Table 1.

Summary of Key Issues in this Review.

Main issue	Challenge for systematic review	Our approach
How do we search for pleasure inclusive interventions?
Lack of universally accepted definitions or key terms for research that is sex positive or incorporates pleasure	Subject headings for sex-positive and pleasure incorporating research do not exist Unclear which key terms will be most effective in capturing relevant publications	We do not query for sex-positive or pleasure terms in our search. Instead, we take on an expansive search strategy approach, whereby we incorporate both subject headings and key terms and look for suitable sexual health interventions. Sex-positive and pleasure incorporating interventions will be a subset of all sexual health interventions and will thus be captured by our search.
How do we identify interventions that incorporate pleasure?
Sex-positive/pleasure incorporating components may not be described in a given publication	Unclear how to screen if we cannot find explicit mentions of relevant components	We commit to reading additional literature and materials, including protocols, feasibility reports, and supplementary materials in order to have a higher chance of capturing all the relevant information for a given trial.
Sex-positive/pleasure incorporating components may be described in different sections of a publication	Limits to what can be achieved during abstract screening An expansive full text screening is required	We do not screen for the inclusion of sex-positive or pleasure incorporating work during the abstract screening stage. For this stage, we only screen for publications that are relevant in terms of topic and methods. This means a high number of papers will be retained for full text screening.
Sex-positive / pleasure incorporating components will likely be described in a variety of ways	The screening strategy needs to be both inclusive of different write-ups and rigorous in applying our definitional standard	We divide our full text screening in two stages. During the first, we accept any mentions of work that incorporates pleasure. During the second, our team engages in thorough discussions of each paper to ensure it meets our definitional criteria for work that incorporates pleasure, and ensure the outcomes of SRHR improvements are measured. We further employ a team of 5 cross-disciplinary specialists to ensure a wide variety of backgrounds and experiences from sexual and public health, as well as systematic review methodology, are represented.