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Law enforcement agencies are being urged or required to use victim-centered approaches that provide child sex trafficking (CST) victims with support and services. However, we have little information about the utilization and effectiveness of policies, practices and training programs related to CST. The National Law Enforcement Agency Child Sex Trafficking is a national survey of law enforcement agencies across the U.S. The current study reports on data collected from 1,306 agencies that provided feedback on the use of nine victim-centered approaches to CST at their agency. Data also included whether each agency investigated at least one case of CST in the year 2021. Almost all agencies (97.5%) said they used or had access to at least one victim-centered approach to CST investigations, with larger agencies reporting a greater number of approaches. Two policies were significantly related to a greater likelihood of investigating at least one case of CST in 2021: Access to a CST-specific task force and access to a CST-specific victim service agency. Findings document a growing orientation to these cases by law enforcement that recognizes youth victimization, with innovative approaches to identification and support. Community collaboration appears to be critical to helping to identify, support and provide justice to CST victims.