The HIV testing, treatment and care programme of the South African public healthcare system depends on HIV
counselling and testing (HCT) that is primarily delivered by lay counsellors. Lay counsellors are expected to educate
clients about HIV/AIDS, advocate behaviour change, convey test results and support those infected and affected to
cope with the emotional and social challenges associated with HIV/AIDS. This research focuses on the emotional
wellbeing of lay HCT counsellors because this influences the quality of services they provide. A mixed methods
approach was used. The emotional wellbeing, level of burnout, depression and coping style of 50 lay HCT counsellors
working at the City of Tshwane clinics were assessed. Additionally, five focus group discussions were conducted.
The results showed that HCT counsellors reported average emotional wellbeing, high levels of emotional exhaustion
and depression. They had a sense of personal accomplishment and positive coping skills. The results revealed that
they may have difficulty dealing with clients’ emotional distress without adequate training and supervision. This
creates a dilemma for service delivery. In the light of the important role they play in service delivery, the role of the lay
HCT counsellor needs to be reconsidered. HCT should develop as a profession with specific training and supervision
to develop their emotional competencies to conduct effective counselling sessions.