Introduction Out of school youths are often prone to high risk behaviours as a result of limited public health interventions including prevention outreach and education efforts. Little is known about injecting drug use among them. Information on drug use is needed to design harm reduction strategies to reduce out of school youths' exposure to HIV through injection. This study assessed factors associated with their injecting drug use.

Methods Secondary analysis of data collected among out of school youths in November 2013 in North Central Nigeria. The data collected socio-demographic, sexual, behavioural and biological information among 1600 participants aged 15–24 years. Multiple logistic regression models were used to assess factors that influence their injecting drug use.

Results Their average age was 20.6 ± 2.7 years, participants from urban areas were 769 (48.1%) and rural area was 831 (51.9%). Male participants were 1023 (63.9%) and age category 20–24 years was 67.6%. Mean age at sexual debut was 16.2 ± 2.8 years; mean age at first alcohol use was 16.2 ± 3.8 years; mean age at first cigarette smoking was 15.1 ± 5.8 years; current smokers was 17.5%; alcohol intake was 53.1%; cocaine intake was 3.9%; heroine intake was 3.3%; sex in the past 12 months was 79.1% and sex in the last 3 months was 30.2%. HIV prevalence was 5.2%; and proportion injecting drug was 5.5% with rural 5.3% and urban 5.8%. Factors associated with injecting drug use were age group 20–24 years OR = 3.4 95% CI 1.5–8.3, smoking status OR = 2.1 95% CI 1.2–4.5, daily alcohol intake OR = 3.1 95% CI 2.0–7.7 and rural area OR = 0.6 95% CI 0.5–0.8.

Conclusion Harm reduction approaches need to be instituted among out of school youths. Programming among them to reduce injecting drug use is important. Their HIV prevalence of 5.2% is above the national youth average of 3.0%. Multi-pronged strategies including motivational programs to reduce drug use and HIV risk are urgently needed. This will involve age-specific targeted interventions to effectively improve their health.

Disclosure of interest statement This is a self-funded research and no pharmaceutical grant was received to conduct this study.