# FairLLaVA: Fairness-Aware Parameter-Efficient Fine-Tuning for Large Vision-Language Assistants

arXiv: https://arxiv.org/abs/2603.26008 · HTML: https://mlsanity.com/paper/2603.26008/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Placed in Medical vision-language models, one of 16 directions in Multimodal LLMs / vision-language models.
- Builds on 38 of its 57 references that are in the map.
- First posted on arXiv 27 Mar 2026.

## Placed in

- Multimodal LLMs / vision-language models / [Medical vision-language models](https://mlsanity.com/mllm/medical-vision-language-models/)

## Builds on (most cited first, 30 of 38)

- [GPT-4 Technical Report](https://mlsanity.com/paper/2303.08774/) (2023)
- [Qwen3 Technical Report](https://mlsanity.com/paper/2505.09388/) (2025)
- [Visual Instruction Tuning](https://mlsanity.com/paper/2304.08485/) (2023)
- [Flamingo: a Visual Language Model for Few-Shot Learning](https://mlsanity.com/paper/2204.14198/) (2022)
- [On the Opportunities and Risks of Foundation Models](https://mlsanity.com/paper/2108.07258/) (2021)
- [CheXpert: A Large Chest Radiograph Dataset with Uncertainty Labels and Expert Comparison](https://mlsanity.com/paper/1901.07031/) (2019)
- [Class-Balanced Loss Based on Effective Number of Samples](https://mlsanity.com/paper/1901.05555/) (2019)
- [BiomedCLIP: a multimodal biomedical foundation model pretrained from fifteen million scientific image-text pairs](https://mlsanity.com/paper/2303.00915/) (2023)
- [MedGemma Technical Report](https://mlsanity.com/paper/2507.05201/) (2025)
- [RadGraph: Extracting Clinical Entities and Relations from Radiology Reports](https://mlsanity.com/paper/2106.14463/) (2021)
- [PadChest: A large chest x-ray image dataset with multi-label annotated reports](https://mlsanity.com/paper/1901.07441/) (2019)
- [Fairness without Demographics through Adversarially Reweighted Learning](https://mlsanity.com/paper/2006.13114/) (2020)
- [CLUB: A Contrastive Log-ratio Upper Bound of Mutual Information](https://mlsanity.com/paper/2006.12013/) (2020)
- [Reading Race: AI Recognises Patient's Racial Identity In Medical Images](https://mlsanity.com/paper/2107.10356/) (2021)
- [TorchXRayVision: A library of chest X-ray datasets and models](https://mlsanity.com/paper/2111.00595/) (2021)
- [GREEN: Generative Radiology Report Evaluation and Error Notation](https://mlsanity.com/paper/2405.03595/) (2024)
- [A Prompt Array Keeps the Bias Away: Debiasing Vision-Language Models with Adversarial Learning](https://mlsanity.com/paper/2203.11933/) (2022)
- [Finetuning Text-to-Image Diffusion Models for Fairness](https://mlsanity.com/paper/2311.07604/) (2023)
- [DeAR: Debiasing Vision-Language Models with Additive Residuals](https://mlsanity.com/paper/2303.10431/) (2023)
- [FairCLIP: Harnessing Fairness in Vision-Language Learning](https://mlsanity.com/paper/2403.19949/) (2024)
- [RaTEScore: A Metric for Radiology Report Generation](https://mlsanity.com/paper/2406.16845/) (2024)
- [CARES: A Comprehensive Benchmark of Trustworthiness in Medical Vision Language Models](https://mlsanity.com/paper/2406.06007/) (2024)
- [FairMedFM: Fairness Benchmarking for Medical Imaging Foundation Models](https://mlsanity.com/paper/2407.00983/) (2024)
- [Visual Representation Alignment for Multimodal Large Language Models](https://mlsanity.com/paper/2509.07979/) (2025)
- [Balancing out Bias: Achieving Fairness Through Balanced Training](https://mlsanity.com/paper/2109.08253/) (2021)
- [FairTune: Optimizing Parameter Efficient Fine Tuning for Fairness in Medical Image Analysis](https://mlsanity.com/paper/2310.05055/) (2023)
- [Debiasing Methods for Fairer Neural Models in Vision and Language Research: A Survey](https://mlsanity.com/paper/2211.05617/) (2022)
- [Overview of the First Shared Task on Clinical Text Generation: RRG24 and "Discharge Me!"](https://mlsanity.com/paper/2409.16603/) (2024)
- [How Multimodal LLMs Solve Image Tasks: A Lens on Visual Grounding, Task Reasoning, and Answer Decoding](https://mlsanity.com/paper/2508.20279/) (2025)
- [Toward Fairness in Text Generation via Mutual Information Minimization based on Importance Sampling](https://mlsanity.com/paper/2302.13136/) (2023)

## Built on by (most cited first, 1 of 1)

- [Reducing the Adaptation Gap Through Reachable Fisher Geometry](https://mlsanity.com/paper/2609.36329/) (2026)

## Abstract (arXiv)

While powerful in image-conditioned generation, multimodal large language models (MLLMs) can display uneven performance across demographic groups, highlighting fairness risks. In safety-critical clinical settings, such disparities risk producing unequal diagnostic narratives and eroding trust in AI-assisted decision-making. While fairness has been studied extensively in vision-only and language-only models, its impact on MLLMs remains largely underexplored. To address these biases, we introduce FairLLaVA, a parameter-efficient fine-tuning method that mitigates group disparities in visual instruction tuning without compromising overall performance. By minimizing the mutual information between target attributes, FairLLaVA regularizes the model's representations to be demographic-invariant. The method can be incorporated as a lightweight plug-in, maintaining efficiency with low-rank adapter fine-tuning, and provides an architecture-agnostic approach to fair visual instruction following. Extensive experiments on large-scale chest radiology report generation and dermoscopy visual question answering benchmarks show that FairLLaVA consistently reduces inter-group disparities while improving both equity-scaled clinical performance and natural language generation quality across diverse medical imaging modalities. Code can be accessed at https://github.com/bhosalems/FairLLaVA.