摘要目的:了解天津市男男性行为人群（MSM）精神活性物质使用情况及影响因素。方法:2017年9月至2020年12月采用滚雪球抽样方法招募MSM开展横断面调查，收集调查对象社会人口学信息、精神活性物质使用情况和相关行为信息，并采集血样开展HIV和梅毒检测。采用多因素logistic回归分析MSM使用精神活性物质的相关因素。结果:MSM研究对象9 218人中，曾经使用精神活性物质占43.5%（4 013/9 218），使用Rush、多种精神活性物质分别占92.6%（3 718/4 013）和17.2%（692/4 013）。精神活性物质使用的相关多因素分析结果显示，汉族是少数民族的0.68倍（95% CI：0.51~0.91），已婚/同居者、离异/丧偶者分别是未婚者的0.65倍（95% CI：0.57~0.74）、0.80倍（95% CI：0.65~0.97），首次同性性行为年龄≥30岁者是<30岁者的0.57倍（95% CI：0.44~0.74），天津市户籍者是外地户籍者的1.12倍（95% CI：1.03~1.23），大专及以上文化程度是初中及以下的1.29倍（95% CI：1.12~1.49），最近6个月发生肛交性行为者是未发生者的1.93倍（95% CI：1.34~2.77），最近1周同性性伴数>2个者是≤2个者的1.62倍（95% CI：1.41~1.87），最近6个月发生同性商业性行为者是未发生商业性行为者的1.99倍（95% CI：1.62~2.45），最近1年被诊断性病者是未患性病者的2.39倍（95% CI：1.82~3.12），最近1年接受过同伴教育者是未接受过同伴教育者的1.63倍（95% CI：1.50~1.78）。 结论:天津市MSM的精神活性物质使用率较高，相关的影响因素较多，需加强针对性的预防干预措施。

abstractsObjective:To understand the use of psychoactive substances and its related factors in men who have sex with men (MSM) in Tianjin.Methods:A cross-sectional survey was conducted in MSM recruited in Tianjin by snowball sampling from September 2017 to December 2020, the information about their social demographic information, use of psychoactive substances and behavioral characteristics were collected, meanwhile the blood samples were taken from them for HIV/syphilis detections. Multivariate logistic regression was used to explore related factors about psychoactive substances use.Results:A total of 9 218 MSM were included in the study, in whom 43.5% (4 013/9 218) had ever used psychoactive substances, including 92.6% (3 718/4 013)who used Rush and 17.2% (692/4 013) who used multi substances. Multivariate analysis showed that, the OR of psychoactive substances use in MSM who were in Han ethnic group was 0.68 (95% CI:0.51-0.91) compared with those who were in minor ethnic group; the OR of psychoactive substances use in MSM who were married or cohabited, divorced or widowed were 0.65 (95% CI: 0.57-0.71), 0.80 (95% CI: 0.65-0.97) respectively compared with those who were unmarried; the OR of psychoactive substances use in MSM who had the first homosexual sex at age of ≥30 years was 0.57 (95% CI: 0.44-0.74) compared with those who had the first homosexual sex at age of <30 years; the OR of psychoactive substances use in local MSM in Tianjin was 1.12 (95% CI: 1.03-1.23) compared with those who were not local residents in Tianjin; the OR of psychoactive substances use in MSM with education level of college or above was 1.29 (95% CI: 1.12-1.49) compared with those with education level of junior middle school or below; the OR of psychoactive substances use in MSM who had anal sex in the past six months was 1.93 (95% CI: 1.34-2.77) compared with those who had no anal sex; the OR of psychoactive substances use in MSM who had >2 homosexual partners in the last week was 1.62 (95% CI: 1.41-1.87) compared with those who had ≤2 homosexual partners; the OR of psychoactive substances use in MSM who had homosexual commercial sex in the past six months was 1.99 (95% CI: 1.62-2.45) compared with those who had no homosexual commercial sex; the OR of psychoactive substances use in MSM who had sexually transmitted diseases in the last year was 2.39 (95% CI: 1.82-3.12) compared with those who had no sexually transmitted diseases and the OR of psychoactive substances use in MSM who received peer education services in the last year was 1.63 (95% CI: 1.50-1.78) compared with those who received no peer education services. Conclusion:The prevalence of psychoactive substances use is high in MSM in Tianjin, and there are many influencing factors. It is necessary to conduct targeted interventions according to the influencing factors.