To the Editor In their recent article, Baggett and colleagues1 present an important update on excess mortality among US homeless persons. Following 28 033 individuals, the investigators showed that drug overdose is an epidemic among homeless adults. Our data from a community-recruited cohort of homeless and unstably housed San Francisco women, which began recruiting human immunodeficiency virus (HIV)-infected individuals2 and recently included uninfected individuals (150 HIV positive and 150 HIV negative), indicate remarkably similar results and suggest generalizability of these findings.