The aim of this study was to evaluate secondary trauma and job burnout and associated factors in a sample of 71 HIV lay counsellors in South Africa. Results indicate that 49.5% were not satisfied with their work environment and 51.4% were potentially secondary traumatic stress cases. In univariate analysis, seeing more HIV counselling and testing clients, being HIV positive and a higher number of lifetime traumas was associated with secondary trauma, while in multivariable analysis only the higher number of lifetime traumas was associated with secondary trauma. In both univariate and multivariable analysis, seeing more HIV counselling and testing clients and a higher number of lifetime traumas were associated with job burnout.