Young Men with Intellectual Disabilities’ Constructions of the Human Papillomavirus and Vaccine

Background: Scotland is one European country offering a national school-based HPV vaccination programme to at least one age-cohort of females, however it does not include young men. A substantial body of literature explores and measures attitudes of young people towards HPV vaccination. Young men, particularly those with an intellectual disability, have been neglected in the literature. Methods: As part of a larger qualitative study, three focus groups with eighteen young men with intellectual disabilities were conducted in November and December 2015. A focus group topic guide and activity-oriented questions explored the men’s understandings of HPV and the vaccine. Data were analysed from a critical public health perspective, underpinned by discursive psychology. Results: Participants positioned themselves as excluded from the HPV public health agenda yet were not sexually naive. HPV appeared to challenge local logic and established safe sex discourses leading to a sense of powerlessness and confusion. Participant reflections on their exclusion from the vaccination programme included anxieties surrounding narratives of cancer and HPV risk leading to the identification of other more “at risk” groups across society. Estranged from HPV discourse at school and elsewhere, appropriate information resources were unavailable with no expectations of being offered the vaccine. In the absence of the HPV vaccine or accessible information, the young men appeared at risk of contracting or transmitting HPV to non-vaccinated partners. Conclusions: Young men with intellectual disabilities require access to health literature regarding HPV, taking into account levels of health literacy and capacity to utilise digital health resources. They can and should be equal partners in shaping public health policy and health messages, since excluding them from HPV discourse will only serve to reduce their expectations for health and increase their likelihood of poor health outcomes