This paper analyzes one of the cultural links in the epidemiological chain of HIV transmission among Muslim women and their infants in Mombasa, Kenya. Through participant observation, structured and semi-structured interviews, this analysis will provide some factors that influence the utilization of maternity health care services by pregnant Muslim women. The reported sample consists of 265 women’s health care seeking and utilization behavior which incorporate traditional healing, herbalism, homeopathic practices, Islamic religious practices, and biomedical methods of healing. This medical pluralism sometimes results in fragmentation of the utilization of health care services. Such fragmentation decreases identification of HIV positive women who are medically high risk of transmitting HIV to their infants in utero, at birth, or during breast-feeding. Women’s complex decision making processes made concurrently within their socio-cultural, religious, political and economic milieu are described to provide an understanding of their beliefs, realities and practices. Local knowledge of health care behavior provides an important impetus to continue the on going discourse of how to decrease perinatal HIV transmission rates in areas such as Kenya that continue to have high HIV/AIDS infection rates.