Introduction: In highly precarious settings, the use of psychoactive substances exacerbates health and social vulnerabilities, particularly among sex workers. It is associated with increased exposure to infections, violence and mental health problems. Despite these challenges, data remain limited in Mali. This study aims to explore the use of psychoactive substances within this specific population. Methodology: A descriptive cross-sectional study with quantitative approaches was conducted among 30 sex workers based at an urban displacement site in Bamako. Data were collected using structured questionnaires and individual interviews, then analysed using SPSS. Results: The participants were predominantly young (16 - 24 years old) and had little formal education (33.4%) and were not in education (63.3%). More than half (56.7%) reported using at least one psychoactive substance, with regular use in more than half of the cases. Tobacco was by far the most common, followed by tramadol, alcohol and cannabis. Furthermore, high levels of exposure to violence were reported: 93% for physical violence and 70% for sexual violence. Conclusion: Psychoactive substance use was common in our setting, which is characterised by a range of multiple vulnerabilities. Integrated interventions, focused on harm reduction and psychosocial support, appear essential for improving health.
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