| Summary: | M.A. === The HIV and AIDS epidemic continues to be one of the greatest challenges facing the world, in particular South Africa. Figures for the country, based on the surveillance of antenatal clinics, estimate that up to 5,54 million people were believed to be living with HIV in 2005 (HIV and AIDS and STI National Strategic Plan for South Africa 2007-2011). In an effort to address these challenges, the City has declared HIV and AIDS a Mayoral priority and strategies aimed at influencing behavior-change and easy access to Primary Health Care and treatment have been developed. Voluntary Counselling and Testing (VCT) services are widely promoted, developed, and instituted as part of the Primary Health Care services for communities to benefit from the health system. VCT has been recognized as the gateway to provision of prevention, care and treatment, and is offered at all fixed health facilities across the seven regions of Johannesburg, by a total of 160 lay counsellors. These lay counselors are required to educate an increasing number of people on all aspects of HIV and AIDS. Troubled and dissatisfied counsellors can negatively impact patient care. In order for counseling standards to be adhered to, the lay counselors should be supported. The supportive role is a necessary function, and organizations are obliged to provide this through professional supervision and general support to workers. This study is quantitative in design, with data collected by means of a questionnaire, and participants were selected through availability sampling in the seven regions of the City of Johannesburg. The data was analyzed using the following categories: profile of the respondents, organizational information, VCT information, VCT training and work-related problems. In terms of strengths, the counsellors felt confident and productive, had good relations and perceived themselves to be accountable, which are all strengths that supervision can build on. The most significant findings of this study indicate that although a significant number of the VCT lay counsellors in the City of Johannesburg felt positive about what they were doing and felt in control, a minority felt that they were at breaking point, which indicates that the work is stressful for some of them. From the questionnaire administered to the respondents, it became clear that the VCT lay counsellors need a supportive environment where they can fulfill their duties without experiencing burnout. It also became clear that the greater majority of the respondents are positively disposed to supervision. Recommendations were made based on the gaps identified, and these recommendations will be forwarded to the Department of Health of the City of Johannesburg, as they emphasize the need to give serious consideration to the supervision and development needs of the VCT lay counselors.
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