In Japan, HIV testing has been offered anonymously and free-of-charge at local public health centers, together with pre- and post-test counseling since 1993. Since then, the number of HIV tests increased steadily to reach a peak in 2008 but has since decreased by 30% during the last decade. The number of tests further decreased in 2020 during the COVID-19 pandemic and steeply by 50% this year compared with the previous year, mostly due to a shift in the workload at these centers to COVID-19-related services. To deal with this decline and thinking beyond the current pandemic, more options for HIV testing are needed, such as self-testing/postal delivery of dried blood spot specimen, a method that is yet to be approved in Japan, in addition to the conventional plasma/serum-based HIV testing.