Negotiating protection and propriety: Maternal responsibility, taboos, and social stigma in HPV preventive care for boys

Background Human papillomavirus (HPV) is the most prevalent sexually transmitted infection globally and a major cause of cancers in both genders. Vaccination uptake among boys lags significantly behind girls, even in jurisdictions that recommend gender-neutral HPV vaccination for early adolescents. Aim This study investigates how taboos and social stigma shape maternal HPV vaccination decisions for boys. Materials and methods We employ a multi-method inductive design, drawing on 28 semi-structured interviews with mothers of boys, four expert interviews, and a netnography of parenting and health forums. Results We identify a “reverse taboo gap”, where the cultural-symbolic anchoring of HPV vaccination to cervical cancer prevention makes taboos and social stigma weigh more heavily on decisions for boys than girls. This gap manifests in three ways: the gendered moral framing of maternal responsibility , the taboo of early adolescent sexual behaviour , and the social stigma of sexually transmitted infections . We theorise these as mechanisms of symbolic violence that constrain the accumulation, conversion, and application of parental health capital. Parents counter these mechanisms through strategies of legitimation: reframing , temporalisation , and validation . Discussion The identified mechanisms and strategies moderate how parental health capital shapes vaccination decisions. The insights and model developed extend beyond HPV vaccination to highlight the role of symbolic violence in shaping parental STI preventive care more broadly.