Category Archives: Special Needs Adoption

Parenting a Child with Down Syndrome

So what’s it like to parent a child with Down syndrome? How long do you have to read this article? Because I could probably fill a book with the myriad of answers to this question. So for the sake of blog etiquette, I’ll keep it as succinct as possible.

My personal experience only goes so far. Our son, Kirill, was adopted from a Russian institution at the age of five and he’s been home with us for 2.5 years. So a lot of our experience has been influenced by the neglect and trauma of living in an orphanage for the first five years of his life. Our experience is vastly different from many of our friends who have biological children with DS, or who have parented their adopted children with DS from birth or soon after.

First, let’s talk about the medical stuff because people are always concerned about that. Kirill doesn’t currently have any additional health complications that sometimes accompany DS. However, we had to do a lot of testing to rule out any of these common issues AND we had to do a lot of interventions and therapies (still do) to help him learn to do many age-appropriate skills. Medically, we had special X-rays of his spine in case there was any sign of instability, extensive heart testing to make sure there were no issues there, and a swallow study. At first, Kirill couldn’t swallow normally and we had to thicken all of his foods and liquids to make sure he didn’t aspirate on them. We worked with a speech therapist and an occupational therapist on swallowing skills for a few months and these issues quickly resolved for him.

Kirill also had a lot of issues with his eyes and we had to go to a specialist who works with children with his specific condition (strabismus). He also had really bad ear infections and gastrointestinal infections. It took us a little while to sort all of that out too. He has tubes in his ears and he had to be on a special diet/take lots of antibiotics to get his guts regulated and clear of infection. He still needs checkups every six months on both his eyes and his ears.

At first, getting all of Kirill’s doctor’s appointments and therapies set up was hard. We had four therapy appointments on a weekly basis. I kept charts and meticulously wrote down every single thing he did.  I did choose to let my professional goals slow down, with the knowledge that both the doctor’s visits and therapy sessions would likely decrease as Kirill grew older, and I could always work later. (Other parents don’t have the same flexibility as I did, which doesn’t mean they are forced to choose between working and caring for their child. The therapists go to the day care in that situation.)

As far as just the hardest thing we deal with on a day-to-day basis, potty-training has been our greatest parenting challenge. Due to low muscle tone and hyposensitivity (difficulty feeling sensation), we are still working on potty training (Kirill is 7. Average age for children with DS to be fully potty trained is 8…so we are right there with the average). Another difficulty we have with Kirill is socially appropriate behavior. He pushes, eats off other people’s plates, and doesn’t sit still very well (also sounds like a typical child at time…ha). Both of these are to be expected and are not impossible to learn for children with DS, just a little harder to teach/learn.

Kirill also doesn’t speak so that presents a lot of extra challenges. I’ve read percentages of kids with DS that never learn to talk at all…it’s not that high…most children with DS do learn to talk at some level. Honestly, I don’t even care anymore if Kirill talks or not. Sometimes, his non-verbalness (is that a word?) even comes in handy. I never have to worry about him talking incessantly on long car trips. He doesn’t talk back. I get lots of “quiet time” if I just have Kirill around. We have another son who doesn’t have special needs. He is on the opposite end of the spectrum…hyperverbal even. So it’s kind of a nice balance. Many parents of adult children with Down syndrome that I’ve talked with often comment upon the fact that their son or daughter with Downs is the “easiest” of the bunch. Although the individual stories will vary, the overall portrait of family life with a person with DS positive. Is it harder in some ways? Sure. But our family motto has become “easier is not better”.

When other people describe children with DS, they often say things like, “They’re so happy all the time!” or “They just go with the flow and are easy to please.” Well, I’m here to tell you that is a myth. Sorry to disappoint, but Kirill has the full range of emotions that any other human being has and then some. He’s really good at letting us know when he’s upset. I think that myth may be perpetuated by something that I DO see in Kirill. He is easy to get over things. He doesn’t really hold a grudge. His frustrations are the same as our other son, but I do think he “gets over it” faster than Clayton. However, that isn’t true of every child with DS.

Which leads me to the main thing I want you to know about parenting a child with DS. It’s very much like parenting any other child. My joy and heart come from seeing Kirill succeed, watching him grow and learn, and looking forward to his future. Maybe my tune will change as he gets older and we face new challenges, but I don’t really think so. God has always given us what we need when we need it. We just take it one day at a time around here. Kirill has taught us to slow down and not worry so much about tomorrow. It’s actually a pretty awesome to be able to realize that in a world where people get so caught up in the rat race.

A lot of people ask, “Will he ever (insert skill here…talk, potty, etc). Well, we don’t know. What we do know is that Kirill is limited. He’s more needy than other children his age. He’s vulnerable because of his special needs. But so am I. So are you. We are all limited, vulnerable, and needy.

I guess that’s where Jesus becomes the common denominator for us all. We all need help…and my help comes from him and the people he uses in my life. We all need community and family and other people with whom to be interconnected. We all need help from Jesus and each other to do life.

 

So maybe life is harder with a child with DS. Maybe it’s just different. All I know is, I wouldn’t have it any other way.

 

By Tesney Davis, Parent to Kirill from Russia

Video

He took our ‘Yes’ – The Boulton Family

There were two main concerns my husband and I had about adopting a child with Down syndrome. How would it affect us, and how would it affect our other children? As we talked and prayed through our concerns we knew that this is what God was asking of our family and we trusted that He would cover it all. The truth is every time you add another member to your family it changes the whole dynamic. There is less time, and less money. But for us what we were to gain was so much more.

We mourned the loss of the dream of a one bedroom retirement house on the beach. We mourned the empty nest that will never be. We mourned the dreams we had for ourselves. And then we allowed God to anoint us with His oil of JOY for the dreams He has for our lives, which we know FAR EXCEED anything we could imagine.

We talked with our kids about the changes that were to come. We would need their help. We would be asking much of them. They were excited! They were ready to welcome another sibling into our family through adoption.

As God would have it, He took our ‘YES’ and ran with it! God brought us TWO BABIES!  We took placement of our Ruby in August 2012, and Conner came home in May 2013.  Both just a few weeks old when we got them, and just 11 months apart from each other.  Both with Down Syndrome.

I wish you could peak into my home and see what these babies have done to us. They are our little gifts. They are healers; they are joy; they are hope; they are angels from heaven. They have given us compassion and patience. My big kids are undone. They would do anything for their babies; and they will defend and guard and protect them always. They walk around wearing Ergos; they hold them and feed them their bottles. They change diapers; they sing songs; they cradle and rock, play hand games, and are learning sign language together. I had no idea how God was going to use our YES and these two blessings to change each of us so radically.

As evidence of how these changes have affected our children, our 12 year old son was given an assignment to creatively express what “inspiration” is to him. His inspiration is his family. This is the video he created.

His video won 1st place in his school, and was entered into the district competition where it also won First Place. Now it moves on to the County competition where more people will see how our family chooses to follow Jesus.

It is wise to pray and discuss and seek counsel before making an important decision like adopting a child, particularly one with special needs. We all worry about how growing our family through adoption can negatively affect our children. The truth is adoption is always hard. It is the result of brokenness. And in the hard, each of us, including our children, have the power to choose how we are going to respond. I choose to trust that God is faithful, and that even in the hard and the broken, the successes and the failures, He is ever changing each one of us to be more like Himself.

— Lyndsay Boulton, U.S. Liaison to Village of Hope

The Faces of HIV in 2013

I was driving to work this morning and passed by a billboard that reads, “I am living with HIV and my brother is standing with me.” As I read it, there was this moment inside of me where I *forgot* that I too am living with people who have HIV. And just as fast, the flash was gone and I remembered my babies.

The truth is, I never thought this would be my life. I mean, come on. MY life? Single and raising not one, but TWO children who have HIV?  Sheez. I must be crazy!  Here’s some more truth:  I never {okay, very rarely} think about it!  My boys, wrestling in full-nelson style on the floor?  Nope. Doesn’t occur to me. Wet beds, runny noses, coughs, vomit?  Never think of HIV.  Leah and Seth sharing drinks, food, baths, and germs?  Not a second thought. My kids engaged in straight-up-mania in the jumping pool?  Zilch. Is there a chance one of them could get hurt and bleed? Um, yea. There’s always that chance! But if they bleed — hear this now — they are not going to “catch” HIV from each other.  Period, full stop.

More truth? Listen up. I don’t think our friends think about it either. {gasp} That’s the thing about the truth. Once you know it, you’re not afraid!!!

I pray that those of you who are considering adoption would consider that HIV is, as our founder Kiel Twietmeyer has said, a “cheater” special need.  It is medically manageable and not scary.  For those children who are in need of a loving home, could God be leading YOU to parent a child with HIV?  Are you willing to step out in faith for this?

 HIV Blog 1

Or this?

 HIV Blog 2

Because this is the face of HIV today:

HIV Blog 3

And this:

 HIV Blog 4

What are you waiting for???

HIV Blog 5

Not Impressed.

A post from Tesney Davis:

Rescue those unjustly sentenced to die. Don’t hesitate to step in and help. If you say, “Hey, that’s none of my business.” Will that get you off the hook? God knows what you know. He’s not impressed with weak excuses. –Proverbs 24:11-12, NLT & The Message mash-up

Since God first wrecked our lives in a most excellent (and most difficult) way through adoption, I’ve gone back and forth, to and from extremes. At first I was all “full throttle ahead, everyone should adopt, and why aren’t they” with my approach.

Then I felt The Lord pressing me to be a little more graceful. I felt him nudging me to be quiet for a while, to listen, offer support, and to let him change hearts. I started learning more about adoption. I visited other countries and saw first-hand how family preservation is so much better IF it’s feasible. I got in touch with Kirill’s birth mom, learned his birth story from her perspective, and realized that family of origin is always the best option. But it isn’t always an available option. 
For Kirill, and most orphaned children with intensive special needs, adoption is probably the only solution. This is where my passion has been re-ignited over the past few months. I’ve felt God telling me it’s time to speak up again. Maybe a little more boldly than ever on behalf of orphaned children with special needs.
Orphaned children with special needs. Let’s talk about that. Let’s allow the reality of their situations to sink in for a moment. A child with special needs with a loving, nurturing family will have some obstacles to overcome. A child with special needswithout a family…well, their obstacles are almost insurmountable. Depending on the country, they are turned out onto the streets, placed in mental institutions, or turned over to nursing homes…obstacles that are impossible to overcome because they don’t have a voice or a family to advocate for them.
Now, think about this for a moment. God tells us repeatedly that the least of these are our responsibility as Jesus-followers. WE are the ones sentencing them to an unfair death by doing nothing.
It is our business. 
 
God is not impressed with weak excuses. 
 
Now, let’s all together say our excuses for not doing something out loud. I will start.
Our plate is full with Kirill. (Feel free to insert your own plate-filling child’s name).
 
Well, it is pretty full. I work. Greg works. We have two kids and one of them has intensive special needs. But the reality is I work primarily from home so I have 6 hours a day alone while my children are at school. We have an extra bedroom. We have food to spare. Honestly, there is room for more from us. Imagine telling Jesus your weak excuse. Would he be impressed? For us, it has become clear that cannot check “special needs adoption” off a list and rest on our laurels for the rest of our lives.
Frankly speaking, it’s not about us. When we shift our focus to the children who need families, and we make it about their needs, everything changes. Our excuses are LAME-O.
So today, on Orphan Sunday, let’s all do better. Let’s start examining excuses. Pray your excuses to God and see how he answers. Adoption is one answer…and for many it is the only answer. But there are eleventy billion other answers he may give you. The 90-year old home bound grandmother may be moved to pray for adopting families and their children. The tween aged crowd may organize a fundraiser for sponsoring a family preservation program. The young married couple may offer respite care for tired adoptive parents. He may tell you to mentor teen moms. We can probably all think of a family in our own community who needs help staying together. Why don’t we come alongside those families and support them instead of judging them? There is plenty we can all do together. Let’s just do something and stop with the excuses. God isn’t impressed.
The views expressed in this article are those of the author alone and do not necessarily reflect the view of each and every staff member at Project HOPEFUL.  Thank you for following along through our Adoption Awareness Month series!  For more information or if you have specific questions about any post, please reach out to us at projecthopeful@projecthopeful.org

Host Families Needed: You can help!

“Without intervention, upon leaving the orphanage, 60% of girls will end up in prostitution, 70% of boys will be on the streets or in jail, and 15% will commit suicide within the first two years on their own. YOU can revolutionize the life of an abandoned child.”                                                             – New Horizons For Children
New Horizons Stat

Project HOPEFUL has been informed of a cutie that has an opportunity to be hosted. You have the opportunity to make a HUGE difference in the life of a child. Every child deserves to know what the love of a family feels like. We don’t have much time left to find Vlad a host family! Please inquire quickly if you are interested in showing this handsome guy the love of Jesus!

Ten year old Vladyslav is a very diligent student and his favorite subjects are math and PE. His director describes him as very active, polite and kind. He Vladthinks logically and likes to analize things. Very friendly and likes to socialize with friends. Vlad attends an art studio where he likes to draw, paint, and work with clay. On his free time he plays soccer and loves to read and watch cartoons. His greatest and most cherished dream – life! Vlad is HIV positive.

Vlad is being offered for hosting via New Horizons for Children (www.newhorizonsforchildren.org) for 5 weeks this summer anywhere in the U.S. Please contact Stacey at smaljian@newhorizonsforchildren.org for more information!

Adopting from Russia: The Davis Family Story

A Guest Post by Tesney Davis~

Two and a half years ago, my husband, Greg, and I began praying for God to do whatever he wanted with our lives. Adoption became something that he was showing us he wanted for our family. We began to pray about adopting a child with special needs. Greg and I have a lot of experience with children who have special needs. It seemed like a natural fit for our family. As we prayed, God opened our eyes to children with disabilities in orphanages across the ocean in Russia. We started our adoption journey of a child with Down Syndrome. We were given a referral for a child in Russia and awaited our invitation to go meet him.

Eight months later, as we neared the finish line of our adoption, one of the family members in Russia stepped forward to adopt the child for which we had been given a referral. We were devastated when we received the news that the child we had planned to bring into our family was no longer available for adoption. We grieved hard. Although heartbroken for our own loss, but God showed us that we were following him, and his ways are perfect. We knew we still wanted to adopt.

Shortly after losing our original referral, we received a new referral for a four-year-old boy with Down Syndrome named Kirill. We were more guarded with our emotions this time, but we had no doubts that we should commit to this child. We had to re-file a lot of our paperwork because of the change in referrals and regions of Russia, but our commitment to this child was not something we took lightly and we gladly did whatever it took to bring him into our family.

Then another piece of devastating news arrived from our adoption agency: a tragic story of an adoptive mother sending her child back to his country alone on a plane with a note pinned to his shirt had hit the media…and the child was from Russia. We were told this was not good and that our adoption could be delayed indefinitely. Adoptions in Russia came to a screeching halt. Kirill’s region stopped processing adoptions for eight long months. The judge refused to accept any Amercian adoption cases until an official treaty was signed between the United States and Russia.

Even though we wouldn’t be able to finalize the adoption in court until the treaty was signed, we were allowed to go visit Kirill and sign our official petition to adopt him in August 2010. We fell in love with him during our visits. This was our son.

During that time, we were told by our in-country facilitator that Kirill would be the first child from his region EVER to be adopted with Down Syndrome. A birth mother keeping her child with Down Syndrome is unheard of in this area of the world. Adoptions of children with Down Syndrome just don’t happen there, these children are literally hidden away from society in orphanages and mental institutions. As our process continued, it became apparent that Kirill would be a pioneer. If our adoption was approved, it would pave the way for other children with special needs to be adopted from this region.

Then, a miracle happened around Christmas and the judge in this region suddenly changed her mind and began processing American adoptions again. We were elated.  Could this be the light at the end of a very long tunnel? We were finally granted a court date-March 17, 2011. St. Patrick’s Day…a lucky day! Our son was coming home!

March 17th arrived, and as we sat in the courtroom and suffered through five agonizing hours of difficult questioning, we were not prepared for anything but an approval of our case by the judge. Two doctors, two social workers, and the Minister of Children’s Services all made very strong statements on our behalf. They fought for us and for our son, Kirill.

But when the ruling was read, the judge said, “Your application to adopt is rejected.” The basis given was that Kirill was “not socially adaptable” due to his “medical condition” and he was better off in an institution than in a home with a family. As the judge read her ruling, she stated several times that we were a good family, that we met all the criteria to adopt a child, but that she would not approve our adoption because Kirill had Down Syndrome and his “level of backwardness” made him unfit for any family. She told us that we could adopt another child, because legally our application had no problems according to Russian adoption law. She said she would approve our adoption for a “typical” child, but not this child. Why? The only reason? Because he has Down Syndrome. Even though we were approved by our home study agency and by the USCIS to adopt a child with special needs. It made no sense whatsoever. Denying a child a family because he has Down Syndrome is a violation of human rights at its most basic level!

We appealed to the Russian Supreme Court in Moscow. Within two months, we received our Supreme Court date to appeal our regional judge’s decision. May 24, 2011, we stood before a panel of three Supreme Court judges and argued our case. We were told by our lawyer prior to our hearing to expect the worst. The best case scenario was that they would allow us another hearing with a different judge in our region, but that they would not overturn our original judge’s ruling. That meant we would have to wait for yet another court date.

But God is still a God of miracles. As the prosecutor in our hearing stood and read his opinion, that we should not be allowed to adopt Kirill, my heart sank. I just knew it was the end for our hopes of Kirill becoming a part of our family. Then a miracle happened: the head judge stood up and read his ruling. “the decision of the regional judge is OVERTURNED by the Supreme Court of Russia”. I didn’t hear much after that except that Kirill’s name was legally changed to “Gregory Kirill Davis”. I was too overwhelmed with emotions as I thanked God and started hugging everyone in the courtroom. We had been told to keep our composure because the Russian Supreme Court was very formal and serious; emotional outbursts would be perceived as weakness and we couldn’t show our feelings. That went out the window when the ruling was read and we celebrated in a flurry of tears and thanks to God for the miracle he had just performed.

We have been home almost 19 months with our son. I still get overwhelmed with emotions when I think about the miracle God performed. Kirill is thriving. He weighed only 19 pounds at five years old when we arrived home in June 2011. Now, he weighs 45 pounds and has grown 19 inches. He had severe problems with his sight and hearing; both have been corrected. He had numerous infections and gastrointestinal parasites. Those have all been treated and he’s healthy and happy. He goes to school, has friends, and we love him with all of our hearts. We cannot imagine our family without him. He brings us great joy and we are so proud to call him our son!NewKirillBeforeAfter

We love the people of Russia and it breaks our hearts to hear of the recent move to ban adoptions of Russian orphans by U.S. citizens. I am a member of several adoption groups and have a large network of fellow adoptive parents who have adopted children from Russia. Every single family I know LOVE and CHERISH their children from Russia.

Although there have been cases of abuse and neglect of children adopted from Russia, this is an exceptionally rare occurrence. These people are not the norm and they should be punished for their crimes.

To deny children the opportunity to have a loving family is a violation of human rights and a horrible crime against humanity. Thousands of children will face a lifetime in an institution instead of loving families if this law is passed. Please stand with us and contact your government officials to voice your opposition to the ban on Russian adoptions by Americans.

Join Project HOPEFUL’s staff in signing this petition to oppose the ban on Russian adoptions HERE. To read more on this story see this BBC News story

I slept with a girl…..and I didn’t catch HIV.

A guest post, by Jenny Clark

She is four years old. Her name is Leah Grace and she is the daughter of my friend Deb (the one I just went to Africa with). She contracted HIV through no fault of her own. She takes her meds every day like a good girl. Because of those meds, and the love of her family, she is a perfectly healthy normal little girl.

While in Uganda, I wiped her snot, drank after her, shared food with her, helped her in the bathroom….all of the things I would do with my own daughter. About halfway through the week we had some friends come and stay with us for a few nights, which caused us to have to do a little shuffle of the sleeping arrangements. I am no stranger to having kids in my bed and all up in my business while I sleep, so I didn’t think twice when Leah Grace wanted to bunk with me.

But then right before I fell asleep, 1987 came back to haunt me ……for a split second.

What if she has a stomach virus and throws up on me during the night?
Is HIV present in urine? What if she wets the bed?
She got a cut on her nose today…what if it opens up while she is asleep?
  

The truth is sometimes ugly, and I really don’t want to admit it…..especially since I am on staff with Project Hopeful, and our whole objective is to shine light on the facts about HIV and to advocate for children who live with it.

But then I realized, that if I KNOW the facts, and 1987 still crept in to my mind for a split second, how would my friends react in the same situation? How would I have reacted a couple of years ago?

Please friends, for the sake of this sweet girl and so many others like her, educate yourself!

Here are the fact about HIV…..most of them are very straightforward and the only thing you can do with them is read/understand them and help educate others……

….but 2 of these facts are things we can CHANGE…..YOU can change….right now…..today………….can you find them? Will you?

You NEVER have to fear contracting HIV through casual contact with an HIV+ person.
 
HIV has NEVER been transmitted in normal family living conditions. Never.

HIV FACTS

#1: HIV is spread in three main ways: Sexual contact, IV drug use (through the sharing of dirty needles), and mother to infant (through pregnancy, birth or breast feeding).

#2: Medications called ARV’s can mean the difference between life and death. Children who receive treatment are expected to live a normal lifespan.

#3: HIV is not found in sweat, urine, feces, tears, saliva or snot. It is found in blood, semen, vaginal fluids and breast milk. While HIV may live for a short while outside of the body, HIV transmission has not been reported as a result of contact with spillages or small traces of blood, semen or other bodily fluids. This is partially because HIV dies quite quickly once exposed to the air, and also because spilled fluids would have to get into a persons bloodstream to infect them.

#4: You don’t have to fear catching HIV through day to day activities with people who are HIV+. You are free to share plates, cups, utensils, food, toilets, towels, linens and other household items without risk of transmission. –American Academy of Family Physicians

#5: Today, HIV is considered a chronic, but manageable disease, much like Type II Diabetes (though Diabetes cannot be transmitted).

#6: If a pregnant mother does not receive medical treatment, there is approximately a 30% chance she will transmit the virus to her child. By treating mother and infant, doctors can reduce that rate to approximately 1%.

#7: A persons HIV+ status is protected medical information. There are US laws in place to protect the privacy of individuals living with the virus. There are also laws to protect citizens from being discriminated against because they have HIV/AIDS should they decide to disclose their HIV status.

#8: Social stigma is perhaps the greatest challenge an HIV+ individual will face.

#9:  A persons viral load is the amount of HIV found in their body. Through the use of HAART treatment it is possible for a patients viral load to become undetectable in laboratory tests. Having an undetectable viral load does not mean a person is cured. It simply means the medications are working to prevent the HIV virus from replicating within the body.

#10: In 2009 the Kaiser Family Foundation conducted a study titled “Survey of Americans about HIV/AIDS” which found that levels of knowledge about HIV/AIDS had not increased in the US since 1987.

#11: Families should use universal precautions whether or not someone in the family has HIV. Kids should be taught not to touch anyone’s blood anyway! This enables them to offer assistance to injured persons in a safe and healthy way.

#12: In the West, HIV is now considered a chronic illness rather than the terminal disease it used to be. Sadly, this isn’t the case for those children infected with HIV who are living in resource-poor settings, where 50% of infected and untreated children are not expected to live past the age of two.

#13: Today, 6,500 people will die as a result of AIDS. 6,000 of those people will leave children behind. Those children will join the already 15 million children who have lost parents to this treatable disease. (note: HIV is NOT AIDS. Patients receiving treatment for HIV (with ARV’s) can be expected to live long healthy lives without ever developing AIDS. In the U.S. ARV’s are readily available, however this is not the case in most developing parts of the world)

#14: There is no reason to fear that a mosquito or other insect could transmit HIV from one person to another through HIV-infected blood left on its mouth parts. Studies conducted by the CDC and elsewhere have shown no evidence of HIV transmission from mosquitoes or any other insects–even in areas where there are many cases of AIDS and large populations of mosquitoes. Lack of such outbreaks, despite intense efforts to detect them, supports the conclusion that HIV is not transmitted by insects.

#15: There are no documented cases of HIV being transmitted during participation in sports. The very low risk of transmission during sports participation would involve sports with direct body contact in which bleeding might be expected to occur. If someone is bleeding, their participation in the sport should be interrupted until the wound stops bleeding and is both antiseptically cleaned and securely bandaged. There is no risk of HIV transmission through sports activities where bleeding does not occur.

#16: No incident of food being contaminated with HIV-infected blood or semen has been reported to CDC. Furthermore, CDC has received no reports of HIV infection resulting from eating food, including condiments. HIV does not live long outside the body. Even if small amounts of HIV-infected blood or semen was consumed, exposure to the air, heat from cooking, and stomach acid would destroy the virus. Therefore, there is no risk of contracting HIV from eating food.

#17: Many scientific studies have been conducted to examine all the possible ways that HIV is transmitted. These studies have NOT shown HIV to be transmitted through air, water, insects, or casual contact.