Relationship between anhedonia and psychosocial functioning in post-COVID-19 condition: a post-hoc analysis.

BACKGROUND: Post-COVID-19 condition (PCC), also known as "long COVID," is characterized by persistent symptoms, negatively affecting the well-being of individuals with PCC. Anhedonia (i.e. reduced capacity for pleasure) and compromised psychosocial functioning are notable symptoms in those with PCC. We aimed to provide insights to understand the effects of anhedonia and impaired psychosocial functioning of individuals with PCC. METHODS: This post-hoc analysis used data from an 8-week, double-blind, randomized, placebo-controlled trial which evaluated vortioxetine for cognitive deficits in individuals with PCC (Clinicaltrials.gov Identifier: NCT05047952). A total of 147 eligible participants were randomly assigned to receive vortioxetine or matching placebo over eight weeks of double-blind treatment. Our study investigated the relationship between anhedonia, assessed by the Snaith-Hamilton Pleasure Scale (SHAPS), and psychosocial functioning, measured with the Post-COVID Functional Status (PCFS) scale. The analysis was conducted using a generalized linear model, with adjustments for relevant covariates such as age, sex, education, suspected versus confirmed COVID diagnosis, MDD diagnosis, and alcohol consumption. RESULTS: Of the 147 participants, 143 participants had available baseline data for analysis. We observed that baseline PCFS score was statistically significantly positively correlated to baseline SHAPS score (ß = 0.070, p = 0.045, 95% CI). DISCUSSIONS: Our analysis revealed a significant relationship between measures of anhedonia and psychosocial functioning in adults with PCC. Strategies that aim to improve patient-reported outcomes with PCC need to prioritize the prevention and treatment of hedonic disturbances in patients experiencing PCC.

Brain representations of affective valence and intensity in sustained pleasure and pain.

Pleasure and pain are two fundamental, intertwined aspects of human emotions. Pleasurable sensations can reduce subjective feelings of pain and vice versa, and we often perceive the termination of pain as pleasant and the absence of pleasure as unpleasant. This implies the existence of brain systems that integrate them into modality-general representations of affective experiences. Here, we examined representations of affective valence and intensity in an functional MRI (fMRI) study (n = 58) of sustained pleasure and pain. We found that the distinct subpopulations of voxels within the ventromedial and lateral prefrontal cortices, the orbitofrontal cortex, the anterior insula, and the amygdala were involved in decoding affective valence versus intensity. Affective valence and intensity predictive models showed significant decoding performance in an independent test dataset (n = 62). These models were differentially connected to distinct large-scale brain networks-the intensity model to the ventral attention network and the valence model to the limbic and default mode networks. Overall, this study identified the brain representations of affective valence and intensity across pleasure and pain, promoting a systems-level understanding of human affective experiences.

Supporting practitioners to talk about sexual wellness and pleasure during radiotherapy for gynaecological cancer.

INTRODUCTION: Radiotherapy treatment for gynaecological cancer has significant negative effects on sexual wellness and pleasure (1-3). Patients undergoing radiotherapy for gynaecological cancers have more sexual dysfunction and experience more sexual and depressive symptoms than those who undergo surgery alone (4). The World Health Organization defines sexual health as a crucial part of health and wellbeing and recognizes the importance of positive and respectful approaches to sexuality, alongside safe and pleasurable sexual experiences free from violence and coercion (5). METHODS: Taking a sex critical approach to sexual wellness and pleasure, this project aimed to support practitioners to have improved and impactful conversations with people receiving radiotherapy treatment for gynaecological cancers. A series of three professional development workshops were held to explore language, unpack assumptions and develop key competencies for practitioners. A fourth workshop involved co-development of resources for use by other practitioners. RESULTS: The group united, sharing insights, learning, and developing practices through reflection developing critical awareness about damaging silences around sexual wellness and pleasure. Co-created resources included conversation cards and a poster. CONCLUSION: The project aimed to build and extend research findings to develop practitioner skills in supporting sexual wellness and pleasure for people receiving gynae-radiotherapy. The study shows the benefits of discussing norms and harms associated with biomedically focused conversations in gynae-radiotherapy to acknowledge diversity and validate concerns about sexual wellbeing and pleasure. IMPLICATIONS FOR PRACTICE: A sex critical approach to sexual wellness and pleasure should be considered a core principle of care for patients during their treatment for gynaecological cancers. Conversations are a key (free) resource within the practitioner-patient relationship that can address and improve patients' psychosocial wellbeing.

An empirical study on the relationship between rider recreational specialization, individual-environment fit, and heart flow experience.

The aim of the study is to create and validate a model of the relationship between specialization in leisure activities, the individual's adaptation to the environment and the heart flow experience. In order to clarify the role of the individual's adaptation to the environment in the relationship between specialization in leisure activities and the heart flow experience. The study utilized purposive sampling, cluster sampling, and random sampling. Using questionnaires and interviews to survey 525 cycling enthusiasts. Descriptive analysis, model construction and testing of the constructed path relationships were conducted using SPSS 20.0 and Amos 20.0. The results indicate that the model of the relationship between recovery specialization, individual-environment fit and heart flow experience has a good overall fit. The model shows good reliability and validity. Cyclists' recreational specialization has a statistically significant effect on individual-environment fit (ß = 0.38, P < 0.001). The fit between individual and environment has a statistically significant influence on the heart flow experience (ß = 0.39, P < 0.001). The fit between individual and environment serves as a mediating variable between recreational specialization and the heart flow experience, with the path showing statistical significance (ß = 0.15, P < 0.001). Recreational specialization has a statistically significant effect on the heart flow experience (ß = 0.30, P < 0.001). And the overall path of the effects of recreational specialization of cyclists on the fit between individual and environment is (ß = 0.45, P < 0.001), with the path showing statistical significance. Conclusion: The stronger the recreational specialization of cyclists and the greater the fit between individual and environment, the stronger their heart flow experience. The fit between individual and environment plays a partially mediating role.

Investigating motivations to eat: Refining and validating a framework of Eating Behaviour Traits in dieters and the general population.

Due to relationships between diet and health including obesity, there is a need to examine the explanatory power of factors that motivate people to (over or under) eat. In a previous investigation, a four-factor subscale-based model of eating behaviour traits (EBTs) was developed which identified individual differences in psychological factors influencing motivations to eat and some residual uncertainties. The current study used a data-driven and theory-driven approach, including individual items to refine and extend previous EBT models. The aim was to examine and validate the domain structure of a framework for EBTs. The analysis used two samples including a representative sample of the UK population (n = 2010, 51% female, 49% male, 18 - 88 years), and members of a weight management program (n = 2317, 96.6% female, 2.8% male, 21 - 84 years), who completed 5 questionnaires including 10 EBTs. The results found some support for a 6-factor model, encompassing reactive eating, negative emotional eating, positive emotional eating, restricted eating, homeostatic eating, and body-food choice congruence (data-driven model) or eating for health (theory-driven model). There were differences between the data-driven model and the theory-driven model regarding the 6th factor. Additionally, the data-driven model did not distinguish between eating for pleasure and reactive eating. The models demonstrated that the eating behaviour factors were significantly associated with BMI category. Overall, this research contributes to a more structured understanding of the dimensions of motivation underlying EBTs, emphasising the utility of this framework for identifying at-risk individuals and tailoring interventions to meet specific individual needs.

Prevalence and Risk Factors for the Presence of Gastric Ulcers in Pleasure and Breeding Horses in Italy.

Equine Squamous Gastric Disease (ESGD) and Equine Glandular Gastric Disease (EGGD) are two terms used to indicate the presence of lesions of the squamous and glandular mucosa of the stomach. Prevalences, pathophysiology, and risk factors are different, and the latter have been investigated in different populations. The aim of this study was to investigate the prevalence and risk factors of ESGD and EGGD in a cohort of pleasure, breeding, and retired horses in Italy. To the authors' knowledge, this is the first study to investigate such a diverse population of animals and the first one that includes a large number of animals in Italy. Gastroscopies were performed in 316 animals, with and without clinical signs of gastric ulcers, and a questionnaire about signalment, management, activity, and health was given to the owners or caretakers. Prevalence of ESGD was similar to the current literature reports in comparable populations, and the disease was associated with signalment, time with the current owner or caretaker, management (time and type of paddock, hay, and supplementary feed administered), and activity performed. In this population, EGGD was present in a lower percentage of animals and, of the parameters evaluated, was associated only with the signalment, while management does not seem to influence the development of lesions in the glandular mucosa in this population.

Why does mobile payment promote purchases? Revisiting the pain of paying, and understanding the implicit pleasure via selective attention.

The past years have witnessed a phenomenal growth of the mobile payment market, but how mobile payment affects purchase behavior receives less attention from academics. Recent studies suggested that lower pain of paying may not fully clarify the relationship between mobile payment and increased purchases (i.e., mobile payment effect). The current research first introduced price level in Study 1 and demonstrated that the pain of paying served as an underlying mechanism only in the high-price condition rather than the low-price condition. As such, Study 2 was conducted in a low-price context to address the uncovered mechanisms. We propose a new concept of "pleasure of payment" that is defined as an implicit and consumption-related hedonic response based on the cue theory of consumption. By tracking spontaneous attention to positive attributes (i.e., benefits) of products, Study 2 demonstrated this implicit pleasure as a psychological mechanism for the mobile payment effect when the pain of paying was not at play. These findings have important implications for mobile payment in research and practice by identifying price level as a boundary condition for the role of pain of paying and understanding the positive downstream consequences of mobile payment usage on consumer psychology.

Sexual Self-Esteem and Orgasm Consistency: Exploring the Unique Roles of Body Image and Genital Image.

We explored the unique roles that body and genital image play in behavior-specific orgasm consistency, beyond overall sexual self-esteem. US adults (N = 599; 64% women) completed questionnaires online. Hierarchical regression analyses predicted orgasm consistency during receptive oral sex and penile-vaginal intercourse (PVI) with additional clitoral stimulation (WAS) and with no additional clitoral stimulation (NAS) for the woman. Body image, genital image, and gender were entered in later steps to assess model improvement above sexual self-esteem. Models accounted for age, sexual and racial minority identities, and current relationship status. Results indicated that genital image improved all models and predicted higher orgasm consistency across all behaviors for men and women. For orgasm during receptive oral sex and PVI-NAS, sexual self-esteem was no longer significant once genital image was included. Genital image was a stronger predictor of women's versus men's orgasm during PVI-NAS; no significant gender differences were found for oral sex and PVI-WAS. Body image was not significant in any models, contrary to expectations, suggesting role overlap with sexual self-esteem. Genital image appears to play a unique role in sexual pleasure beyond overall sexual self-esteem and body image.

Those who (enjoy to) hurt: The influence of dark personality traits on animal- and human directed sadistic pleasure.

BACKGROUND AND OBJECTIVES: Sadistic pleasure - gratuitous enjoyment from inflicting pain on others - has devastating interpersonal and societal consequences. The current knowledge on non-sexual, everyday sadism - a trait that resides within the general population - is scarce. The present study therefore focussed on personality correlates of sadistic pleasure. It investigated the relationship between the Dark Triad traits, and both dispositional and state-level sadistic pleasure. METHODS: N = 120 participants filled out questionnaires to assess their level of Dark Triad traits, psychopathy subfactors, and dispositional sadism. Then, participants engaged in an animal-directed task in which they were led to believe that they were killing bugs; and in a human-directed task where they could ostensibly noise blasts another participant. The two behavioral tasks were administered within-subjects, in randomized order. Sadistic pleasure was captured by increases in reported pleasure from pre-to post-task. RESULTS: All Dark Triad traits related to increased dispositional sadism, with psychopathy showing the strongest link. The coldheartedness psychopathy subscale showed a unique combination with both self-reported sadism and increased pleasure following bug grinding. LIMITATIONS: Predominantly female and student sample, limiting generalizability of findings. CONCLUSIONS: Out of all Dark Triad components, psychopathy showed the strongest link with gaining pleasure from hurting others. The results underscore the differential predictive value of psychopathy's subcomponents for sadistic pleasure. Coldheartedness can be considered especially disturbing because of its unique relationship to deriving joy from irreversible harm-infliction (i.e. killing bugs). Our findings further establish psychopathy - and especially its coldheartedness component - as the most adverse Dark Triad trait.

Pleasurable emotions and internalizing psychopathology: A multi-study examination of specificity and alternative explanations.

OBJECTIVES: Past research has been inconclusive regarding the specificity of associations between discrete pleasurable emotions and internalizing symptoms. Contentment may be especially relevant to depression, whereas tranquillity may be especially relevant to worry. The goal of the current research was to clarify the mixed findings regarding the relation between pleasure deficits and internalizing psychopathology. METHODS: Participants from three samples (Total N = 757) completed alternative measures of depression and pleasurable emotions. Participants in Study 1 also completed a measure of anticipatory and consummatory pleasure, and close peers to a subset of participants (N = 64) reported their perceptions of participants' depression severity. Participants in Studies 2 and 3 also completed a measure of worry. RESULTS: Across the three samples, contentment was significantly negatively associated with self-reported depression. This association could not be accounted for by tranquillity, cheerfulness, anticipatory pleasure, or consummatory pleasure. Contentment was also strongly negatively associated with peer-reported depression. Contentment was more strongly associated with depression than was cheerfulness. However, the strength of the association between contentment and depression relative to the strength of the association between tranquillity and depression depended on how contentment and depression were measured. Conversely, tranquillity was more strongly associated with worry than were contentment or cheerfulness. CONCLUSIONS: This study provides further evidence of the potential importance of the role of contentment in depression and tranquillity in worry. It may be useful to attend to contentment when assessing and treating depression and to attend to tranquillity when assessing and treating elevated worry.

Pleasure and Satisfaction as Predictors of Future Cigarette and E-Cigarette Use: A Novel Two-Stage Modeling Approach.

INTRODUCTION: Subjective experience of e-cigarettes may be an important factor in helping people who use combustible cigarettes switch completely to e-cigarettes to reduce harms from smoking. This paper describes a novel two-stage analysis using pleasure and satisfaction responses from Ecological Momentary Assessments (EMA) of both cigarette and e-cigarette use to predict future cigarette and e-cigarette tobacco use. METHODS: This observational study included adult users of cigarettes and e-cigarettes who provided 7-days of EMA, capturing cigarette and e-cigarette use, followed by biweekly reports of cigarette and e-cigarette use over one year. Participants were 279 adults who provided both cigarette and e-cigarette responses during the EMA. We employed a two-stage analytic approach in which EMA data were used to predict subsequent levels of cigarette and e-cigarette use. In the first stage, EMA responses of cigarette and e-cigarette events were modeled via a mixed-effects location scale (MELS) model to yield summaries of participants' means and variability on event-related ratings of pleasure and satisfaction. These EMA summaries served as predictors in the second stage analysis of the biweekly post-EMA longitudinal cigarette and e-cigarette use data. RESULTS: EMA pleasure and satisfaction ratings were similar for both products and predicted both longitudinal cigarette and e-cigarette use, even after controlling for baseline cigarette and e-cigarette dependence. Relatively higher levels of satisfaction with e-cigarettes were associated with greater decreases in cigarette use over time. CONCLUSIONS: Pleasure and satisfaction are important predictors of subsequent cigarette and e-cigarette use. IMPLICATIONS: Experienced subjective pleasure and satisfaction from e-cigarettes relative to cigarettes may be an important factor in helping individuals who smoke to switch completely to e-cigarettes as a harm reduction approach. In order to help sustain complete product switching and reduce dual use or relapse to smoking, e-cigarettes may need to deliver more satisfaction to the user compared to that experienced from cigarettes.

Olfactory EEG induced by odor: Used for food identification and pleasure analysis.

As the need for food authenticity verification increases, sensory evaluation of food odors has become widely recognized. This study presents a theory based on electroencephalography (EEG) to create an Olfactory Perception Dimensional Space (EEG-OPDS), using feature engineering and ensemble learning to establish material and emotional spaces based on odor perception and pleasure. The study examines the intrinsic connection between these two spaces and explores the mechanisms of integration and differentiation in constructing the OPDS. This method effectively visualizes various types of food odors while identifying their perceptual intensity and pleasantness. The average classification accuracy for odor recognition in an eight-category experiment is 96.1%. Conversely, the average classification accuracy for sensory pleasantness recognition in a two-category experiment is 98.8%. The theoretical approach proposed in this study, based on olfactory EEG signals to construct an OPDS, captures the subtle perceptual differences and individualized pleasantness responses to food odors.

Effects of anhedonia on health-related quality of life and functional outcomes in major depressive disorder: A systematic review and meta-analysis.

BACKGROUND: Major depressive disorder (MDD) is a heterogeneous group of mood disorders. A prominent symptom domain is anhedonia narrowly defined as a loss of interest and ability to experience pleasure. Anhedonia is associated with depressive symptom severity, MDD prognosis, and suicidality. We perform a systematic review and meta-analysis of extant literature investigating the effects of anhedonia on health-related quality of life (HRQoL) and functional outcomes in persons with MDD. METHODS: A literature search was conducted on PubMed, OVID databases, and SCOPUS for published articles from inception to November 2023, reporting on anhedonia and patient-reported outcomes in persons with MDD. The reported correlation coefficients between anhedonia and self-reported measures of both HRQoL and functional outcomes were pooled using a random effects model. RESULTS: We identified 20 studies that investigated anhedonia with HRQoL and/or functional outcomes in MDD. Anhedonia as measured by the Snaith-Hamilton Pleasure Scale (SHAPS) scores had a statistically significant correlation with patient-reported HRQoL (r = -0.41 [95 % CI = -0.60, -0.18]) and functional impairment (r = 0.39 [95 % CI = 0.22, 0.54]). LIMITATIONS: These preliminary results primarily investigate correlations with consummatory anhedonia and do not distinguish differences in anticipatory anhedonia, reward valuation or reward learning; therefore, these results require replication. CONCLUSIONS: Persons with MDD experiencing symptoms of anhedonia are more likely to have worse prognosis including physical, psychological, and social functioning deficits. Anhedonia serves as an important predictor and target for future therapeutic and preventative tools in persons with MDD.

S'attaquer aux défis de l'adhésion aux principes de la saine alimentation.

The purpose of this article is to describe the impact of the research program entitled "Adherence to healthy eating recommendations: identification of measures, determinants and interventions". Beyond the main results described in this article, this program had a major impact on the training of graduate students. It was also a unique opportunity to develop and validate measurement tools relevant to nutrition research, and to make them available to the scientific community. Lastly, this program was a catalyst for establishing new collaborations and setting up larger-scale studies.

Guided recall of positive autobiographical memories increases anticipated pleasure and psychological resources, and reduces depressive symptoms: a replication and extension of a randomised controlled trial of brief positive cognitive-reminiscence therapy.

Reminiscence-based interventions focus on recalling autobiographical memories and reflective reasoning to develop a healthy and adaptive view of oneself and one's life. This study aimed to replicate the effects of a three-session, group-based, positive-memory version of cognitive-reminiscence therapy (CRT) on psychological resources and mental well-being and extend the findings to anticipated pleasure. The participants (N = 75, Mage = 43.7 (SD = 16.7), 60% females) were randomised to CRT or control group. Anticipated pleasure, psychological resources (schemas of positive self-esteem, self-efficacy, meaning in life, optimism), mental well-being (depression, anxiety, and stress symptoms) and theorised change processes (automatic negative thoughts, awareness of narrative identity) were assessed. Relative to the control group, the CRT group reported significantly higher anticipated pleasure (d = 0.76-0.93) and psychological resources of self-esteem, self-efficacy, and optimism (d's = 0.58-0.99) at post-CRT and follow-up, and lower depressive symptoms post-CRT and at follow-up (d = 0.56-0.67). Findings on meaning in life and negative automatic thinking were partially replicated. This study replicates findings of the effectiveness of this intervention for improving psychological resources such as self-worth, confidence and optimism and depressive symptoms, and indicates additional effects on anticipated pleasure. CRT may serve as a standalone intervention, or as an adjunct "memory booster" for interventions focused on future thinking and related anticipated reward.

Examining the effects of increasing then decreasing exercise intensity within a session of aerobic exercise.

Recent studies have examined the relations between the slope of pleasure experienced during exercise and remembered pleasure, forecasted pleasure, and enjoyment. OBJECTIVES: This study advances this line of research by examining the effects of exposing participants to exercise that increases in intensity and then decreases in intensity. METHODS: In a within-subjects design, participants completed three exercise sessions matched for total and average work. One session steadily increased in intensity, another steadily decreased in intensity, and a third increased-then-decreased in intensity. Remembered pleasure, forecasted pleasure, and exercise enjoyment served as primary outcome variables. RESULTS: Remembered pleasure, forecasted pleasure, and enjoyment did not differ between conditions. Remembered pleasure was positively associated with mean experienced pleasure, the overall slope of pleasure during the exercise session, affect experienced at the end of exercise, forecasted pleasure, accomplishment, and enjoyment. CONCLUSIONS: These data add to a growing literature on the effects of patterns of exercise intensity on affective responses to exercise. The results are discussed in context of previous and more recent research.

The neuroscience of human empathy for pleasure: protocol for a scoping review.

OBJECTIVE: The neuroscience of human empathy for pleasure and positive affect is an emergent, scarcely addressed topic. The main aim of this scoping review is to map the impact of this new research domain on the field of social and affective neuroscience. INTRODUCTION: Most of the literature on empathy and affect sharing has hitherto focused on negative emotions, with a special focus on pain. However, understanding, sharing, and reacting to others' pleasures is an evolutionarily and socially important function. Our scoping review addresses this gap in the literature and tries to unify the available information under the empathy for pleasure umbrella. INCLUSION CRITERIA: This scoping review is intended to cover studies on empathy for positive emotions, pleasant sensory outcomes, and other rewards in healthy individuals and neurological/neuropsychiatric/neurodevelopmental disorders populations. METHODS: We will perform a systematic search in the Medline (PubMed), Scopus, and Web of Science (WoS) databases. Two authors will independently screen all titles, abstracts, and then full-text articles that meet the inclusion criteria. The year range of interest will be 2000-2022, and only journal articles published in English will be assessed. Data will be extracted and presented in tables and/or graphical representations to synthesize and describe the results. The extracted data will be reported in a comprehensive summary. RESULTS: The final manuscript is intended for submission to an indexed journal in late 2023/beginning 2024. CONCLUSIONS: To our knowledge, the present scoping review will be the first to address the variety and heterogeneity of available evidence on human empathy for pleasure. We ultimately aim at perusing the growing literature on this far-reaching field of study and informing future research. SYSTEMATIC REVIEW REGISTRATION: The neuroscience of human empathy for pleasure: Protocol for a scoping review.  https://doi.org/10.17605/OSF.IO/W7H6J . (December 27, 2022).

[Sex therapy and support for women and couples]. / Sexothérapie et accompagnement de la femme et du couple.

Sexuality is shaped by experience and by what has been passed down. Body image and sex influence desire and pleasure. In the case of endometriosis, suffering and pain can lead to shame and guilt. Encouraging people to talk to each other helps to create a free eroticism that resembles the couple.

Infant hedonic/anhedonic processing index (HAPI-Infant): Assessing infant anhedonia and its prospective association with adolescent depressive symptoms.

BACKGROUND: Anhedonia, an impairment in the motivation for or experience of pleasure, is a well-established transdiagnostic harbinger and core symptom of mental illness. Given increasing recognition of early life origins of mental illness, we posit that anhedonia should, and could, be recognized earlier if appropriate tools were available. However, reliable diagnostic instruments prior to childhood do not currently exist. METHODS: We developed an assessment instrument for anhedonia/reward processing in infancy, the Infant Hedonic/Anhedonic Processing Index (HAPI-Infant). Exploratory factor and psychometric analyses were conducted using data from 6- and 12-month-old infants from two cohorts (N = 188, N = 212). Then, associations were assessed between infant anhedonia and adolescent self-report of depressive symptoms. RESULTS: The HAPI-Infant (47-items), exhibited excellent psychometric properties. Higher anhedonia scores at 6 (r = 0.23, p < .01) and 12 months (r = 0.19, p < .05) predicted elevated adolescent depressive symptoms, and these associations were stronger than for established infant risk indicators such as negative affectivity. Subsequent analyses supported the validity of short (27-item) and very short (12-item) versions of this measure. LIMITATIONS: The primary limitations of this study are that the HAPI-Infant awaits additional tests of generalizability and of its ability to predict clinical diagnosis of depression. CONCLUSIONS: The HAPI-Infant is a novel, psychometrically strong diagnostic tool suitable for recognizing anhedonia during the first year of life with strong predictive value for later depressive symptoms. In view of the emerging recognition of increasing prevalence of affective disorders in children and adolescents, the importance of the HAPI-Infant in diagnosing anhedonia is encouraging. Early recognition of anhedonia could target high-risk individuals for intervention and perhaps prevention of mental health disorders.

Sexual Health and Well-Being: A Framework to Guide Care.

Although the acceptance of sex positivity centering pleasure and justice has grown, clinical and public health strategies for sexually transmitted infection management have remained focused on risk and adverse outcomes. To promote sex-positive health care practice in clinical settings and beyond, health care practitioners should use an integrated, patient-centered approach to sexual health. These strategies include initiating discussions, continued sexual health education, providing informative material for patients, and knowledge of different communication strategies. Patient-provider interactions might be enhanced by using such methods.