Organization background:

Eminyeeto was developed under the overall umbrella of the Center for Sustainable Development within the Earth Institute at Columbia University. The Earth Institute is working to help guide the world onto a path toward sustainability by blending scientific research, education and practical solutions. The Earth Institute comprises more than 30 research centers and some 850 scientists, postdoctoral fellows, staff and students. Working across many disciplines, the Earth Institute studies and creates solutions for problems in public health, poverty, energy, ecosystems, climate, natural hazards and urbanization. The Institute’s work in Uganda and sub-Saharan Africa focuses on holistic solutions to poverty, including through reproductive health and youth development.

Need identified:

Cross-generational sex—or “Big Man” syndrome—is a pattern of sexual behavior between adolescent girls 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, but girls as young as 10 years of age have been reported to be targets. Their male partners are at least 10 to 20 years older. Although most cross-generational sex is based on the exchange of favors or material goods, it is considered different from commercial sex or prostitution.

Photo credit: Megan DaPisa

Photo credit: Megan DaPisa

Cross-generational sex (CGS) is not a sexual behavior that is limited to sub-Saharan Africa, but most research on the practice has been conducted in that region 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. It is clear that in much of Africa, young women bear the brunt of the AIDS epidemic.

In order to estimate the burden of cross-generational sex in the Ruhiira village cluster in Uganda, we conducted an ethnographic study including 6 weeks non-participant observation, structured interviews, and focus group discussions with adolescents (males and females, 18-21 years) and adults (males and females, 21+) living within the Ruhiira and Kabuyanda villages, two of the six within the whole cluster. Topics of discussion ranged from everyday life to HIV awareness and sexual practices. All discussions took place in the local language, Runyankore. Community perspectives were gathered through analyzing the opinions and quotations of the participants. The study revealed that 70 to 80% of girls in a village-cluster of 50,000 people engage in the practice in order "to acquire pocket-money and pay school fees.” Additional findings led our study team to conclude that gender discrimination and a limited investment in adolescents, especially girls, is inextricably linked to marginalization seen in of all the various sectors (agriculture, education, health, infrastructure, gender equality, and business development). Furthermore, it is an issue that is dangerously neglected. Our research team strongly believed that the preventative approach to HIV could not be adequately achieved if such marginalization was not addressed.

In addition to the direct health consequences, the practice of CGS and other types of sexual coercion damages young girls’ self-esteem and causes many to believe their only option for self-improvement and future livelihood necessitates early, often unprotected, sexual activity.  Many times, these young women become pregnant due to CGS, rape, or other types of sexual coercion. Condoms are almost never used, as "girls believe they have no right to challenge the man’s decision not to use one." According to the 2011 Uganda Demographic Health Survey, the teenage pregnancy rate was 24% in rural communities. Teenage pregnancies often result in negative consequences for the girls including socioeconomic difficulties and stigma. Additionally, that social stigma and strong community pressure force many women under the age of 25 to drop out of school when they become pregnant. It is common for the man to disappear when she becomes pregnant, leaving her to deal with these consequences alone. 


Sensitization and health-education alone are not enough to affect lasting behavioral change. Young women in particular need the financial and social support from their community to use the knowledge they gain to make informed decisions and protect themselves from cross-generational sex, HIV transmission, and early, unplanned pregnancies. Currently, these resources do not coexist and these issues continue unchecked in this cohort.