Table 4 Risk behaviours (injecting, sexual and displacement) and associated individual and structural level risk factors

Afghanistan

Todd, 2007[55]

86.4% lived outside Afghanistan in last 10 years

UV

Living outside of Afghanistan: always use a new needle with every injection OR 0.51 (95%CI 0.21–0.88);

Todd, 2010[56]

26.9% ever use condoms with a female sex worker

UV

Associated with condom use with female sex worker: living outside Afghanistan in the last decade AOR 5.52 (95%CI 1.83–16.71); higher income AOR 2.03 (95% CI 1.17–3.51); > lifetime partners AOR 1.80 (95% CI 1.32–2.45); younger age AOR 0.985 (95%CI 0.973–0.998; p 0.024). Adjusted for site

Nasir, 2011 [41]

Changing from smoking to injection

MV

Associations with non-transition to injection: Sharing needles or syringes in the last 6 months (AOR = 0.50, 95% CI 0.27–0.94), aspirating and re-injecting blood (AOR = 0.39, 95% CI 0.23–0.68), and receiving assistance with injecting (AOR = 0.36, 95% CI 0.21–0.62). Analyses controlled for the Jalalabad site (having smaller number [60.6%] of PWID changing from smoking to injection)

Todd, 2016[58]

8% Injected with used needles/syringes in past 3 months;

MV

Associated with sharing of needles/syringes: impacted by conflict AOR 6.23 (95%CI 1.41–27.6)

Rasekh, 2019[44]

13.4% injecting drugs

MV

Associated with injecting drug use: unemployed AOR 2.92 (95% CI 1.20–7.11); starting drug use in other countries AOR 7.46 (95% CI 1.99–28.03); previously in prison AOR 3.57 (95% CI 1.85–6.86)

Zafar,2003[62]

8.3% used an opiate as first drug

51.3% ever had sex with a sex worker

60% currently injecting drugs

MV

Associated with opiate used as first drug: Afghani vs Pakistani drug users AOR 1.97 (95%CI 0.97–4.00)

Associated with ever had sex with a sex worker: Afghani versus Pakistani drug users AOR 0.61 (95%CI 0.37–0.99)

Associated with currently injecting drug use: Afghani vs Pakistani drug users AOR 0.66 (95% CI 0.18–2.44)

Colombia

Berbesi-Fernandez, 2013

Salud mental[34]

44% injected with a used needle/syringe in last 6 months

UV

Associated with needle/syringe sharing: lives alone OR 1.67(95% CI 1.0–2.3); consumption of Basuco OR 1.58 95% CI 1.11–2.23

Berbesi-Fernandez, 2013 [33]

47% of PWID used syringes received from others < 6 months

MV

Associated with syringe sharing: No Condon use with non-regular partner AOR 4.46 (95% CI 1.23–16.05)

Berbesi-Fernandez, 2017[32]

40.3% shared syringes

MV

Associated with sharing needles/syringes: male AOR 0.492 (95% CI 0.325–0.742); completed secondary education AOR 1.933 (95% CI1.324–2.874); exchanging other equipment AOR 5.553 (95% CI 4.162–7.409); crack consumption AOR 1.591 (95% CI 1.173–2.156); HCV positive AOR 1.476 (95% CI 1.076–2.024)

Myanmar

Morineau, 2000[40]

61% sharing drug injecting equipment; 46.7% injecting drug use = 

UV

Associated with sharing drug injection equipment: being a farmer (OR 3.6; 95% CI 1.4–9.7); being a driver (OR 3.5; 95% CI 1.1–12.4) compared to sellers and craftsmen (1.0); having > 1 previous detox episode (OR 1.7; 95% CI 1–3.1); exclusively intravenous drug use (OR 2.3 (95%CI 1–5.6)

Associated with an intravenous pattern of drug use: being from Myitkyina (OR 2.4, 95% CI 1.4–4.0); drug use > 1 year (OR 3; 95% CI 1.6–5.4)

Saw, 2016 [49]

Sex-trading: involvement in the sex trade during the last 3 months: 40%

MV

Associated with sex-trading: having a regular job AOR 5.10 (95%CI 1.65–15.72); > 2 partners AOR 3.88 (95%CI 1.55–9.72; having homosexual preferences AOR 4.90 (95%CI 1.61–14.95); stimulant drug use AOR 2.38 (95%CI 1.10–5.15); using drugs ≥ twice per day AOR 2.62 (95%CI 1.19–5.77); drug use before/during sex in past 3 months AOR 2.76 (95%CI 1.08–7.03)

Saw, 2018 [48]

Risky sexual behaviours:

Inconsistent condom use: males = 90.7%, females = 85.2%

Multiple sexual partners: males = 94.2%, females = 47.2%

History of STIs: males = 55.7%, females = 56.0%

MV

Associated with engaging in risky sexual behaviours:

Men being employed AOR 1.42 (95%CI 1.08–1.87); using MA before /during sex AOR 1.67 (95%CI 1.23–2.28); visiting sex workers within 6 months AOR 1.41(95%CI 1.08–1.83); using > 2 ATS types AOR 1.77(95%CI 1.30–2.41)

Women being employed AOR 1.57 (95%CI 1.13–2.18); migrated from elsewhere in Myanmar AOR 2.70 (95% CI 1.86–3.39); using MA before/during sex AOR 3.39 (95% CI 2.51–4.56); using MA once a week AOR 2.06 (95% CI 1.41–3.02); using MA > 4 times a week AOR 2.44 (95% CI 1.66–3.60); higher education (high school/ higher level of education) AOR 0.42 (95%CI 0.31–0.56) were less likely to engage in high-risk sexual behaviors compared to those with secondary or below level of education