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.

California passed the Community Assistance, Recovery, and Empowerment (CARE) Act in 2022 to provide behavioral health and housing services to individuals with psychotic spectrum and schizophrenia disorders who are deemed unable to care for themselves. This policy brief from the Benioff Homelessness and Housing Initiative at UCSF and the California Policy Lab uses anonymized data to estimate how many San Franciscans in a database of individuals who have contact with the urgent and emergent care system may be eligible for referral to CARE Court and describe their service needs.

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.

The homeless population is aging and adults who experience homelessness for the first time in older age are more likely to progress to chronic homelessness. To prevent or delay homelessness, many people live temporarily live with family or friends. In this qualitative study of homeless older adults, researchers conducted 46 semi-structured interviews. They found that structural barriers to family and friends providing housing for temporary or permanent exits from homelessness included housing regulations, geographic and transportation challenges, and environments inconducive to older adults.

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 the United States there has been a simultaneous rise of mass incarceration and homelessness. Both of these phenomena are driven by the same structural factors, housing being the most important. Researchers present evidence-based approaches to improve housing strategies for reentry populations, prevent homelessness among those in community supervision, and rehouse members of the reentry community experiencing homelessness.

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.

In this cross-sectional study, researchers studied the association between residential relocation and health outcomes in people who inject drugs (PWID). PWID are at an increased risk of low socioeconomic status and homelessness. Researchers found that any residential movement in the past 30 days was associated with increased odds of bad health outcomes.

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.

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.

The number of Latino/a people experiencing homelessness in the United States is increasing due to increased housing costs, economic disruption from the COVID-19 pandemic, and increased homelessness among migrants. There is little known about the lived experiences of Latino/a individuals experiencing homelessness. We conducted qualitative interviews in English and Spanish with 84 participants who self-identified as Latino/a as part of a large mixed methods representative study of homelessness. We analyzed qualitative interview transcripts from the California Statewide Study of People Experiencing Homelessness (CASPEH) to elucidate factors contributing to increased risk of homelessness for the Latino/a population, the vulnerabilities Latino/a individuals face while navigating homelessness, and how these vulnerabilities influence access to housing and services.

A record number of seniors are burdened by high housing costs. A new report from University's Joint Center for Housing Studies sounds the alarm as the US population ages rapidly. The number of seniors who will qualify for federal housing subsidies will continue to grow. The report also notes that more people over the age of 50 are losing housing for the first time. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, said, "Increasingly, the story of homelessness among adults is going to be older adults living in poverty, who are spending what should be their retirement years in the streets."

The University of California, San Francisco Benioff Homelessness and Housing Initiative (BHHI) today released a report that examines Latine Californians' experiences of homelessness and makes recommendations for policymakers and practitioners.

This JAMA Health Forum research letter estimates how ending federal support for Housing First programs could affect homelessness in the United States. Programs incorporating a Housing F...

In the state of California, the three major utility companies, have nearly doubled electricity rates over the last decade. With growing increase in energy demands, the rising utility costs are pushing families already at the margins to the brink of homelessness. Many people are forced to making an impossible choice. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, said, "I think recognizing energy insecurity as a contributor to this crisis, this is the next frontier that we need to really worry about."

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.

People with multiple, complex health and housing needs frequently receive fragmented care because the providing systems operate independently. The California Policy Lab at UC Berkeley and the UCSF Benioff Homelessness and Housing Initiative worked with partners in San Francisco’s public health and criminal legal systems to link together ten years of data from the physical health, behavioral health, housing, and criminal legal sectors.

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.

SAN FRANCISCO (December 28, 2024) – Following is a statement by Dr. Margot Kushel, MD, Director of the Benioff Homelessness and Housing Initiative (BHHI) at the University of California...

Recently the demographic characteristics of people experiencing individual homelessness have changed; more individuals over the age of 50 are experiencing homelessness. BHHI researchers examined the motivations for and challenges of older adults experiencing homelessness staying with or moving in with family or friends. Researchers found barriers to stay such as feelings of shame and concerns about burdening the hosts. Findings suggest that family members and friends may play an important role in supporting older adults experiencing homelessness.

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.

Latine Californians represent more than one-third of the state's homeless population. Yet their experiences are too often left out of research, policy, and service design. To better understand these experiences, we examined data from the California Statewide Study of People Experiencing Homelessness. This report, based on the California Statewide Study of People Experiencing Homelessness (CASPEH), examines who experiences homelessness in the Latine community, their experiences while homeless, and offers evidence-based policy and program solutions.

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 research-backed solutions for preventing and responding to homelessness among survivors of IPV.