Tracey McCormick wears a white do-rag, a basketball jacket and a grateful expression. Her neighborhood of boarded-up houses, rife with drug addiction and prostitution, is short on warm comforts.
But every Thursday before the sun rises, she can count on finding a van parked in the same spot, a generator purring to ensure a toasty interior. There, women greet her with hot chocolate, granola bars and medical referrals.
"I look so forward to seeing you folks," said McCormick, 41, sipping from a mug in the van's breakfast nook. "It makes my day, for real."
The Baltimore City Health Department recently launched its first program aimed at curbing prostitution and related health hazards, which include HIV and other sexually transmitted diseases.
The program, operated from a city needle-exchange van, serves two neighborhoods known for a sex trade that many addicted women rely upon to pay for drugs, food and shelter.
Outreach workers Shirldene Brown and Melanie Reese walk loops around the neighborhoods, hoping to draw in women who are looking for drugs or sex customers who might be driving to or from work. Women visiting the van can be tested for HIV, can exchange dirty needles for clean ones, or can pick up supplies including alcohol swabs and lip balm.
The initiative is called WOW, for Women Outreaching to Women, and includes health and drug-treatment referrals. But to the Health Department official who conceived it, the program is all about starting a conversation that might put women on the right course.
"Nobody can save any one person, but we might be able to give them choices where they can do that themselves," said Chris Serio-Chapman.
Women who sell sex are considered core transmitters of HIV because of their high infection rates and multiple partners. Compounding the problem are their male customers, who often refuse to use condoms.
Jacqueline Robarge, director of a nonprofit assistance group called Power Inside, is a regular presence on the van. She is familiar to many of the women who stop by. They call her by name and embrace her when they meet. McCormick recognized her from a prison-support group that Robarge runs.
"We're always here to problem-solve, to be a cheerleader," Robarge said of the new program.
WOW's $68,000 budget is enough to carry it through June, and the Health Department is applying for a grant to continue longer.
One aim is to connect women with treatment programs offering buprenorphine, an opioid substitute that blocks the craving for heroin. Once off heroin, women might stop selling sex, officials say.
But treatment works only if patients show up. So far, WOW has referred 13 women, but only one has appeared consistently enough to be enrolled.
"It's seems so easy, just asking them to go to the doctor and get treatment, but for them, it's really hard to change," said Serio-Chapman. "We're just going to keep coming back and encouraging them."
McCormick, who has lost custody of her two young children, hasn't shown up for two appointments despite having a wish list of things she'd like to accomplish.
"Once I get my identification card, I want to get a job, then a home, then my kids back," she said, warming up on a frosty morning.
McCormick said she had resorted to prostitution to raise money for drugs, but not as often as many of her neighbors.
Susan G. Sherman, an epidemiologist with the Johns Hopkins Bloomberg School of Public Health, will evaluate the van program to determine, among other things, its success in reducing risk factors for HIV, such as drug abuse and prostitution. "It's sort of a drop in the bucket in a sea of a lot of despair," Sherman said.