Knox, from Seattle, spent four years behind bars after the half-naked body of fellow exchange student Meredith Kercher was found on 2 November, 2007 in a bedroom of the apartment they shared in the central Italian city of Perugia.
The 31-year-old is controversially back in Italy for a discussion panel entitled "Trial by Media" at the Criminal Justice Festival in the northern city of Modena.
"To tell the truth I am afraid, afraid of being harassed, insulted, afraid of being trapped and new accusations being directed at me," Knox said.
"I have come back because it was something I had to do -- there was a time when I felt at home in this beautiful country and I hope one day to recapture this feeling," Knox, speaking in Italian, told the forum, her voice often close to breaking.
"I know that, despite my acquittal, I remain a controversial figure in the face of public opinion, especially here in Italy. I know many people think I am wicked," said the American.
"Some have even suggested that by being here I am once again traumatising the Kercher family and profaning Meredith's memory," she went on.
"They are wrong," she insisted.
"The fact I continue to be held responsible for the Kerchers' pain shows how powerful false narratives can be and how they can undermine justice, especially when reinforced and amplified by the media," said Knox.
The conference has been organised by a group of Modena lawyers and the Italy Innocence Project, which focuses "on the issues related to wrongful convictions and miscarriages of justice".
"The Italy Innocence Project didn't yet exist when I was wrongly convicted in Perugia," Knox tweeted in May.
From the outset, her case sparked lurid headlines in Britain and Knox's hometown of Seattle, Washington.
Prosecutors described the murder as a drug-fuelled sex game gone awry involving Knox, her Italian boyfriend Raffaele Sollecito and an Ivorian drifter, Rudy Guede.
Sollecito was acquitted alongside Knox, but Guede was convicted in a separate "fast track" trial and is serving a 16-year jail term in Italy.
Defence lawyers argued their clients could not get a fair trial because of the media frenzy over the murder, with lurid headlines seizing on the young US student's nickname "Foxy Knoxy".
Knox left Italy after she was acquitted on appeal in 2011.
In an essay published online on Wednesday, she recalled fleeing the country "in a high-speed chase, paparazzi literally ramming the back of my stepdad's rental car".
Knox's sentence was raised to 28 years in prison when her conviction was upheld in 2014, though both she and Sollecito were finally acquitted by Italy's top court the following year and she returned home to work as a journalist and commentator.