(February 2009) Cross-generational sex—or Sugar Daddy syndrome—is a pattern of sexual behavior between young women and much older men that brings increased health risks and consequences for young women. In most cases of cross-generational sex, the women are ages 15 to 19 and unmarried; their male partners are at least 10 years older. Although most cross-generational sex is based on the exchange of favors or material goods, it is different from commercial sex or prostitution.

Cross-generational sex is not limited to sub-Saharan Africa, but most research on the practice has been conducted in that region (see table) because the behavior is associated with a higher risk of HIV infection. Data show that young women ages 15 to 24 in sub-Saharan Africa are three times more likely to be infected with HIV than young men the same age.1 It is clear that in much of Africa, young women bear the brunt of the AIDS epidemic.

Sadly, few large-scale interventions have been undertaken to combat this risky behavior, and even fewer have been evaluated to show how well they actually work. However, in Uganda, an important collaboration between the government, local organizations, and the U.S. Agency for International Development may be leading the way. According to the 2006 Demographic and Health Survey in Uganda, 7 percent of young women ages 15 to 19 reported that they had recently had high-risk sex with a partner 10 or more years older than themselves.2 The survey also reports that age-mixing in sexual relationships is more common among young women who do not know where to get a condom, those in rural areas, and those with only primary-level education.3 These factors often leave young women vulnerable to high-risk sexual behavior and HIV infection.