A) I am a white heterosexual male and 29 years old from the U.S. I've read that the majority of people globally and ~50% of people in the U.S have HSV-1, mostly acquired in childhood. Is this true? 

B) I know my test results aren't going to show how long I've had it. But I've never had cold sores/lesions/bumps/etc. anywhere on my body. Is there further testing I need to do to determine whether my HSV-1 is oral or genital? 

So a positive HSV 1 antibody test simply says that you are infected, not where.  If you've received oral sex in your lifetime and you've never had a cold sore on your lip or in your nostril, it could be either oral or genital.  Oral HSV 1 recurs far more often than genital HSV 1.  And you are correct, about 47% of the US population between 14 and 29 is infected with HSV 1.  You could ask your parents if you ever had a cold sore as a child. 

If your partner tests negative for HSV 1 and you want to offer them the greatest protection against infection, you could certainly take a daily antiviral medicine.  But remember that the traditional IGG test misses 30% of HSV 1 compared to the gold standard western blot antibody test for herpes.  If your partner is also positive for HSV 1, I wouldn't worry about this really.  If you have genital HSV 1, it is very unlikely that your partner would get this orally because HSV 1 genital infection is pretty quiet.  If you have oral HSV 1, there is a greater risk, though we don't know how great, that you could infect her genitally by giving her oral sex.  It's complicated, as you can see.

Terri

If 50% of the population has it, is it really an “issue” at all?

I’m guessing a ton of those people don’t know they have it and therefore neither taking medication.

And because the world (not just the U.S.) has become more “promiscuous” over time, so many people are having exposures and not knowing it, correct?

It is an issue of you infect someone who is not in the 50%, right?

It is true that the vast majority of people who have HSV 1 and HSV 2 don't know they are infected, that's correct.

The rates of both HSV 1 and HSV 2 are actually going down in the US over time.  Not dramatically, but definitely going down.

Terri