Little is known how older adults with a current or recent experience of homelessness navigated the switch to telehealth during the COVID-19 pandemic. Researchers examined the perceptions and use of telehealth, sampling from a larger longitudinal study on homeless-experienced adults in Oakland, CA. They found that the participants experienced challenges accessing the necessary technologies for telehealth.

People who use drugs (PWUD) commonly experience housing instability due to intersecting structural vulnerabilities. Researchers conducted a qualitative study in Vancouver, Canada's downtown eastside, interviewing PWUD who were recently evicted fron the downtown eastside. Narratives from the interviewees provided context on how the demands of the institutional circuit deepened vulnerablitities and prolonged experiences in homelessness. Researchers suggested that interventions that address survival needs and preserve agency will be necessary to mitigate risks within the institutional circuit.

People who inject drugs (PWID) experience housing instability and other structural barriers, making it hard for PWID to complete direct-acting antiviral (DAA) treatment of Hepatitis C. Researchers found that simple, low-cost medical storage containers, can be incorporated as a key component of a medication management plan. It is important to create a non-judgemental approach to providing HCV care.

High users of the health care system use a disproportionate amount of health services yet have poorer health outcomes. This study aimed to examine natural trends in emergency department visits among high users of health and social services and assess whether the trends differed during the COVID-19 pandemic. In this retrospective cohort study, researchers found that there was a decrease in emergency department visits. Further research is needed to elucidate COVID-19 pandemic specific factors associated with a decrease in emergency department visits.

People living with HIV (PLH) experiencing homelessness or unstable housing have lower rates of viral suppression compared to people who are housed. In 2020, only 20% of PLH experiencing homelessness in San Francisco were virally suppressed, compared to 71% of those who were housed. Researchers examined case preferences among PLH experiencing homelessness during the COVID-19 pandemic in San Francisco. They found that the strongest preference were for the same provider, visit incentives, and drop-in visits.

In this qualitative study, UCSF BHHI researchers found that providing mobile testing, incentives, and trusted community members for outreach mitigated barriers to COVID-19 testing and v...

Long-acting injectable antiretroviral therapy (LAI-ART) is approved for treatment-naive or experienced people with human immunodeficiency virus (HIV; PWH). The researchers performed the first LAI-ART demonstration project to include PWH unable to achieve or maintain viral suppression due to challenges adhering to oral ART at San Francisco's Ward 86. Researchers found preliminary short-term effectiveness of the treatment. More data on LAI-ART in hard-to-reach populations are needed.

People living with HIV experiencing homelessness are more likely to have higher viral loads. The POP-UP model at the Ward 86 HIV clinic in San Francisco was designed to address barriers to care engagement. Researchers found an improvement in the 12-month HIV viral suppression from 0% to 44%. However, many patients were not virally suppressed. Researchers suggest that POP-UP clinics are promising to improve care engagement and HIV viral suppression among people experiencing homelessness.

A new study from UCSF Benioff Homelessness and Housing Initiative and the San Francisco Department of Public Health describes how San Francisco rapidly scaled a hotel-based isolation and quarantine (I/Q) system of care for people experiencing homelessness during the COVID-19 pandemic. Researchers found the program safely delivered integrated medical and behavioral health support to more than 1000 individuals outside the hospital setting, while helping to preserve hospital capacity.

People living with HIV/AIDS (PLWHA) have an increased risk of experiencing homelessness. The underlying drivers of homelessness are structural, however individual factors such as mental health and substance use problems are also common drivers. People living with HIV/AIDS who experience homelessness are more likely to have uncontrolled viral load. Researchers from BHHI suggest integrating HIV treatment with mental health and substance use treatment.

This study from UCSF BHHI researchers examined deaths among people experiencing homelessness in San Francisco during the first year of the COVID-19 pandemic. They found 82% of 331 deaths were associated with drug overdose, not COVID-19 infection. Traumatic injury, including homicide and suicide, was the second most common cause of death. This research highlights a need for strategies that address both homelessness and drug use, including housing, evidence-based treatment of opioid addiction, and overdose prevention programs.

Drug overdose has increased in the U.S. since the COVID-19 pandemic began in 2020. In San Francisco, single-room occupancy (SRO) tenants are more likely to dive of opioid overdose than non-SRO residents. The SRO project aimed to reduce fatal overdoses in SROs. In this eight month ethnographic field work, researchers found that the SRO project increased awareness, access to, and understanding of naloxone, as well as, supporting the privacy and autonomy of tenants regarding their drug use.

Following is a statement by Dr. Margot Kushel, MD, Director of the Benioff Homelessness and Housing Initiative (BHHI) at the University of California, San Francisco on the 2023 Annual Homeless Assessment Report, released today by the U.S. Department of Housing and Urban Development.

Conducted by the UCSF Benioff Homelessness and Housing Initiative, the California Statewide Study of People Experiencing Homelessness (CASPEH) is the largest representative study of homelessness in the United States since the mid-1990s. The study provides a comprehensive look at the causes and consequences of homelessness in California and recommends policy changes to shape programs in response.

To better understand the experiences of Black Californians experiencing homelessness, the UCSF Benioff Homelessness and Housing Initiative examined the experience of Black Californians within the California Statewide Study of People Experiencing Homelessness (CASPEH), the largest representative study of homelessness since the mid-1990s. This report reviews who experiences homelessness in the Black community, what may have precipitated their homelessness, experiences during their episode of homelessness, and what impacts their return to permanent housing. These findings aim to inform evidence-based solutions for preventing and ending homelessness for Black Californians.

To better understand the experiences of survivors of intimate partner violence currently experiencing homelessness, this report analyzed data related to IPV in the California Statewide Study of People Experiencing Homelessness (CASPEH)—the largest representative study of homelessness since the mid-1990s. The mixed-methods study included data about participants’ experiences of violence across the life course, in the six months prior to homelessness, and during their current episode of homelessness. The report presents these findings to advance evidence-based solutions for preventing and responding to homelessness among survivors of IPV. 

The University of California, San Francisco Benioff Homelessness and Housing Initiative (BHHI) today released a special report on Black Californians’ experiences of homelessness. The report explores who in the Black community experiences homelessness, how they lost their housing, their experiences while homeless, and the barriers they face to regaining housing. The goal of the report is to inform evidence-based solutions for preventing and ending homelessness for Black Californians.

The COVID-19 pandemic disrupted economic systems, social networks, and individual behaviors, altering patterns in health care use. In this study, researchers compared homeless and unstably housed (HSH) women who did and did not use an emergency department during the first 10 months of the pandemic. The researchers found that the rate of emergency department use among HUH women during the pandemic was similar to prior research.

COVID-19 impacted access to medical care and social services, potentially worsening HIV outcomes among people experiencing homelessness. In San Francisco, Ward 86, initiated POP-UP, a low-barrier, multicomponent model of care to address barriers to care for people living with HIV experiencing homelessness. Researchers found that care engagement and viral suppression did not worsen among the 85 patients enrolled, despite concerns that the COVID-19 pandemic might worsen outcomes. The study suggests that multicomponent interventions may help maintain viral suppression despite unanticipated structural barriers.

Domestic violence, frequently referred to as intimate partner violence (IPV), is a common precipitant of homelessness. This webinar is about the intersection of intimate partner violence and homelessness. Anita Hargrave, MD; Lived Expertise Advisory Board Members Jesica Giannola and Dez Martinez; Tiana Moore, PhD, and Debbie Chang, MPH, CEO of the Blue Shield of California Foundation discussed relevant findings from the California Statewide Study of People Experiencing Homelessness (CASPEH), highlighted key policy recommendations, and answered audience questions.

Veteran homelessness has dropped about 55% in the United States, while it has remained relatively stagnant amongst the general population. The US government has reached a consensus and has offered a wide range of programs to limit homelessness or factors that put people at risk for experiencing homelessness. The VA’s Supportive Services for Veteran Families (SSVF), the Department of Housing and Urban Development’s (HUD) Veterans Affairs Supportive Housing (VASH) program are the foundation to the efforts. Margot Kushel, MD, a professor of medicine and director of the Benioff Homelessness and Housing Initiative at UCSF, said "I think it gives us a blueprint of exactly what we need to do."

During the COVID-19 pandemic youth experiencing homelessness (YEH) were disproportionately impacted; there were common upstream factors, including racism, homophobia, poverty, and structural violence that place youth at risk for homelessness and exposure to SARS-CoV-2. Public health guidelines overlooked YEH. In this commentary, researchers discuss practical strategies to address the unique health and social needs of YEH.