Kelly Ray Knight
Dados Biográficos
| ID | 651638 |
|---|---|
| NOME | Kelly Ray Knight |
| PRENOMES | Kelly Ray |
| SOBRENOME | Knight |
| ASSINATURA | KNIGHT K R |
| AFILIAÇÕES | University of California, San Francisco |
| ORCID | 0000-0002-5838-8592 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 43 |
| TOTAL DE CITAÇÕES | 88 |
| TOTAL COMO AUTOR | 43 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 1996 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2026 |
| ÍNDICE H | 6 |
Understanding the Impact of Structural Racism and Violence Across the Lifespan on Overdose Vulnerability Among Black San Franciscans Experiencing Homelessness
Overdose in California is highly racialized, with Black Californians experiencing excessive mortality. People experiencing homelessness (PEH) report high rates of fentanyl-stimulant co-use and drug-related harm. There is limited research examining structural racism and intersectional violence of policing, homelessness, and overdose throughout the lifespan of Black people. POLY HOME is a qualitative study among PEH who fentanyl and stimulants in S…
Barriers to Buprenorphine Treatment Among People Experiencing Homelessness
People experiencing homelessness (PEH) face a high risk of opioid-related deaths, yet there is limited qualitative data on the barriers encountered when accessing buprenorphine treatment for opioid use disorder (OUD). To address this gap, we interviewed 28 clinicians, outreach workers, and administrators from organizations serving PEH with OUD. Our goal was to understand the barriers and facilitators at the patient, clinic, and institutional leve…
How Anti-Immigrant Policies Impact Research Among Latinx and Undocumented People Who Use Drugs
Since January 2025, anti-immigrant policies, criminalization, and xenophobic rhetoric have rapidly intensified, threatening the health and well-being of Latinx communities. Under new executive orders, funding and research related to racial health disparities and equity is being scaled back or halted. The negative effects of immigration enforcement on the health of Latinx communities have been well documented. Less is known about how the implement…
Methodological Lessons Learned From a Longitudinal Study of Overdose Vulnerability Among People Experiencing Homelessness Who Co-use Fentanyl and Stimulants in San Francisco, CA, USA
The U.S. overdose crisis is now driven by polysubstance use involving fentanyl and stimulants. We received funding through the National Institutes on Drug Abuse’s Helping to End Addiction Long-Term (HEAL) initiative to conduct longitudinal qualitative research on polysubstance use among people experiencing homelessness (PEH) in San Francisco, California. An Intersectional Risk Environment Framework was used to examine the interaction between soci…
“We remember the pain”
Rates of homelessness among adults aged 50 and over are rising. Common strategies for exiting homelessness rely on social and family support. However, intergenerational trauma may disrupt these social support networks and contribute to homelessness. Understanding the impact of intergenerational trauma on living with family or friends may give insight into addressing homelessness among older adults. We purposefully sampled 46 adults who reported l…
Loneliness among homeless-experienced older adults with cognitive or functional impairments
Loneliness is a complex and heterogenous social phenomenon, with homeless-experienced older adults with cognitive or functional impairments exhibiting diverse loneliness experiences based on their individual life circumstances and needs. While the most distressing loneliness experience occurred among those with physical impairment and mobility challenges, social and structural factors such as interpersonal and structural violence during homelessn…
Radical hospitality
The co-location of an OPS within a multi-service drop-in center is an important example of how such an organization can build positive sociality among PWUD while protecting autonomy and reducing overdose mortality. Overdose response and reversal is an act of relational accountability in which friends, peers, and even strangers intervene to protect and revive one another. This powerful intervention was operationalized as an anti-oppressive, horizo…
The Clinical Evolutions of Surveillance and Violence During Three Contemporary US Crises
In 2020, three crises coalesced to transform the clinical care landscape of addiction medicine in the United States (US). The opioid overdose crisis (crisis #1), which had been contributing to excess US mortality for over two decades, worsened during the COVID-19 pandemic (crisis #2). The racial reckoning (crisis #3) spurred by the murder of George Floyd at the hands of police impacted clinical care, especially in safety net clinical settings whe…
Accounting for the interplay of interpersonal and structural trauma in the treatment of chronic non-cancer pain, opioid use disorder, and mental health in urban safety-net primary care clinics
While the epidemiological literature recognizes associations between chronic non-cancer pain (CNCP), opioid use disorder (OUD), and interpersonal trauma stemming from physical, emotional, sexual abuse or neglect, the complex etiologies and interplay between interpersonal and structural traumas in CNCP populations are underexamined. Research has documented the relationship between experiencing multiple adverse childhood experiences (ACEs) and the …
Barriers and facilitators to resolving older adult homelessness through stays with family
Living with family and friends is a common strategy used to prevent or exit homelessness, but little is known about structural barriers that impede family and friends' ability to provide temporary or permanent housing for older homeless adults. We conducted semi-structured interviews with 46 homeless participants from the HOPE HOME study, a cohort of 350 community-recruited homeless adults age 50 or older in Oakland, CA, who reported having staye…
Get in and get out, get on with life”
Eased restrictions on methadone van implementation represent a new strategy for expanding OUD treatment access. In our qualitative study, patients and staff were satisfied with methadone van implementation, though the OTP still faced implementation challenges. Audio-only counseling and other workflow solutions helped facilitate implementation, and several policy considerations like maintaining audio-only counseling flexibilities are key to ensuri…
Rethinking urban-rural designations in public health surveillance of the overdose crisis and crafting an agenda for future monitoring
Rurality has served as a key concept in popular and scientific understandings of the US overdose crisis, with White, rural, and low-income areas thought to be most heavily affected. However, we observe that overdose trends have risen nearly uniformly across the urban-rural designations employed in most research, implying that their importance has likely been overstated or incorrectly conceptualized. Nevertheless, urbanicity/rurality does serve as…
Saving lives in our homes
It's no foundation, there's no stabilization, you're just scattered
People who use drugs (PWUD) commonly experience housing instability due to intersecting structural vulnerabilities (e.g., drug prohibition, discriminatory housing policies), and prejudicial or illegal evictions are common. In Vancouver, Canada, evictions have proliferated in the Downtown Eastside, a historically low-income neighbourhood with high rates of drug use and housing instability, resulting in many PWUD being evicted into homelessness. Th…
A mereological qualitative study protocol for understanding the lived experience of homelessness in California
Although qualitative interview studies provide in-depth understandings of the opinions and lived experiences of social groups, they are typically small in scale, bounded by a small number of physical or virtual spaces, and designed to capture relatively demarcated aspects of participants' experiences. This paper describes the qualitative component of a large mixed method study of homelessness in California. The qualitative study consisted of seve…
Temporary stays with housed family and friends among older adults experiencing homelessness
Background: The proportion of adults age 50 and older experiencing homelessness is growing. People at risk for homelessness may stay with family and friends to prevent homelessness. Moving in with housed family and friends is a strategy used to exit homelessness. Little is known about these stays with family and friends. This study examined the motivations for and challenges of older adults experiencing homelessness staying with or moving in with…
Substance use policy and practice in the Covid-19 pandemic
The COVID-19 pandemic has created an unprecedented natural experiment in drug policy, treatment delivery, and harm reduction strategies by exposing wide variation in public health infrastructures and social safety nets around the world. Using qualitative data including ethnographic methods, questionnaires, and semi-structured interviews with people who use drugs (PWUD) and Delphi-method with experts from field sites spanning 13 different countrie…
Federal and State Regulatory Changes to Methadone Take-Home Doses
Structural Adaptations to Methadone Maintenance Treatment and Take-Home Dosing for Opioid Use Disorder in the Era of Covid-19
Author(s): Suen, Leslie W; Coe, William H; Wyatt, Janan P; Adams, Zoe M; Gandhi, Mona; Batchelor, Hannah M; Castellanos, Stacy; Joshi, Neena; Satterwhite, Shannon; Pérez-Rodríguez, Rafael; Rodríguez-Guerra, Esther; Albizu-Garcia, Carmen E; Knight, Kelly R; Jordan, Ayana
The Opioid Industry Documents Archive
Structural Competency
Introduction: Research on disparities in health and health care has demonstrated that social, economic, and political factors are key drivers of poor health outcomes. Yet the role of such structural forces on health and health care has been incorporated unevenly into medical training. The framework of structural competency offers a paradigm for training health professionals to recognize and respond to the impact of upstream, structural factors on…
Racial discrimination in the life course of older adults experiencing homelessness
Over 2.5 million people experience homelessness yearly in the United States. Black persons are overrepresented by three-fold among those experiencing homelessness but little research has examined the relationship between race and homelessness. We aimed to understand the relationship between race and the experience of homelessness for older adults. We used grounded theory methodology to analyze in-depth qualitative interviews (n = 65) of persons e…
Structural competency and global health education
Structural competency is a new curricular framework for training health professionals to recognise and respond to disease and its unequal distribution as the outcome of social structures, such as economic and legal systems, healthcare and taxation policies, and international institutions. While extensive global health research has linked social structures to the disproportionate burden of disease in the Global South, formal attempts to incorporat…
Patients’ and clinicians’ perspectives of co-use of cannabis and opioids for chronic non-cancer pain management in primary care
Women on the Edge
The current “opioid epidemic” provides an opportunity to identify age-old social anxieties about drug use while opening up new lines of inquiry about how and why drug use epidemics become gendered. This paper reflects on the intertwined phenomena of opioid and benzodiazepine prescribing to U.S. women to examine how gender, race, and class inform social anxieties about reproduction and parenting. Multiple discourses abound about the relationship b…
You can't do nothing in this damn place”
In an effort to deepen our understanding of how circumstances of forced separation and the interdiction of physical contact affect women's sexual behavior, we investigated the development and maintenance of heterosexual couples' intimacy when the male partner is incarcerated. As HIV-prevention scientists who work with women visiting men at a California state prison, we recognize that correctional control extends to these women's bodies, both when…
Opioid pharmacovigilance
A Day
It's no foundation, there's no stabilization, you're just scattered
People who use drugs (PWUD) commonly experience housing instability due to intersecting structural vulnerabilities (e.g., drug prohibition, discriminatory housing policies), and prejudicial or illegal evictions are common. In Vancouver, Canada, evictions have proliferated in the Downtown Eastside, a historically low-income neighbourhood with high rates of drug use and housing instability, resulting in many PWUD being evicted into homelessness. Th…
Women on the Edge
The current “opioid epidemic” provides an opportunity to identify age-old social anxieties about drug use while opening up new lines of inquiry about how and why drug use epidemics become gendered. This paper reflects on the intertwined phenomena of opioid and benzodiazepine prescribing to U.S. women to examine how gender, race, and class inform social anxieties about reproduction and parenting. Multiple discourses abound about the relationship b…
Recent Violence in a Community-Based Sample of Homeless and Unstably Housed Women With High Levels of Psychiatric Comorbidity
Objectives. We determined associations between co-occurring psychiatric conditions and violence against homeless and unstably housed women. Methods. Between 2008 and 2010, we interviewed homeless and unstably housed women recruited from community venues about violence, socioeconomic factors, and psychiatric conditions. We used multivariable logistic regression to determine independent correlates of violence. Results. Among 291 women, 97% screened…
Unprotected Sexual Behavior Among Heterosexual HIV-Positive Injection Drug Using Men
Federal and State Regulatory Changes to Methadone Take-Home Doses
Addiction trajectories
Treatment as Harm Reduction, Defunding as Harm Maximization
Despite numerous research studies demonstrating the efficacy of methadone maintenance treatment (MMT) in general and the value of retention in particular, the increasing defunding of this modality has compromised its potential. From 1990 to 1995 the lead author conducted a longitudinal research project to determine the impact of the cost of treatment on 233 San Francisco Bay Area study participants seeking, enrolled in, or defunded from MMT. This…
Violence
We investigate the relationships between violence, drug use and methadone maintenance treatment (MMT) for women injection drug users (IDUs). The data presented here come from a longitudinal study of 233 IDUs both in and out of MMT in the San Francisco Bay Area. Each was interviewed five times over a period of three years, both qualitatively and quantitatively. Using grounded theory principals, we analyze 55 women's accounts of violence. We find t…
Managing HIV among serodiscordant heterosexual couples
A qualitative study was conducted with 28 men and women in HIV-serodiscordant couples to explore the management of HIV in their relationship. Content analysis of the interviews revealed the role of serostatus and stigma in shaping partners' experience of HIV, sex and risk. Partners' differing serostatus often created feelings of alienation within the relationship. Compounding this interpersonal dynamic, the HIV service community was experienced a…
Drug users talk about HIV testing
Injection drug use plays a critical role in the spread of HIV/AIDS, with an estimated 19,000 drug users infected each year. Counselling and testing services can be an important gateway for engaging HIV-infected individuals into medical care and can positively influence the preventive behaviours of IDUs. This study seeks to document and understand the complexity and range of motivations and deterrents to HIV testing among IDUs. Participants were r…
The Life Priorities of HIV-Seropositive Injection Drug Users
You can't do nothing in this damn place”
In an effort to deepen our understanding of how circumstances of forced separation and the interdiction of physical contact affect women's sexual behavior, we investigated the development and maintenance of heterosexual couples' intimacy when the male partner is incarcerated. As HIV-prevention scientists who work with women visiting men at a California state prison, we recognize that correctional control extends to these women's bodies, both when…
Unprotected Sexual Behavior Among Heterosexual HIV-Positive Injection Drug Using Men
Split Ends
Examining the narratives of eighteen heterosexual drug-injecting men living with HIV, this study seeks to understand how HIV-positive men negotiate issues of masculinity, sexuality, and emotional intimacy. It focuses specifically on strategies HIV-positive men use to manage emotional vulnerability in sexual encounters. We identify a core theme of 'splitting,' in which men compartmentalize the domains of sexuality and emotional intimacy. We examin…
Predictors of Current Housing Status Among HIV-Seropositive Injection Drug Users (IDUs)
Syndemic Vulnerability, Sexual and Injection Risk Behaviors, and HIV Continuum of Care Outcomes in HIV-Positive Injection Drug Users
Single room occupancy (SRO) hotels as mental health risk environments among impoverished women
Recent Violence in a Community-Based Sample of Homeless and Unstably Housed Women With High Levels of Psychiatric Comorbidity
Objectives. We determined associations between co-occurring psychiatric conditions and violence against homeless and unstably housed women. Methods. Between 2008 and 2010, we interviewed homeless and unstably housed women recruited from community venues about violence, socioeconomic factors, and psychiatric conditions. We used multivariable logistic regression to determine independent correlates of violence. Results. Among 291 women, 97% screened…
Addicted.pregnant.poor
addicted.pregnant.poor is an ethnography addressing the biomedical, social, political, and ethical dimensions of ongoing illicit drug use during pregnancy. A result of four years of fieldwork in daily-rent hotels – privately owned buildings in which the exploitation of women’s sex work and on-going poor health was normative – the book follows nineteen women who had twenty-three pregnancies. To answer the question ‘What forms of life are possible …
Addiction trajectories
Addicted.pregnant.poor
addicted.pregnant.poor is an ethnography addressing the biomedical, social, political, and ethical dimensions of ongoing illicit drug use during pregnancy. A result of four years of fieldwork in daily-rent hotels – privately owned buildings in which the exploitation of women’s sex work and on-going poor health was normative – the book follows nineteen women who had twenty-three pregnancies. To answer the question ‘What forms of life are possible …
Opioids
Women on the Edge
The current “opioid epidemic” provides an opportunity to identify age-old social anxieties about drug use while opening up new lines of inquiry about how and why drug use epidemics become gendered. This paper reflects on the intertwined phenomena of opioid and benzodiazepine prescribing to U.S. women to examine how gender, race, and class inform social anxieties about reproduction and parenting. Multiple discourses abound about the relationship b…
A Day
Opioid pharmacovigilance
Patients’ and clinicians’ perspectives of co-use of cannabis and opioids for chronic non-cancer pain management in primary care
Structural Competency
Introduction: Research on disparities in health and health care has demonstrated that social, economic, and political factors are key drivers of poor health outcomes. Yet the role of such structural forces on health and health care has been incorporated unevenly into medical training. The framework of structural competency offers a paradigm for training health professionals to recognize and respond to the impact of upstream, structural factors on…
Racial discrimination in the life course of older adults experiencing homelessness
Over 2.5 million people experience homelessness yearly in the United States. Black persons are overrepresented by three-fold among those experiencing homelessness but little research has examined the relationship between race and homelessness. We aimed to understand the relationship between race and the experience of homelessness for older adults. We used grounded theory methodology to analyze in-depth qualitative interviews (n = 65) of persons e…
Structural competency and global health education
Structural competency is a new curricular framework for training health professionals to recognise and respond to disease and its unequal distribution as the outcome of social structures, such as economic and legal systems, healthcare and taxation policies, and international institutions. While extensive global health research has linked social structures to the disproportionate burden of disease in the Global South, formal attempts to incorporat…
Temporary stays with housed family and friends among older adults experiencing homelessness
Background: The proportion of adults age 50 and older experiencing homelessness is growing. People at risk for homelessness may stay with family and friends to prevent homelessness. Moving in with housed family and friends is a strategy used to exit homelessness. Little is known about these stays with family and friends. This study examined the motivations for and challenges of older adults experiencing homelessness staying with or moving in with…
Substance use policy and practice in the Covid-19 pandemic
The COVID-19 pandemic has created an unprecedented natural experiment in drug policy, treatment delivery, and harm reduction strategies by exposing wide variation in public health infrastructures and social safety nets around the world. Using qualitative data including ethnographic methods, questionnaires, and semi-structured interviews with people who use drugs (PWUD) and Delphi-method with experts from field sites spanning 13 different countrie…
Medicine (29 obras) · Psychology (24 obras) · HIV, Drug Use, Sexual Risk (19 obras) · Psychiatry (19 obras) · Sociology (17 obras) · Homelessness and Social Issues (14 obras) · Opioid Use Disorder Treatment (14 obras) · Political science (14 obras) · Qualitative research (14 obras) · Social Psychology (12 obras)