Background: Due to the lack of sufficient and valid studies on STD surveillance system problems, evidence based decision-making is impossible. Therefore, using a qualitative approach to evaluate the system in terms of its weak points, strengths, threats and opportunities as well as finding appropriate solutions is necessary. Methods: A Mixed Method approach was conducted. For a reciprocal evaluation of STD surveillance, participants were selected from two mutual groups of AIDS and STD experts and STD related practitioners through targeted and convenient sampling respectively. In-depth interview and filling checklist were applied for the first group while an open structured questionnaire was used for the second group. Qualitative data was classified and summarized through content analysis methods. Quantitative data was analyzed by descriptive statistics. Results: A great number of patients did not seek care because of stigma, taboo, over the counter drugs, dissatisfaction with the services, and the cost of tests. STD surveillance in Iran is mostly affected by threats and weak points. Low participation of the private sector on one hand and mismanagement and budget constraints in the health system on the other hand were the most important weak points. Weakness in the current reporting system was the common weak point of the two groups. Conclusion: In order to empower and promote STD surveillance and to follow WHO recommendations, designing a road map based on the opinions and experiences of experts and stakeholders and systematic review of studies is suggested.
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