TARGETING LINK BETWEEN HIV, PROSTITUTION AND ADDICTION

State, City Health Officials Seek Answers

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.

Insufficient optionsAdvocates 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.

Moving forward 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.