Islamic tradition has a strong emphasis on promoting health and reducing harm, where health is seen holistically as body, mind and soul. Because HIV is predominantly caused by sex outside marriage, this results in Muslim countries in stigma and prejudice. In Islam, sex outside marriage is forbidden, yet sexual activity outside marriage occurs. HIV prevention in Malaysia is seen positively, although some stakeholders feel that much more could be done to reduce HIV. Differing viewpoints are most apparent with regards to Men who have Sex with Men, sex workers and transgender women, all considered not permitted in Islam. Stakeholders take differing approaches; religious leaders call for a return to Islamic teaching, while PLHIV and NGOs deem it necessary for a practical, less moralistic harm reduction strategy. Between these two poles resides the stance of the Ministry of Health, trying to deal with a concentrated HIV epidemic as public health physicians as well as reconciling personal aspects of navigating practices that are considered un-Islamic.