Sure, you get better at dodging feces and ignoring the drug use, littering, and theft, but let's not pretend it's confined to "downtown, the tenderloin, soma, etc".
I've lived and worked in Manhattan and DC, and spent time in many international cities. I've walked all over all of them, and never felt less safe than I regularly did walking to work in soma.
SF has a unique political situation, a climate that makes homelessness "bearable" and a huge number of absentee landlords (thanks, Prop 13).
We were sad to move out in January. SF is a gorgeous city filled with kind, interesting people. "Horrible dystopia" is certainly an exaggeration, but the situation is bad and has gotten much worse in the past few years.
880 had cardboard cities up and down it; my morning walk for coffee had 3-4 “regulars” living along it with frequent homeless transients.
Many neighborhoods full of Multi-million dollar properties that looked, and felt, like unmaintained slums.
The societal decay of SF extends through the entire Bay Area; certainly extends outside of its “tourist” centers.
Yes, some parts of the city definitely have it worse than others, but I don't think it's fair to dismiss these issues on the basis that there are small residential enclaves that are less affected.
If you want to enjoy SF's restaurant scene, nightlife, hiking, etc., you will inevitably have to go to areas where this crime is rampant. And this crime should not be happening in an American city, let alone one that is so rich.
Mainly it's the hills. Hard to be homeless and hike up the castro hill. Same with why Bernal is so clean.
But anywhere in Mission or along Market gets pretty sketch.
2000 years ago humans realized people shitting in random places was bad and needed to be solved. And it was.
And now we have people saying human shit on the sidewalks is “not a problem”.