Culturally competent care for HIV-infected transgender persons in the inpatient hospital setting: the role of the clinical nurse leader.

HIV infection rates among transgender persons are estimated to be high. This often invisible group is stigmatized and suffers greatly from discrimination in employment, housing, and health care (Lombardi & Van Servellen, 2000; San Francisco AIDS Foundation, 2009, Sevelius, Reznick, Hart & Schwarcz, 2009). HIV-infected transgender persons may require inpatient care at some point in their lives. Inpatient health care personnel are often not aware of issues related to transgender clients and may provide culturally insensitive care. The clinical nurse leader (CNL) could provide transgender patients an ideally positioned advocate to model, instill, and coordinate consistent and culturally competent care at the bedside and beyond. The CNL, acting as an educator and advocate involved in direct patient care, can be instrumental in shaping the inpatient experience for the transgender patient while working to maximize continuity of care to improve patient outcomes. Sesa Keiswetter, MS, RN, is in the RN residency program, behavioral health/medical unit at Washington Hospital Center, Washington, DC. Becky Brotemarkle, MSN/MBA, HIV Infection in Transgender Persons RN, ACRN, CCM, is a clinical instructor, Organizational Systems and Adult Health, School of Nursing, University of Maryland, Baltimore. The authors report no real or perceived vested interests that relate to this article (including relationships with pharmaceutical companies, biomedical device manufacturers, grantors, or other entities whose products or services are related to topics covered in this manuscript) that could be construed as a conflict of interest. HIV-infected persons are considered to be a vulnerable population in the health care system. The risk for discrimination and disparity in care delivery increases when these people are also transgender persons. Identification of HIV-infected transgender persons can be challenging because the data reporting system at the