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A large body of research has found that nonheterosexual methamphetamine users engage in substantially higher levels of risky sex compared to nonusers. Considerably fewer studies have examined methamphetamine use and high-risk sex among heterosexuals. The present study is a meta-analysis of the empirical literature on methamphetamine use and high-risk sexual behavior among heterosexual individuals. Four risky sex outcomes were examined: unprotected vaginal intercourse, unprotected anal sex, inconsistent condom use, and sex with multiple partners. Analysis of 24 studies (26 independent samples) including 286,781 individuals found that the pooled mean weighted odds ratios ranged from 1.37 (unprotected vaginal intercourse) to 1.72 (inconsistent condom use), indicating that the odds of engaging in risky sex for heterosexual methamphetamine users is, on average, between 37% and 72% greater than for nonmethamphetamine users. Date of publication, percentage of White Caucasian respondents, and sample size were significant moderators of effect size magnitude. Moreover, symmetry plots revealed little direct evidence for publication bias. It is recommended that future research explore additional categorical and continuous variables as potential moderators of effect size strength.