The NHS is standing firm and says it has no responsibility to provide the treatment, known as Prep.
It says the onus should fall on local authorities instead.
Charities have called the decision "shameful", and warned that lives would suffer as a result.
Prep (pre-exposure prophylaxis) is a daily pill that can considerably lower a person's chances of catching HIV.
If taken correctly, it is almost entirely effective in preventing HIV.
NHS England has promised Â£2m in funding to treat about 500 people with Prep over the next two years.
But after considering representations from stakeholders, it still does not believe it should be the body responsible for offering the drug.
A statement on the NHS England website said: "'As set out in the Local Authorities (Public Health Functions and Entry to Premises by Local Healthwatch Representatives) Regulations 2013, local authorities are the responsible commissioner for HIV prevention services."
Ian Green, chief executive of the Terrence Higgins Trust, said: "Today is a shameful day for HIV prevention.
"This country used to lead the way in the fight against the HIV epidemic, but today, our national health service has washed its hands of one of the most stunning breakthroughs we've seen - a pill which, if taken correctly, is almost 100% effective in preventing HIV.
"A pill which is already available in America, Canada, France, Kenya and soon to be Australia.
"How did it come to this? It defies belief that, after 18 months of false hope, delays and u-turns in the battle to see Prep made available on the NHS to people at high risk of HIV, today we are in a worse position than when we started."
He said repercussions for those at high risk of HIV infection could be dire.
"It's not right that people who know themselves to be at high risk of HIV have to buy Prep themselves from the internet at considerable personal expense. Currently, only those who can afford it are able to access this life-changing treatment."
The NHS in Wales, Scotland and Northern Ireland have not yet made a decision on Prep.
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The pup was found on the opposite shore from Conwy town with an eye injury and with no sign of its mother earlier this month.
It was taken to the Welsh Mountain Zoo where its wounds have since healed.
RSPCA inspector Mike Pugh said: "It's fantastic news that this seal pup is on the mend, after such a tough ordeal."
But he urged the public not to approach all lone seals, as they have not necessarily been abandoned by their mothers.
The pup's release has been planned for the first three months of 2017.

He completed the 138 nautical mile voyage from Cowes to Dinard in nine hrs three mins and six secs last month.
It has been acknowledged as the fastest single-handed crossing in a yacht less than 60 feet long by the World Sailing Speed Record Council.
"It's fantastic news and a great feeling to have an official world record under my belt," Sharp said.
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Sharp sailed his 40-foot Imerys yacht between the isle of Wight and northern France on 24 November, taking almost three hours off the previous record that had stood for 12 years.
"Imerys was on fire in these windy conditions. These latest Class 40's are seriously optimised racing machines, averaging speeds of 15 knots and surfing at over 20 knots," he said.
"It is still difficult to believe that Imerys managed to carve three hours off the previous time. Hopefully this sets the bar high enough to hold on to the record for some time at least."
NHS England has reiterated it will not fund a "game-changer" drug treatment that can prevent HIV, angering HIV charities which had been campaigning to reverse the decision.
[NEXT_CONCEPT]
A seal pup that was rescued in Conwy county is recovering well and could be released into the wild in the new year, RSPCA Cymru has said.
[NEXT_CONCEPT]
Jersey-based sailor Phil Sharp's has had his single-handed cross-Channel record officially ratified.