Young men with intellectual disabilities, the HPV vaccine, and constructions of sexual health risk

Abstract

Background: The Human Papilloma Virus (HPV) Vaccine was introduced internationally in order to provide a vaccine against common strands of the HPV virus which is implicated in cervical and other cancers. Substantial literature explores attitudes and meanings of young people towards HPV vaccination. Young people with an intellectual disability, however, have been absent and are neglected within sexual health literature generally, despite being sexually active. Recent vaccine debates in the UK centre on decisions about expanding the HPV vaccine to include boys in the schedule and thus it is important to include young men’s perspectives. The aim of this study was to explore how young men with intellectual disabilities construct meanings around HPV and the HPV vaccine. Methods: Three qualitative focus group discussions utilising activity-oriented questions were conducted to explore meanings around the HPV virus and HPV vaccine amongst young men with intellectual disabilities aged 16-22 (n=18). Analysis was informed by critical discursive psychology. Findings: Discourses identified tensions around vulnerability and sexuality; paternalism and inequity of information provision; and an appeal to social justice in the face of exclusion from public health discourse. In the absence of the HPV vaccine or accessible information, young men with an intellectual disability appeared at risk of contracting or transmitting HPV to non-vaccinated partners. Discussion: Opportunities are required to discuss behavioural risks and consequences of HPV across educational, social and medical contexts for marginalised groups. Accessible health information including digital health ought to be designed in partnership with people with intellectual disabilities.