Courtney A McKnight
Courtney A McKnight
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Clinical Associate Professor of Epidemiology
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Professional overview
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Dr. Courtney McKnight is a Principal Investigator specializing in mixed methods research focused on the epidemiology of drug use, opioid overdose, HIV and HCV infection. Dr. McKnight has over 20 years of experience conducting public health research related to drug use, as well as field experience as a harm reduction service provider.
Prior to joining NYU, Dr. McKnight served as the assistant director of research at the Chemical Dependency Institute at the Icahn School of Medicine at Mount Sinai, where she was an investigator and project director on numerous federally funded research studies, including evaluations of syringe services programs; investigations of the drivers that contribute to disparate rates of HIV and HCV; and interventions to increase access to HIV and HCV testing and care.
Previous to Dr. McKnight’s work in research, she directed a harm reduction program for women who use drugs and volunteered at a syringe services program in New Jersey.
Dr. McKnight received her DrPH from the City University of New York Graduate Center, her Master of Public Health from Hunter College, and her Bachelor of Arts in sociology from Rutgers University. Her dissertation examined the impact of Medicaid coverage of methadone and buprenorphine on treatment access for opioid dependent beneficiaries.
Dr. McKnight’s current research interests include examining the shifting landscape of illicit opioids, including the increasing prevalence of illicitly manufactured fentanyl, and risk environments of people who use drugs.
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Education
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BA, Women's Studies, Rutgers University, New Brunswick, NJMPH, Community Health Education, Hunter College, New York, NYDrPH, The City University of New York, New York, NY
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Areas of research and study
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Behavioral ScienceDrug addictionEpidemiologyHarm reductionHepatitisHIV/AIDSInfectious DiseasesMixed-Methods ResearchOpioidQualitative ResearchSocial epidemiologySubstance Abuse
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Publications
Publications
Effectiveness of respondent-driven sampling for recruiting drug users in New York City : Findings from a pilot study
AbstractAbdul‐Quader, A. S., Heckathorn, D. D., McKnight, C. A., Bramson, H., Nemeth, C., Sabin, K., Gallagher, K., & Des Jarlais, D. C. (n.d.).Publication year
2006Journal title
Journal of Urban HealthVolume
83Issue
3Page(s)
459-476AbstractA number of sampling methods are available to recruit drug users and collect HIV risk behavior data. Respondent-driven sampling (RDS) is a modified form of chain-referral sampling with a mathematical system for weighting the sample to compensate for its not having been drawn randomly. It is predicated on the recognition that peers are better able than outreach workers and researchers to locate and recruit other members of a "hidden" population. RDS provides a means of evaluating the reliability of the data obtained and also allows inferences about the characteristics of the population from which the sample is drawn. In this paper we present findings from a pilot study conducted to assess the effectiveness of RDS to recruit a large and diversified group of drug users in New York City. Beginning with eight seeds (i.e., initial recruits) we recruited 618 drug users (injecting and non-injecting) in 13 weeks. The data document both cross-gender and cross-race and -ethnic recruitment as well as recruitment across drug-use status. Sample characteristics are similar to the characteristics of the drug users recruited in other studies conducted in New York City. The findings indicate that RDS is an effective sampling method for recruiting diversified drug users to participate in HIV-related behavioral surveys.Respondent-driven sampling in a study of drug users in New York City : Notes from the field
AbstractMcKnight, C. A., Des Jarlais, D., Bramson, H., Tower, L., Abdul-Quader, A. S., Nemeth, C., & Heckathorn, D. (n.d.).Publication year
2006Journal title
Journal of Urban HealthVolume
83Issue
7 SUPPL.Page(s)
i54-i59AbstractBeth Israel Medical Center (BIMC), in collaboration with the Centers for Disease Control (CDC) and the New York State Department of Health (NYSDOH), used respondent-driven sampling (RDS) in a study of HIV seroprevalence among drug users in New York City in 2004. We report here on operational issues with RDS including recruitment, coupon distribution, storefront operations, police and community relations, and the overall lessons we learned. Project staff recruited eight seeds from a syringe exchange in Lower Manhattan to serve as the initial study participants. Upon completion of the interview that lasted approximately 1 h and a blood draw, each seed was given three coupons to recruit three drug users into the study. Each of the subsequent eligible participants was also given three coupons to recruit three of their drug-using acquaintances. Eligible participants had to have: injected, smoked or snorted an illicit drug in the last 6 months (other than marijuana), aged 18 or older, adequate English language knowledge to permit informed consent and complete questionnaire. From April to July 2004, 618 drug users were interviewed, including 263 (43%) current injectors, 119 (19%) former injectors, and 236 (38%) never injectors. Four hundred sixty nine (76%) participants were men, 147 (24%) were women, and two (Update : Syringe exchange programs - United States, 2002
AbstractMcKnight, C. A., McKnight, C. A., Des Jarlais, D. C., Perlis, T., Eigo, K., Krim, M., Auerbach, J., Purchase, D., Solberg, A., Jones, T. S., & Garfein, R. S. (n.d.).Publication year
2005Journal title
Journal of the American Medical AssociationVolume
294Issue
15Page(s)
1892-1894Abstract~What's community got to do with it? Implementation models of syringe exchange programs
AbstractDowning, M., Riess, T. H., Vernon, K., Mulia, N., Hollinquest, M., McKnight, C. A., Des Jarlais, D. C., & Edlin, B. R. (n.d.).Publication year
2005Journal title
AIDS Education and PreventionVolume
17Issue
1Page(s)
68-78AbstractSyringe exchange programs (SEPs) have been shown to be highly effective in reducing HIV transmission among injection drug users (IDUs). Despite this evidence, SEPs have not been implemented in many communities experiencing HIV epidemics among IDUs. We interviewed 17 key informants in nine U.S. cities to identify factors and conditions that facilitated or deterred the adoption of SEPs. Cities were selected to represent diversity in size, geographic location, AIDS incidence rates, and SEP implementation. Key informants included HIV prevention providers, political leaders, community activists, substance use and AIDS researchers, and health department directors. SEPs were established by one or more of three types of implementation models: (a) broad community coalition support, (b) community activist initiative, and (c) top-down decision making by government authorities. In each model, coalition building and community consultation were critical steps for the acceptance and sustainability of SEPs. When others were not prepared to act, community activists spearheaded SEP development, taking risks in the face of opposition, but often lacked the resources to sustain their efforts. Leadership from politicians and public health officials provided needed authority, clout, and access to resources. Researchers and scientific findings lent force and legitimacy to the effort. Rather than adopting adversarial positions, successful SEP implementers worked with or avoided the opposition. Fear of repercussions and lack of leadership were the greatest barriers to implementing SEPs. Communities that successfully implemented SEPs were those with activists willing to push the agenda, public officials willing to exercise leadership, researchers able to present authoritative findings, and proponents who effectively mobilized resources and worked to build community coalitions, using persistent but nonadversarial advocacy.Public Funding of US Syringe Exchange Programs
AbstractDes Jarlais, D. C., McKnight, C. A., & Milliken, J. (n.d.).Publication year
2004Journal title
Journal of Urban HealthVolume
81Issue
1Page(s)
118-121AbstractAlthough there has been no federal government funding of syringe exchange, there is substantial state and local government funding. We report here on program characteristics associated with receiving state and local government funding. Annual telephone surveys were made of program directors of syringe exchange programs known to the North American Syringe Exchange Network. The number of syringe exchange programs known to this network has increased from 63 in 1994-1995 to 127 in 2000. Approximately 80% of programs participated in each of the surveys. Approximately 50% of programs receive state and local government funding, and this has remained constant from 1994 to 2000. Receiving state and local government funding was associated with larger numbers of syringes exchanged per year and providing more on-site services. Among programs that received state or local government funding, this funding accounted for a mean of 87% of the budget for syringe exchange services. In the absence of federal funding, state and local government support is associated with better syringe exchange performance.What predicts which metropolitan areas in the USA have syringe exchanges?
AbstractTempalski, B., Friedman, S. R., Des Jarlais, D. C., McKnight, C. A., Keem, M., & Friedman, R. (n.d.).Publication year
2003Journal title
International Journal of Drug PolicyVolume
14Issue
5-6Page(s)
417-424AbstractHIV epidemics among IDUs vary widely across different cities in the USA [American Journal of Public Health 86 (5) (1996) 642]. Few studies have focused on how localities differ in regard to response to the HIV epidemic. While syringe exchange programmes (SEPs) are a response to HIV among IDUs, they are often unwelcome and difficult to set up even in communities hit hardest by the epidemic. It is important to understand what metropolitan area characteristics are related to when and if an SEP opens in a particular locality. Logistic regression models are used to explore how need, political factors, SEP diffusion from Tacoma (the first SEP), and metropolitan socioeconomic characteristics are related to SEP presence. Results indicate that need is not a significant predictor of having an SEP. Predictors were the percentage of the population who are men who have sex with men (AOR = 6.95; 95% CI = 1.29-37.49), and metropolitan area population (AOR = 1.08 per 100,000; 95% CI = 1.02-1.14). Predictors of having an SEP in a metropolitan area seem to be political factors and metropolitan area population size, not need among IDUs. Gay political influence and/or support may well facilitate SEP formation, and geographic diffusion may influence where SEPs are established.Legal syringe purchases by injection drug users, Brooklyn and Queens, New York City, 2000-2001.
AbstractDes Jarlais, D. C., McKnight, C. A., & Friedmann, P. (n.d.).Publication year
2002Journal title
Journal of the American Pharmaceutical Association (Washington,D.C. : 1996)Volume
42Issue
6 Suppl 2Page(s)
S73-76AbstractOBJECTIVE: To assess preliminary results of the Expanded Syringe Access Demonstration Program (ESAP) in New York City. DESIGN: Temporal trends of pharmacy use among injection drug users (IDUs) in Brooklyn and Queens were analyzed from December 2000 through December 2001. SETTING: Brooklyn and Queens, New York City. PARTIPANTS: IDUs. MAIN OUTCOME MEASURES: Attempts to purchase syringes from pharmacies and success in doing so. RESULTS: Of the 1,072 IDUs interviewed from December 2000 through December 2001, the majority were daily heroin injectors, but there was also substantial speedball and cocaine injection. There was a clear increase over time in both the percentage of subjects who attempted to purchase syringes in pharmacies and in the percentage who successfully purchased syringes. Among IDUs interviewed 4 or more months after ESAP began, large majorities of those who attempted to purchase syringes were successful in doing so. No differences in use of ESAP by IDUs were identified in Brooklyn versus Queens: 27% of IDUs interviewed in Queens reported that they had attempted to purchase syringes in pharmacies versus 28% in Brooklyn. Persons who reported injecting on a daily or more frequent basis were more likely to have attempted pharmacy purchases than persons who reported injecting less frequently, 32% versus 21%. CONCLUSIONS: The ESAP program has led to an increase in the use of pharmacies as sources of sterile injection equipment among IDUs in New York City. The extent to which pharmacies become an important source of sterile injection equipment and the effect of legal pharmacy sales on risk behaviors for human immunodeficiency virus (HIV) infection remain to be determined.As Evidence Mounts that ‘War on Drugs’ Has Failed, Harm Reduction Advocates Call for New Policies.
McKnight, C. A. (n.d.).Fentanyl in NYC
McKnight, C. A. (n.d.).Fentanyl Is Fueling an Unprecedented Rise in Overdose Deaths.
McKnight, C. A. (n.d.).In New York, fentanyl replaces heroin, without the knowledge of drug addicts.
McKnight, C. A. (n.d.).Invited Panelist for Selected Presentations at the IHRC23 Press Conference.
McKnight, C. A. (n.d.).Large number of drug users might be unknowingly using fentanyl
McKnight, C. A. (n.d.).Many people who use heroin are getting fentanyl with it.
McKnight, C. A. (n.d.).More than 80% of drug users test positive for fentanyl.
McKnight, C. A. (n.d.).Most Injection Drug Users Are Not Seeking Out Fentanyl
McKnight, C. A. (n.d.).Most Injection Drug Users Are Not Seeking Out Fentanyl.
McKnight, C. A. (n.d.).Most Injection Drug Users Are Not Seeking Out Fentanyl.
McKnight, C. A. (n.d.).Most People Who Inject Drugs in NYC Test Positive for Fentanyl.
McKnight, C. A. (n.d.).Vast Majority of Fentanyl Use is Unintentional. Reported on Spectrum News NY1
McKnight, C. A. (n.d.).‘Tranq’: the flesh-rotting drug adding to America’s opioid crisis.
McKnight, C. A. (n.d.).