Women who sell sex for drugs will receive new attention from public health authorities interested in finding ways to curb the spread of HIV.
State and city health officials say they will join forces to explore the links between prostitution, drug addiction and transmission of the virus.
Officials with both agencies said they will hold the first in a series of meetings this month in an effort to tap the expertise of community organizations that have been helping women engaged in prostitution.
Baltimore Health Commissioner Dr. Joshua M. Sharfstein said the agencies plan a two-pronged approach. The first is a question: "Are we doing everything we can do to reach this population?"
Second, he said, officials will consider how to collect better data on prostitution and its role in the AIDS epidemic. Such information will help policymakers decide how much money needs to be spent and on what type of services.
The fact-finding was triggered by The Sun's publication this week of a report on the plight of female addicts who raise money by selling sex to get drugs, the officials said. Prostitution is an important but largely overlooked reason why Baltimore has the nation's second-highest rate of AIDS diagnoses, according to the most recent data.
Experts say prostitutes are "core transmitters" of the virus because of their high infection rates and large number of sexual contacts. Many involved in this life -- including two women profiled in The Sun's report -- had been molested and introduced to drugs and alcohol during childhood. Many are also victims of robberies, assaults and rapes.
Advocates who extend services to women engaged in prostitution say there are not enough housing and drug treatment options. Two of those advocates greeted the news of the city's plans warmly.
"There have been fits and starts around this issue -- the intersection of women, addiction and trauma," said Jacqueline Robarge, director of Power Inside, an East Baltimore group.
"I'm unsure why it hasn't gained traction before, but I'm hopeful that as people become more aware of how serious the issue is, that we can put forth a good-faith effort," Robarge said.
With cold weather approaching, Robarge said, the discussions will be occurring at a time of great need.
"Women are dying, women are overdosing, and there are going to be many women trading sex for housing just to stay warm," she said.
Sidney Ford, director of You Are Never Alone, a drop-in center in West Baltimore, said the effort was "an exciting and outstanding initiative."
'A lot of promise'
"There is a lot of promise in any collaboration between the city, state and private providers to focus attention on this much-neglected issue," he said.
Claudia Gray, prevention chief at the Maryland AIDS Administration, said that the first meeting will bring together four or five community organizations serving female prostitutes. She declined to identify the groups.
She said officials will ask leaders of the groups about the services they provide and what they perceive to be their greatest needs.
Officials hope this and subsequent meetings will help equip them to develop a better strategy for reducing prostitution and its health effects.
Dr. William Blattner, co-director of the Baltimore City Commission on HIV/AIDS, said he will raise the topic at the group's next meeting Dec. 14. There, too, the commission will draw on people familiar with the female addicts' lifestyles.
"I think we need to ask some tough questions about how things are handled in this city in terms of the Block and other places," said Blattner, epidemiology director at the University of Maryland's Institute of Human Virology.
Some of the women interviewed for the Sun report said they danced and performed sexual favors at strip clubs on the Block before setting out as prostitutes.
The Baltimore Health Department recently announced its first initiative aimed directly at helping women involved in prostitution.
Starting in January, the agency will send a van twice a week to locations well known for street prostitution.
Outreach workers will fan out into the surrounding neighborhoods in an effort to persuade women to be tested for HIV and accept referrals to services such as drug treatment and shelters.
Meanwhile, the state's attorney's office is moving forward with plans to establish a weekly prostitution court sometime next year.
The court, in planning for several months, will link defendants to various types of services. Its sessions will be held in the Hargrove District Courthouse at 700 E. Patapsco Ave. in southeast Baltimore. All prostitution cases will be handled there, no matter where the arrests occurred.
Public and private agencies dealing with housing, drug treatment, HIV and other related issues will be asked to help out with referrals and counseling.
Defendants may be able to avoid a jail sentence if they accept referrals for treatment, counseling or other services.
"Having them do 60 days or 90 days at a time, then releasing them -- with no services and no support and no knowledge of where to turn -- leads to them doing life in prison in an installment plan," said Jennifer Etheridge, an assistant state's attorney involved in the planning.
To read The Sun's special report and find other information on aids, visit www.baltimoresun. com/AIDS
Related coverage at baltimoresun.com/aids