Nationally up to 60 % of persons living with HIV are neither taking antiretroviral therapy (ART) nor well engaged in HIV care, mainly racial/ethnic minorities. This study examined a new culturally targeted multi-component intervention to address emotional, attitudinal, and social/structural barriers to ART initiation and HIV care. Participants (N = 95) were African American/Black and Latino adults with CD4<500 cells/mm3 not taking ART, randomized 1:1 to intervention or control arms, the latter receiving treatment as usual. Primary endpoints were adherence, evaluated via ART concentrations in hair samples, and HIV viral load suppression. The intervention was feasible and acceptable. Eight months post-baseline, intervention participants tended to be more likely to evidence “good” (that is, 7 days/week) adherence (60 vs. 26.7 %; p = 0.087; OR = 3.95), and had lower viral load levels than controls (t(22) = 2.29, p = 0.032; OR = 5.20), both large effect sizes. This highly promising intervention merits further study.
Trauma‐informed practices in the juvenile justice system are increasingly recognized as effective for promoting public safety through case management, rehabilitation, and treatment that is responsive to a traumatic event exposure and current trauma reactions. As court systems explore integration of trauma‐informed practices, tools for identifying best practices and strategically implementing trauma‐informed approaches are integral for judges and court administrators aiming to develop trauma‐informed courts. The current paper reviews the National Child Traumatic Stress Network's development of the Trauma‐Informed Juvenile Court Self‐Assessment (TI‐JCSA). Implications for self‐guided strategies to shift court practices and policies to align with trauma‐informed approaches will be discussed.
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