Libby Larsen composed "Perineo" for the AIDS Quilt Songbook project of William Parker, baritone and AIDS sufferer. The project gathered songs by composers responding to the spread of the AIDS virus and used them to raise funds for AIDS research. "Perineo" is written for baritone and piano, and uses an unpublished poem by Roberto Echavarren as its text. Echavarren's poem is about breathing, and Larsen's music responds to this subject on many levels. The music itself rushes in and out, loud and soft, and at times as the baritone draws out the very last syllables of a slow, soft line it sounds as if he is using the last wisp of his breath. "Perineo" is Spanish for "perineum," which is the region of the body from which successful singers are said to draw breath, and Larsen sometimes highlights "breathing" words like "open up" with word-painting. Yet the poem is about a singer who seems unsure of his ability to draw breath, and music of the music reflects this tentativeness as well. Larsen provides a vivid journey into the musings of the singer described in the poem, both highlighting its features and adding her own distinct commentary.

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