Interruptions in payments for lay counsellors affects HIV testing at antenatal clinics in Johannesburg.

HIV testing uptake at 3 antenatal clinics in Johannesburg was 53% (1 333/2 502) during 4 months when lay counsellors were unpaid, which was lower than the 7 months when payment was provided (79%; 3 705/4 722; p<0.001), and a subsequent 12-month period (86%, 11 877/13 767; p<0.001) when counsellors were paid. Consistent remuneration of lay counsellors could markedly improve services for preventing mother-to-child HIV transmission.