The study aimed to assess the association between hormonal contraceptive use and risk of HIV-1 acquisition by women and HIV-1 transmission from HIV-1-infected women to their male partners. 3790 heterosexual HIV-1-serodiscordant couples participating in two longitudinal studies of HIV-1 incidence in seven African countries were followed up. Among injectable and oral hormonal contraceptive users and non-users, rates of HIV-1 acquisition by women and HIV-1 transmission were compared from women to men. Among 1314 couples in which the HIV-1-seronegative partner was female, rates of HIV-1 acquisition were 6·61 per 100 person-years in women who used hormonal contraception and 3·78 per 100 person-years in those who did not. Among 2476 couples in which the HIV-1-seronegative partner was male, rates of HIV-1 transmission from women to men were 2·61 per 100 person-years in couples in which women used hormonal contraception and 1·51 per 100 person-years in couples in which women did not use hormonal.