Background: Interface of drug abuse, needle sharing and high-risk-sex are potential menace multiplying HIV risk. This paper analyses covariates of multiplicity of risk behaviour among injecting drug users (IDUs) in the selected countries of South Asia. Methods: Findings are based on data from 1393 male IDUs from Nepal (2010-11), 1290 from Bangladesh (2015-16) and 1977 from India (2010). Bivariate and multivariate analysis was carried out to understand the covariates of multiplicity of risk behaviours among Injecting drug users in Bangladesh, Nepal and India of south Asian countries. Results: The mean duration of involvement in injecting drug use are 4.5 to 8.7 years across the countries with the mean age at first injecting drug use is higher among older age groups and married IDUs. Needle sharing is relatively prevalent especially among younger and illiterate IDUs. Further, it is reported that multi partner behaviour is more prevalent among those IDUs who involved in needle sharing practices. Condom use with commercial partners is almost four-fifth across the countries, whereas with regular partner its approximately 40% except Bangladesh. Coexistence of needle sharing and unprotected sex enhances (sexually transmitted infections (STI) prevalence as 7 % in Nepal, 32 % in Bangladesh and 5 % in India. Conclusions: Working towards risk reduction for IDUs must deal with the multiplicity of risk. Interventions should deal with covariates of risk, addressing youth, substance abuse and risky sexual behaviour interface.

Keywords: IDUs, Covariates, HIV Risk, Needle sharing, Condom, South Asia