A substantial part of community‐based AIDS care in South Africa is currently undertaken by poor, female volunteer community health workers (CHWs). Retention of volunteers over time is challenging, however. In this study, 12 female AIDS care volunteers in KwaZulu‐Natal, South Africa, were interviewed about their motivations for becoming volunteers, perceived challenges in care work, and reasons for sustained volunteering. All women reported altruism and empathy as their main motivation for volunteering. Motivations for sustained volunteering included supportive networks, hopes of future employment in the formal health care system, personal growth, and appreciation from patients and community members. Despite reporting several challenges, all women were motivated to continue volunteering. To encourage retention, policy makers should pay attention to personal and professional rewards gained from volunteering, create career paths and clarify CHWs' roles and rights in the health care sector, and provide various coordination and support measures, including remuneration and stigma reduction.