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Its a city not a suburb.

If you hang around certain places in SF, yes you would see all these sights. If they bother you, avoid Civic Center and Market Street between Montgomery and Van Ness. Golden Gate park is messy and disreputable on the far eastern side. Then there is skid row, the shipyard and the poorer neighborhoods, but those places are the same anywhere.

The rest of the place, Golden Gate park included, is neat, clean, safe and beautiful as anywhere in the world, and far more so than most.

I saw many of those sights in the financial district, not skid row. It isn't confined to the tenderloid or other skid row areas. The BART stations smell of urine, and I was panhandled while standing in line, and while at the ticket machines. I used to work in SF on Sansome street, not exactly skid row. I'd have to step around vomit and human manure in the mornings. Lovely. When going to the opera house, we were accosted by many homeless panhandling us, and I didn't feel safe. Many of them are agressive. I've never been to the shipyards or the poorer neighborhoods. If they are worse than what I saw, then I'm glad I hadn't gone there. These things are enough to make me very much prefer suburban sprawl.