Background: Sex under the influence of drugs is widely known to be associated with high-risk of sexually transmitted disease. However, the impact of psychoactive substances (PAS) on the sexuality of MSM is rarely considered. To describe the pattern of drug use among substance-using men who have sex with men (SUMSM) and its association with sexual practice. Methods: A self-report anonymous form was administered to SUMSM in addictology department or on web site during six month in 2014. Respondents reported demographic characteristics and indicated which PAS they had used, and the effects sought on the sexual level. Results: 228 SUMSM answered, with mean age of 39 ± 13 years, integrate socially (74%), and having sex with multiple partners in 35% of cases. Most study participants (45%) reported HIV positive status. First time drug use was linked to sexual pleasure (51%). The most used substances are volatile alkyl nitrites (72%), cocaine (60%), and ecstasy (48%), with alcohol association in 58% and sildenafil in 43% of cases. In 54%, subjects report substancerelated disorder. The take-part of PAS in sexuality and weight of MSM identity have discussed. Conclusion: Harm reduction policy needs specific MSM interventions on both the issues of risky sexual behaviour and drug use.