Visual Question Answering (VQA) with Vision-Language Models (VLMs) is increasingly used in privacy-sensitive and bandwidth-constrained settings. Federated Learning (FL), Split Learning (SL), and U-Shaped Split Learning (USL) keep raw data local, but transmitting all visual tokens across a model partition remains costly and can expose private information. We propose QPriv-VL, a question-guided, privacy-aware token-pruning framework for FL, SL, and USL that prunes visual tokens before transmission based on task utility and privacy sensitivity. Its core component is a lightweight Dynamic Threshold Predictor (DTP) that jointly estimates a sample-specific pruning ratio and a token-level retention mask in one forward pass. DTP combines question relevance, computed from cross-modal similarity between visual patches and the pooled question embedding, with a sensitivity signal derived from frozen DINOv2 features. This allows the model to suppress potentially sensitive regions while preserving patches useful for answering the question, without requiring sensitivity labels. We evaluate QPriv-VL on GQA, OK-VQA, VQAv2, SLAKE, VQA-RAD, and PathVQA against four privacy attack families: FSHA, FORA, iDLG, and attribute-inference membership inference attacks. DTP matches or outperforms fixed-ratio pruning while using substantially fewer transmitted tokens. On VQA-RAD, it reduces membership-inference attack success from 0.99 to 0.76-0.79, lowers FSHA and FORA reconstruction PSNR relative to fixed-ratio pruning, and preserves competitive VQA accuracy using about 40% of the original visual-token budget. A sensitivity exclusion ratio of 1.20 +/- 0.18 indicates preferential removal of privacy-sensitive patches, while explainability analysis shows that retention adapts to question semantics rather than generic visual saliency.

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