[PhantomGremlin]

There was some confusion about who should be paying for this preventative treatment.

This is the part I really don't understand. I suppose its a consequence of big bureaucracies.

This is a clear case of "an ounce of prevention is worth a pound of cure". It is so much cheaper to pay for the PrEP than to pay for treatment of HIV.

And in the UK the HIV treatment is "free", i.e. part of their national healthcare, right? So wouldn't it make so much sense for them to flood the country with PrEP, giving it at very low cost to anyone who expresses an interest?

[DanBC]

It's incredibly frustrating to me too.

Firstly, this is only for England. Health is devolved in Scotland, Wales, and Northern Ireland.

Preventative stuff and a lot of sexual health stuff (STD screening, free contraception) is paid for by "Public Health", which is part of local government.

Treatment is paid for by the NHS, which is sort of nationally funded by NHS England to local Clinical Commissioning Groups.

Sometimes you'll have "joint commissioning" -- for example in Gloucestershire there's joint commissioning across public health and the NHS for Mental Health.

But yes, it's stupid bureaucracy and budget holding and it's caused harm.