The authors' research and that of others documents the pervasiveness of witnessed or indirect violence in the daily lives of street-level prostitutes both within and outside the activities of prostitution. There is also evidence that exposure to indirect violence may lead to experimentation with and the first use of drugs as a means of coping with the emotional trauma linked to life in a violent environment. Further, exposure to indirect violence leads to the erosion of self-esteem, a factor in chronic depression and anxiety. The risks inherent to street-level prostitution, notably sexual contact with partners with HIV infection and intravenous drug use, further increase prostitutes' risk for HIV infection. This occurs in an environment with limited support services for dealing with trauma. Agencies responsible for interventions to protect citizens from harms to their health should target women who have been exposed to indirect violence for prolonged periods of time. Intervention for street-level prostitutes must be attentive to the effects of exposure to a violent environment that induces trauma, drug abuse as a coping mechanism, and attendant risks for HIV infection. 96 references