I have HSV-1 and its oral. I didn't know I had it until I gave it to my girlfriend orally in her anal area.  I can never remember having symptoms so I have no idea when I got it. Now that we both have it and have gone through the trauma of this realization we would like to resume a normal sexual relationship. Are there any risks of me now transmitting it to her lips or her to my genitals. If the risk is low would suppression therapy help eliminate the chance. 

In 33 years of practice, I might have seen one and heard about one case of a person getting HSV 1 in one location and then getting it in a new location on their body.  And I see probably 200 herpes patients a month, so you can see that it is very rare.  If I was in your situation, I wouldn't give herpes another thought, in terms of where else it might go in your own bodies and would experience the full range of sexual possibilities and expression.  Even if you were the third in my whole career, who bad would that really be?  HSV 1 genitally rarely recurs and HSV 1 orally is a cold sore and you didn't give it to her yet and I assume you were kissing as well as giving her oral sex?  That was a really simple question for me.  Please feel free to follow up with more questions if you like

Terri
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The oral sex we have had has been 99.9% in the vagina.  Very little anal.  So we were surprised that the herpes ended up there.  I am assuming that she doesn't have to worry about it showing up in her vagina since the infection is in the nerves related to the anus?

The nerves that supply the anal area also supply the genital area so she may well have genital recurrences as well. 
I'm not clear how suppressive therapy would help you at this point at all.  She is already infected and so are you so there is not a concern.  What were you thinking would be the benefit of you being on suppression?

Terri
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Just to be sure I don't spread it to her lips. 

I understand.  But one she has it genitally and it is well established (say four months), you don't need to worry about her getting it in a new location.  If she does develop sores orally, it is because you both kissed her and gave her oral sex and she could be infected in both locations.  but since she has not developed oral symptoms, that seems unlikely at this point

Terri
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