Background: Methamphetamine is a highly addictive psychostimulant. Narcotics also reduce anxiety and aggression and create a kind of euphoria. These characteristics provide a special attraction for the abuse of these substances for sexual behaviors, and by that, high-risk sexual behaviors. Objectives: The current research intended to compare the impact of methamphetamine and narcotics on sexual high-risk behaviors. Patients and Methods: This comparative study was performed on 91 men (49 amphetamine and 42 narcotics abusers) from the patients of Yareegar Clinic in Tehran, Iran, within 2019 - 2021. A substance-influenced sexual behavior questionnaire was used to collect the data. Data were analyzed using the analysis of variance. Results: The results showed that the use of amphetamine and narcotics affect on sexual desire, function, and sexual pleasure (P < 0.001). The investigation of behaviors in the two groups showed significant differences between the two groups in increasing sexual desire, sexual pleasure, desire for sex in anonymous situations, and intimacy and eroticism in a relationship and reducing the negative emotional consequences of sexual behavior (P < 0.001). Conclusions: The use of amphetamines can provide a vicious cycle of arousal-desire by desire and intensification of sexual behaviors, thereby increasing the likelihood of the occurrence and spread of infectious disorders, a phenomenon that is also observed in the use of narcotics. By training sexual skills and making individuals more efficient and cognitive, they can be prevented from entering the aforementioned cycle.