Peer workers as bridge-makers: symbolic representation and co-production of services for stigmatized groups

Public services often struggle to reach stigmatized populations, as professionals may lack the trust, cultural knowledge, or standing needed to engage them effectively. Peer workers—people involved in service delivery who share an identity or lived experience with the population served—are increasingly used to bridge this gap. This study investigates these bridge-making benefits of peer workers through the lens of symbolic representation and co-production. Specifically, we analyze which approaches of “symbolic peer co-production” enable peer workers to engage effectively with both professionals and stigmatized groups, and the variety of roles played by peer workers with different identities as bridge-makers. Using a case study of HIV prevention in São Paulo, we conducted a documentary and social media analysis to examine how symbolic representation and lived experience help peer workers to act as bridge-makers between professionals and stigmatized groups. The findings suggest that peer workers enhance service accessibility by leveraging shared identities and experiences, reducing stigma, and building trusting relationships. This study contributes a novel theoretical framework integrating symbolic representation and co-production, and offers insights for designing more inclusive public services for stigmatized populations.