Courtney A McKnight

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Clinical Assistant Professor of Epidemiology

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.

Education

BA, Women's Studies, Rutgers University, New Brunswick, NJ

MPH, Community Health Education, Hunter College, New York, NY

DrPH, The City University of New York, New York, NY

Areas of research and study

Behavioral Science

Drug addiction

Epidemiology

Harm reduction

Hepatitis

HIV/AIDS

Infectious Diseases

Mixed-Methods Research

Opioid

Qualitative Research

Social epidemiology

Substance Abuse

Publications

Anti-vaccine attitudes and COVID-19 vaccine status at the end of the U.S. public health emergency

Engagement in hepatitis C virus cascade of care and factors associated with testing among people who inject drugs in Iran

Fentanyl Polysubstance Use Patterns and Their Associations With Hepatitis C Virus, Skin and Soft Tissue Infections, and Non-Fatal Overdose Among People Who Inject Drugs in New York City

Harms associated with injecting in public spaces: a global systematic review and meta-analysis

Khezri, M., Kimball, S., McKnight, C., Rouhani, S., Bunting, A. M., Karamouzian, M., Ompad, D. C., & Des Jarlais, D. (n.d.).

Publication year

2025

Journal title

International Journal of Drug Policy

Volume

140

10.1016/j.drugpo.2025.104819

Abstract

Abstract

Background: Despite increasing backlash against harm reduction efforts and the need to understand the risk environments encountered by people who inject drugs (PWID), a quantitative systematic review on public injecting and associated health and drug-related outcomes is lacking. We aimed to summarize the global evidence on the prevalence and harms associated with injecting in public spaces. Methods: We searched MEDLINE, Embase, PsycINFO, CINAHL, Scopus, Global Health, and Web of Science from inception to March 21, 2024. We pooled data from included studies using random-effects meta-analyses to quantify the associations between recent (i.e., current or within the last year) public injecting and associated outcomes. Public injecting was defined as injecting in public or semi-public spaces, including streets, parks, and abandoned buildings. Risk of bias was assessed using the Joanna Briggs Institute's critical appraisal tool. Results: Of the 6144 initial records, 84 studies were eligible for inclusion. The pooled prevalence of recent public injecting was 48.85 % (95 % confidence intervals [CI] 43.87, 53.85). Public injecting was associated with increased odds of recent non-fatal overdose (odds ratio [OR] 2.51, 95 % CI 2.01, 3.13), HCV infection (OR 1.55, 95 % CI 1.18, 2.02), recent needle/syringe sharing (OR 2.41, 95 % CI 1.97, 2.94), recent sex work (OR 1.75, 95 % CI 1.03, 2.97), recent incarceration (OR 2.10, 95 % CI 1.78, 2.47), and recent unstable housing/homelessness (OR 4.23, 95 % CI 3.17, 5.65). Public injecting showed a statistically non-significant association with HIV infection (OR 1.41, 95 % CI 0.80, 2.46). Public injecting was also associated with a higher willingness to use supervised injection facilities (OR 2.66, 95 % CI 1.86, 3.80). Conclusion: Public injecting is prevalent among PWID and associated with various adverse drug- and health-related outcomes, highlighting the need for increased access to safe injection spaces. Findings support developing interventions to reduce harms from public injecting, such as addressing structural risks from law enforcement, expanding naloxone programs, and establishing overdose prevention centers. Housing interventions, in particular, could serve as an effective upstream strategy to reduce public injecting and related harms.

Heroin, Fentanyl, Intentional Fentanyl Use and HIV Transmission in a Community-Recruited Sample of Persons Who Inject Drugs, New York City: 2021–2023

COVID-19 vaccination uptake and determinants of booster vaccination among persons who inject drugs in New York City

Facilitators and barriers to monitoring and evaluation at syringe service programs

Hepatitis C treatment outcomes among people who inject drugs experiencing unstable versus stable housing: Systematic review and meta-analysis

COVID-19 vaccination and HIV transmission among persons who inject drugs during the first two years of the COVID-19 pandemic in New York City

Field Testing the “Avoid the Needle” Intervention for Persons at Risk for Transitioning to Injecting Drug Use in Tallinn, Estonia and New York City, USA

Global epidemiology of abortion among female sex workers: a systematic review, meta-analysis, and meta-regression

HIV risk and prevention among clients of a delivery-based harm reduction service during an HIV outbreak among people who use drugs in northern rural Minnesota, USA

Non-fatal drug overdose among persons who inject drugs during first two years of the COVID-19 pandemic in New York City: Prevalence, risk factors

Understanding intentionality of fentanyl use and drug overdose risk: Findings from a mixed methods study of people who inject drugs in New York City

Modeling HIV transmission among persons who inject drugs (PWID) at the “End of the HIV Epidemic” and during the COVID-19 pandemic

Recurrent Injecting Drug Use as a Mediator between Psychiatric Disorder and Non-Fatal Overdose

Thick trust, thin trust, social capital, and health outcomes among trans women of color in New York City

Is your syringe services program cost-saving to society? A methodological case study

Hepatitis C incidence and prevalence among Puerto Rican people who use drugs in New York City

Toward the Interpretation of Positive Testing for Fentanyl and Its Analogs in Real Hair Samples: Preliminary Considerations

Alternative kinship structures, resilience and social support among immigrant trans Latinas in the USA

Geographic distribution of risk ("Hotspots") for HIV, HCV, and drug overdose among persons who use drugs in New York City: The importance of local history

Injection and Heterosexual Risk Behaviors for HIV Infection Among Non-gay Identifying Men Who Have Sex with Men and Women

Prescription opiate analgesics, heroin, HIV and HCV among persons who inject drugs in New York City, 2016-2018

Being “hooked up” during a sharp increase in the availability of illicitly manufactured fentanyl: Adaptations of drug using practices among people who use drugs (PWUD) in New York City