults
An offer you can't refuse? Provider-initiated HIV testing in antenatal clinics in rural Malawi
International organizations promote provider-initiated, 'routine' HIV testing of pregnant women seeking antenatal care as an effort to curb mother-to-child transmission. We offer an account of the perceptions of HIV testing at antenatal clinics in rural Malawi. Although it is both international and Government of Malawi policy that women must be explicitly informed of their right to refuse testing, analysis of in-depth interviews, focus group disc…
Let's Talk about Sex, Maybe: Interviewers, Respondents, and Sexual Behavior Reporting in Rural South Africa
Researchers are often skeptical of sexual behavior surveys: Respondents may lie or forget details of their intimate lives, and interviewers may exercise authority in how they capture responses. We use data from a 2010-2011 cross-sectional sexual behavior survey in rural South Africa to explore who says what to whom about their sexual lives. Results show an effect of fieldworker age across outcomes: Respondents report "safer," more "responsible" s…
Implementing 'insider' ethnography: Lessons from the Public Conversations about HIV/Aids project in rural South Africa
We describe the conceptualization and implementation of a research methodology in which 'insider' community members work with 'outsider' investigators as participant observers to document everyday conversations taking place in public settings in their communities. Our study took place in a resource-poor area of rural South Africa and focused on HIV/AIDS, yet we aim here to provide a road map for those interested in implementing this approach in o…
Popular Moralities and Institutional Rationalities in Malawi's Struggle Against Aids
The AIDS epidemic in sub-Saharan Africa is fertile ground for examining how moral evaluations evolve over time and across different settings. We compare the discourse on AIDS in Malawi as presented in the media with that of everyday conversations. Drawing on two sets of texts, newspaper articles and conversational journals, produced over a ten-year period from 1999 through 2008, we analyze their moral injunctions, or what individuals should or sh…
The Meaning of Health in Rural South Africa: Gender, the Life Course, and the Socioepidemiological Context
This article examines the meaning of health among middle-aged and older adults in a rural South African setting, where 72 percent of adults aged 40 and over are living with a major chronic condition, and 81 percent report good or very good health. We draw on a unique mixed-methods dataset that includes a population-based survey with disease biomarkers (hypertension, diabetes, HIV), self-assessments of health including self-rated health, functiona…
The more you learn the less you know? Interpretive ambiguity across three modes of qualitative data
BACKGROUND: Researchers across disciplines face a similar challenge ensuring our methods can give us valid, usable answers to our questions. But what happens when multiple strategies of inquiry give us different answers to the same research question? We explore this question through three different modes of qualitative inquiry--interviews, focus groups, and participant observation - oriented around local attitudes to HIV testing. OBJECTIVE: We in…
A Nowadays Disease: HIV/Aids and Social Change in a Rural South African Community
Why do some people adapt successfully to change while others do not? We examine this question in the context of a severe HIV/AIDS epidemic in South Africa, where adapting (or not) to social change has borne life and death consequences. Applying an age-period-cohort lens to the analysis of qualitative life history interviews among middle-aged and older adults, we consider the role of the life course and gendered sexuality in informing Africans' st…
Going most of the way: Technical virginity' among American adolescents
They are looking just the same: Antiretroviral treatment as social danger in rural Malawi
Reconsidering Gendered Sexualities in a Generalized Aids Epidemic
Using the threat of a severe AIDS epidemic in a collection of rural villages in South Africa, we illustrate how men and women reconsider gendered sexualities through conversations and interactions in everyday life. We draw from data collected by local ethnographers and focus on the processes through which men and women collectively respond to the threat posed by AIDS to relationships, families, and communities. Whereas previous research has shown…
Working with teams of 'insiders: Qualitative approaches to data collection in the Global South
The convergence of two qualitative methodological strategies - working in "teams" and with "insiders" - can facilitate access, efficiency, and insights into research questions of interest to demographers. Even though this approach is becoming more common a
How to “Live a Good Life”: Aging and HIV Testing in Rural South Africa
We conclude with recommendations to increase HIV testing uptake among older adults including home testing, couples testing, and HIV testing concurrently with noncommunicable diseases
The Missing Millions: Uncovering the Burden of Covid‐19 Cases and Deaths in the African Region
Early in 2020, experts warned of the devastating toll that COVID‐19 would have on African countries. By the close of 2021, however, Africa remained one of the least affected regions in the world, leading commentators to speculate about a so‐called “Africa paradox”. This review evaluates current research and data to establish the burden of COVID‐19 infections and mortality in the African region. Despite claims that African countries were spared fr…
Biomedical bargains: Negotiating "safe sex" on antiretroviral treatment in rural South Africa
Making Sense of Troubled Livelihoods: Gendered Expectations and Poor Health Narratives in Rural South Africa
When men and women cannot attain idealized gendered forms of economic provision and dependence, how do they make sense of this perceived failure? In this article, we posit that poor health narratives serve as a gendered tool to make sense of inadequate livelihoods, even when that inadequacy is attributable to structural conditions. We draw on survey and life-history interview data from middle-aged and older rural South Africans. The survey data s…
Unpacking the black box of latent class analysis using qualitative life history interviews: A data-linked explanatory approach examining sexual behavior in rural South Africa
BACKGROUNDSexual behaviors are determined by present-day factors and past/future considerations.Previous work utilizing latent class analysis on a population-based cross-sectional survey of rural South Africans aged 15-plus showed how sexual behaviors cluster in distinct population subgroups (Class 1: Single with consistent protective behaviors; Class 2: Risky behaviors; Class 3: In union with lack of protective behaviors) and their associations …
Understanding Household Dynamics From the Ground Up: A Longitudinal Study From a Rural South African Setting
Investigations into household structure in low- and middle-income countries (LMICs) provide important insight into how families manage domestic life in response to resource allocation and caregiving needs during periods of rapid sociopolitical and health-related challenges. Recent evidence on household structure in many LMICs contrasts with long-standing viewpoints of worldwide convergence to a Western nuclearized household model. Here, we adopt …
Clusters of HIV Risk and Protective Sexual Behaviors in Agincourt, Rural South Africa: Findings from the Ha Nakekela Population-Based Study of Ages 15 and Older
Going most of the way: Technical virginity' among American adolescents
Increasing the acceptability of HIV counseling and testing with three C's: Convenience, confidentiality and credibility
Working outside of the box: How HIV counselors in Sub-Saharan Africa adapt Western HIV testing norms
An offer you can't refuse? Provider-initiated HIV testing in antenatal clinics in rural Malawi
International organizations promote provider-initiated, 'routine' HIV testing of pregnant women seeking antenatal care as an effort to curb mother-to-child transmission. We offer an account of the perceptions of HIV testing at antenatal clinics in rural Malawi. Although it is both international and Government of Malawi policy that women must be explicitly informed of their right to refuse testing, analysis of in-depth interviews, focus group disc…
Testing differences: The implementation of Western HIV testing norms in sub-Saharan Africa
This paper examines the implementation of Western HIV testing norms - counselling, consent and confidentiality ('3Cs') - in Malawi, a high prevalence, rural African setting. It considers the differential perspectives of three categories of stakeholders: proponents, implementers and intended beneficiaries. The proponents are members of the 'Counseling and Testing Establishment'. For them, the 3Cs are human rights imports that are worth defending f…
Prevalence of HIV among those 15 and older in rural South Africa
A greater knowledge of the burden of HIV in rural areas of Southern Africa is needed, especially among older adults. We conducted a cross-sectional biomarker survey in the rural South African Agincourt Health and Socio-demographic Surveillance site in 2010-2011 and estimated HIV prevalence and risk factors. Using an age-sex stratified random sample of ages 15+, a total of 5037 (65.7%) of a possible 7662 individuals were located and 4362 (86.6%) c…
The more you learn the less you know? Interpretive ambiguity across three modes of qualitative data
BACKGROUND: Researchers across disciplines face a similar challenge ensuring our methods can give us valid, usable answers to our questions. But what happens when multiple strategies of inquiry give us different answers to the same research question? We explore this question through three different modes of qualitative inquiry--interviews, focus groups, and participant observation - oriented around local attitudes to HIV testing. OBJECTIVE: We in…
Popular Moralities and Institutional Rationalities in Malawi's Struggle Against Aids
The AIDS epidemic in sub-Saharan Africa is fertile ground for examining how moral evaluations evolve over time and across different settings. We compare the discourse on AIDS in Malawi as presented in the media with that of everyday conversations. Drawing on two sets of texts, newspaper articles and conversational journals, produced over a ten-year period from 1999 through 2008, we analyze their moral injunctions, or what individuals should or sh…
Making meaning in the time of Aids: Longitudinal narratives from the Malawi Journals Project
The Malawi Journals Project is one of the longest-running observational field studies in rural sub-Saharan Africa, ongoing since 1999. The journals provide real-time accounts of the unfolding epidemic, from the days when AIDS was considered by rural Malawians to be a death sentence, through the advent of international AIDS organisations bearing advice on avoiding infections by self-control, and then the turn to institutionally-based efforts to co…
Cardiometabolic disease risk and HIV status in rural South Africa: Establishing a baseline
Sub-Saharan Africa is facing intersecting epidemics of HIV and hypertension. In this setting, around half the adult population require long-term care for at least one of HIV, hypertension or diabetes. Together with the adverse effects that HIV and its treatment have on lipids, this may have serious implications for the South African health care system. Monitoring of the interaction of HIV, ART use, and cardiometabolic disease is needed at both in…
HIV after 40 in rural South Africa: A life course approach to HIV vulnerability among middle aged and older adults
Working with teams of 'insiders: Qualitative approaches to data collection in the Global South
The convergence of two qualitative methodological strategies - working in "teams" and with "insiders" - can facilitate access, efficiency, and insights into research questions of interest to demographers. Even though this approach is becoming more common a
Implementing 'insider' ethnography: Lessons from the Public Conversations about HIV/Aids project in rural South Africa
We describe the conceptualization and implementation of a research methodology in which 'insider' community members work with 'outsider' investigators as participant observers to document everyday conversations taking place in public settings in their communities. Our study took place in a resource-poor area of rural South Africa and focused on HIV/AIDS, yet we aim here to provide a road map for those interested in implementing this approach in o…
Ready Rhetorics: Political Homophobia and Activist Discourses in Malawi, Nigeria, and Uganda
They are looking just the same: Antiretroviral treatment as social danger in rural Malawi
Let's Talk about Sex, Maybe: Interviewers, Respondents, and Sexual Behavior Reporting in Rural South Africa
Researchers are often skeptical of sexual behavior surveys: Respondents may lie or forget details of their intimate lives, and interviewers may exercise authority in how they capture responses. We use data from a 2010-2011 cross-sectional sexual behavior survey in rural South Africa to explore who says what to whom about their sexual lives. Results show an effect of fieldworker age across outcomes: Respondents report "safer," more "responsible" s…
Reconsidering Gendered Sexualities in a Generalized Aids Epidemic
Using the threat of a severe AIDS epidemic in a collection of rural villages in South Africa, we illustrate how men and women reconsider gendered sexualities through conversations and interactions in everyday life. We draw from data collected by local ethnographers and focus on the processes through which men and women collectively respond to the threat posed by AIDS to relationships, families, and communities. Whereas previous research has shown…
Sexual behavior and HIV risk across the life course in rural South Africa: Trends and comparisons
There is limited information about sexual behavior among older Africans, which is problematic given high HIV rates among older adults. We use a population-based survey among people aged 15-80+ to examine the prevalence of sexual risk and protective behaviors in the context of a severe HIV epidemic. We focus on variation across the life course, gender and HIV serostatus to compare the similarities and differences of young, middle aged, and older a…
Taking care’ in the age of Aids: Older rural South Africans’ strategies for surviving the HIV epidemic
Older adults have been largely overlooked in community studies of HIV in highly endemic African countries. In our rural study site in Mpumalanga Province, South Africa, HIV prevalence among those aged 50 and older is 16.5%, suggesting that older adults are at risk of both acquiring and transmitting HIV. This paper utilises community-based focus-group interviews with older rural South African men and women to better understand the normative enviro…
How to “Live a Good Life”: Aging and HIV Testing in Rural South Africa
We conclude with recommendations to increase HIV testing uptake among older adults including home testing, couples testing, and HIV testing concurrently with noncommunicable diseases
Lgbt Visibility and Anti-Gay Backlash
Throughout the 2000s, donor organizations successfully argued for the inclusion of men who have sex with men (msm) in the global response to HIV/AIDS. These efforts have had unintended consequences for msm and lesbian, gay, bisexual, and transgender (lgbt) populations in sub-Saharan Africa. Focusing on Malawi and Senegal, we find that donors’ emphasis on msm provided new urgency and sources of support for nascent lgbt- and msm-identified groups t…
Sometimes it is not about men’: Gendered and generational discourses of caregiving HIV transmission in a rural South African setting
In this paper, we examine a prominent interpretation of HIV risk in a rural South African setting experiencing a severe HIV epidemic well into older ages: the discourse of caregiving HIV transmission. By caregiving transmission, we refer to HIV infection resulting from caring for family members who are living with HIV and may be sick with AIDS-related illnesses. We draw on individual life history and community focus group interviews with men and …
The end of Aids? HIV and the new landscape of illness in rural South Africa
The global HIV/AIDS scientific community has begun to hail the dawn of 'the End of AIDS' with widespread anti-retroviral therapy (ART) and dramatic declines in AIDS-related mortality. Drawing on community focus groups and in-depth individual interviews conducted in rural South Africa, we examine the complex unfolding of the end of AIDS in a hard-hit setting. We find that while widespread ART has led to declines in AIDS-related deaths, stigma pers…
Clusters of HIV Risk and Protective Sexual Behaviors in Agincourt, Rural South Africa: Findings from the Ha Nakekela Population-Based Study of Ages 15 and Older
From “Secret” to “Sensitive Issue”: Shifting Ideas About HIV Disclosure Among Middle-Aged and Older Rural South Africans in the Era of Antiretroviral Treatment
Particularly as the epidemic ages in South Africa and globally, tracing changes in older persons' views on disclosure is an important step in developing messaging that could enhance treatment as prevention and ART adherence
HIV/AIDS Research and Interventions (25 works) · Medicine (24 works) · Sociology (24 works) · Adolescent Sexual and Reproductive Health (20 works) · Psychology (20 works) · Political science (15 works) · Gerontology (13 works) · Demography (12 works) · Population (12 works) · Economic growth (11 works)