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But there's one place they can feel safe. Beth Abbit reports. Don't miss a thing by getting the latest from the Manchester Evening News sent direct to your inbox. In between punters they can go and warm up, have a chat with a friendly face, get a hot sweet drink and a pie. It's an urban oasis. And, four nights a week, this van can be found in the red light districts of Strangeways, Cheetham Hill and Back Piccadilly.
It's also a place where they can chat about life and pass the time of day, like any other worker. No-one will judge them behind these doors. From women selling sex to pay the bills, to being tricked into unprotected encounters with strange men, to the emergence of worrying new trends - MASH's frontline staff hear it all.
Two things are clear. Austerity and migration - poverty here and abroad - has changed the nature of the sex trade in Manchester, meaning the women caught up in it are as vulnerable as they've ever been. Hot chocolate is the most popular choice among the sex workers who step aboard for a drink, staff say. Some of the punters are even out at 5am before they start work. Street prostitution has been in the shadows of life in the city since at least the Industrial Revolution, when Manchester began expanding rapidly from the market town it had been; in the midth century, contemporary writers recorded there being anything up to 1, women selling sex.
And, though the city has changed dramatically since then, the sex workers who populate the backstreets on the outskirts of town today are plagued by some of the same problems that troubled their Victorian counterparts.
For a handful, even life-threatening illnesses, once thought to be confined to history, such as syphilis and tuberculosis, are appearing again. The problem goes both ways - with the team hearing cases of beggars approached by men who have tried to engage them in sex work. Many of the women who seek help from MASH have been working on the streets for years. Others are just teenagers. On a typical night the skeleton staff manning the MASH van speak to around 17 women.