“Innovation is not born from the dream; innovation is born from the struggle,” renowned leadership expert Simon Sinek once said. Patrick Whiteside, CEO of covered entity PREVENTION X, could probably tell you a thing or two about that. The community-based healthcare organization, a partner of Avita Pharmacy and Q Care Plus (both Avita Care Solutions companies), is committed to combating HIV and its associated stigma by providing accessible sexual health services across Florida.
After more than 10 years of foundational work and growth, PREVENTION X now offers a comprehensive range of services, including the compassionate provision of HIV pre-exposure prophylaxis (PrEP), post-exposure prophylaxis (PEP), Doxycycline Post-Exposure Prophylaxis (Doxy-PEP), as well as testing for HIV, STI, and Hep C. The organization also offers a behavioral health program. All services are available via telemedicine or in-person at one of the organization’s clinics in Miami, Tampa, or St. Petersburg. The organization is also planning to open another in-person clinic in Orlando by the end of the year and is exploring the feasibility of a hybrid approach to care provision in other underserved markets.
But it all started with two advocates sharing a sushi dinner and some vented frustration about stifled PrEP access. We chatted with Patrick to learn more about the PREVENTION X story, including its history, growth, and the partnerships central to its significant impact on Florida’s underserved patient populations.
After more than 10 years of foundational work and growth, PREVENTION X now offers a comprehensive range of services, including PrEP, PEP, Doxy-PEP, as well as testing for HIV, STI, and Hep C. The organization also offers a behavioral health program.
Avita: I hear there’s an interesting story behind how Prevention X was founded. Tell me all about it.
Patrick: If we go back to the very beginning, the whole idea of PREVENTION X (originally named PREVENTION 305 after the Miami area code of the organization’s first location) came to fruition when the founder, John Byrne, and I went out for sushi.
We had both started PrEP around the same time, and during dinner, we started complaining about the hassles of getting started. My doctor and his team were all gay men, so they were more than happy to prescribe PrEP to me. My issue was that the prior authorization process with the insurance company took forever.
John had a very different kind of negative experience. He’s spoken about it in The Atlantic and The Body. When he asked for PrEP, his clinician told him to tape a condom to his leg. When he got a prescription from another doctor, his pharmacist told him he didn’t believe insurance should cover PrEP because there were other ways to protect yourself from HIV.
During that dinner, we discussed that we hated to think other people were facing similar challenges accessing PrEP. We realized some folks would be much worse off than us because we’re two white guys with good jobs and great insurance. And that’s not even considering the challenges faced by people who have newly arrived in the U.S. and struggle to navigate our nation’s complex healthcare system.
John said he would love to do something, and I said, “Let’s put our heads together and figure something out.” PREVENTION X started as a grassroots initiative. John ran with the idea and did the heavy lifting, while I was offered a position at the Pride Center in Wilton Manors to build out their PrEP outreach and linkage program. My contribution to PREVENTION X between 2015 and 2018 was identifying culturally competent prescribers, and I also served as a member of the board of directors.
John invested a significant amount of time and personally donated funds during the organization’s early years. He would publish postcards about accessing PrEP and join volunteers in handing them out to people on 12th Street Beach. Then, John received a grant, formalized the organization, and hired some outreach folks. The program was initially built around talking to people on Grindr about PrEP and referring them to a website with a directory of LGBTQ+-friendly doctors open to prescribing PrEP. Everything evolved from there.
We had both started PrEP around the same time, and during dinner, we started complaining about the hassles of getting started. We discussed that we hated to think other people were facing similar challenges accessing PrEP. We realized some folks would be much worse off than us.
Avita: Eventually, what was once a pet project for you became a full-time gig. And it wasn’t long before innovation was born from challenge once again.
Patrick: Yes, John stepped down as the volunteer executive director, as he had planned to do, and I took over. One of the first things I wanted to do was enroll the organization in the 340B drug discount program, which would help lessen our dependence on grants. I got the ball rolling on that. Meanwhile, our PrEP outreach and doctor referral program on Grindr had taken off and was extremely successful. We received specific deliverables from the Florida Department of Health, which helped us add more discipline and structure to the program.
Then COVID hit.
Avita: Oh boy.
Patrick: Luckily, we were well prepared because our model was already entirely remote. At the time, we didn’t even have office space. By the time COVID happened, I had already hired a 340B consultant (now the organization’s 340B Director, Roland Hewitt), and our 340B status was approved in May 2020. We were working with a small LGBTQ+ doctors’ office in Orlando to handle our patients via telemedicine, and we were immediately able to generate cost savings through the 340B program.
However, we encountered some issues at the clinic, and we needed a new approach. Roland knew that Q Care Plus (Avita’s community-based telehealth pillar, which leverages technology to compassionately remove health barriers through stigma-free PrEP access, HIV treatment, and sexual wellness care) was just getting off the ground. In fact, I believe we were Q Care Plus’ very first client.
That’s how we entered the 340B sphere, and it was life-changing for the organization. All at once, we transformed from a program based on grassroots outreach to providing direct services.
That’s how we entered the 340B sphere, and it was life-changing for the organization. All at once, we transformed from a program based on grassroots outreach to providing direct services.
Avita: PREVENTION X now includes three in-person clinic locations and an administrative office in Orlando (with a fourth coming later this year), in addition to the telehealth partnership with Q Care Plus and a pharmacy services partnership with Avita Pharmacy. Tell me, what challenges have those partnerships helped you solve, and how do they align with your organization’s core values?
Patrick: Well, when we first started working with Q Care Plus, they were also a new start-up. Their business model fit hand-in-glove with ours since we were fully remote at the time, and especially due to the need for telehealth during the pandemic. We were able to provide our patients with stigma-free access to PrEP without taking unnecessary risks by entering a clinical space during the pandemic.
Q Care Plus and Avita have consistently provided us with best-in-class digital marketing, as well as educational and outreach resources. That freed up our budget, allowing us to grow our team to meet patient demand.
And they’re just generally supportive. One of the first questions our Avita Account Executive, Jeff Paramore, always asks us is, “How can we help you?” That provides peace of mind, whether it’s co-sponsoring events, providing us with marketing materials, or offering us specialty promotional items.
I have always been extremely appreciative that the Q Care Plus and Avita Pharmacy teams were never not in touch. If we’ve had an issue, there is always an open line of communication between our outreach staff and their care providers; they have a great back-and-forth.
Finally, I’ve always made it clear to the Q Care Plus and Avita teams that if they’ve got a new idea for something, count PREVENTION X as first in line to be your guinea pig. I originally came from an advertising background, where you can never let yourself run out of ideas. The folks at Q Care Plus and Avita seem genuinely interested in hearing those ideas and have, at times, incorporated them into their projects. An open line of communication and a willingness to listen to ideas—some of which probably sounded pretty crazy at times—is a plus in my book.
I have always been extremely appreciative that the Q Care Plus and Avita Pharmacy teams were never not in touch. If we’ve had an issue, there is always an open line of communication between our outreach staff and their care providers; they have a great back-and-forth.
Avita: How does the Q Care Plus/Avita Pharmacy partnership help PREVENTION X navigate the 340B space?
Patrick: I don’t think there was ever a 340B question I had that they couldn’t answer. PREVENTION X is also fortunate to have Roland as our 340B director; he joined the team full-time last year. He’s absolutely one of the most knowledgeable people in the 340B space, and he previously worked for Avita.
I’ve never doubted the 340B knowledge of the folks at Avita and Q Care Plus, and there have been numerous times when Roland and I have gotten on the phone with them to troubleshoot issues together. The 340B program is frequently shifting. When a new challenge arises, one of the first things we do is get their take on the issue. They help us ensure we never have to tell a patient we can’t help them.
I’ve never doubted the 340B knowledge of the folks at Avita and Q Care Plus, and there have been numerous times when we have gotten on the phone with them to troubleshoot issues together.
Avita: Let’s chat about Doxy-PEP. I know PREVENTION X patients have been able to access the benefits of Doxy-PEP, a medication that can prevent bacterial sexually transmitted infections (STIs) like syphilis, chlamydia, and gonorrhea when taken after sex without a condom or other barrier protection, through Q Care Plus. Our clinicians have been speaking at biomedical conferences across the country about the importance of Doxy-PEP from not only a sexual wellness standpoint but also the relationship between Doxy-PEP and PrEP adoption and adherence. How is your organization’s outreach program progressing?
Patrick: I was so excited to learn that Q Care Plus was introducing Doxy-PEP. And I’ll echo what your team’s research has found, which is that sometimes people walk in the door wanting Doxy-PEP, and they realize that PrEP will benefit them too.
At PREVENTION X, we value innovation, and often that comes from experimenting. I always tell our team, “When you’re experimenting with something, don’t be afraid to fail. Expect to fail. Failure is an option when we’re experimenting. Of course, operationally, please try not to fail.”
As I mentioned, Q Care Plus and Avita have always listened to my ideas and allowed PREVENTION X to test programs with them. So, we certainly made the right choice in terms of those partnerships. They’ve both done right by us.
Q Care Plus and Avita have always listened to my ideas and allowed PREVENTION X to test programs with them. So, we certainly made the right choice in terms of those partnerships. They’ve both done right by us.
