Risk, responsibility, resistance: Young women’s negotiations of identity and healthy citizenship in human papillomavirus (HPV) vaccination narratives

The introduction of human papillomavirus (HPV) vaccination has resulted in a proliferation of discourse about HPV-related health risks, with a particular emphasis on the link between HPV and cervical cancer. Using a discursive narrative approach, we critically examine how young women navigate and construct their identities in relation to discourses on HPV vaccination, and the master narratives of risk, medicalization and individual responsibility for health that inform these discourses. Drawing on positioning theory, the narratives of three women who accepted, declined and were undecided about vaccination are presented to illustrate how they actively and uniquely negotiate their identities in relation to the positions idealized by HPV vaccination discourse, and in the context of their intimate relations and everyday lives. These findings fundamentally challenge dominant techno-scientific perspectives on health risk that underpin the majority of research on HPV vaccine decision-making, and health promotion research more generally. We suggest that discursive narrative approaches can advance critical understanding of how health risk discourse, and emerging technologies aimed at reducing health risks, are implicated in promoting neoliberal constructions of healthy citizenship that frame health risk management as an individual responsibility and moral obligation.