'Dallas Buyers Club' (R)

The first moment you see Matthew McConaughey in Dallas Buyers Club, you can’t help but wince: The actor looks gaunt and skeletal, his clothes hanging at odd angles from his body, his face tight, like a skull. Then he starts talking, and you practically recoil from the screen. He’s a hateful, mean-spirited creep. McConaughey plays Ron Woodroof, a good-ol’-boy Texan who was diagnosed with HIV in 1985 and given 30 days to live. At first, Ron doesn’t believe his doctors (Jennifer Garner and Denis O’Hare), because back then, everyone knew the virus was something only “queers” like Rock Hudson got. He continues partying with hookers and drugs, weakening his immune system even further, until he develops AIDS.

But Ron won’t go down quietly. First he bribes a hospital janitor to slip him a supply of AZT, the first (and at the time only) medication being trial-tested by the FDA. But his condition worsens. Then he goes to Mexico, where an exiled American physician (Griffin Dunne) tells him AZT is poisonous and suggests a cocktail of vitamins and fatty acids instead. The new treatment seems to stabilize Ron: He’s feeling better. It also gives him the idea to start importing the meds over the border in bulk and selling them to other AIDS patients, creating a “buyers club” with a $400 enrollment fee.

Dallas Buyers Club was written by Craig Borten and Melisa Wallack, inspired by an article that appeared in The Dallas Morning News in 1992, while Woodroof was still alive. The project had kicked around Hollywood since then, circled by various big-name actors (including Brad Pitt and Ryan Gosling). But financing always fell through until McConaughey committed to getting it made.

You can see what drew the actor to the role: Ron is the antithesis of practically every character the actor has ever played, often deeply unlikable, selfish, racist, homophobic and all-around jerk. McConaughey lost 38 pounds for the film, and he also got rid of all his charisma, too. Director Jean-Marc Vallée (C.R.A.Z.Y., Café de Flore) doesn’t try to soften the character’s edges or find a hidden nugget of humanity in him. Instead, we come to understand Ron gradually, the same way he comes to gain compassion and respect for other people, no matter their sexual orientation.

Unrecognizable under full drag, Jared Leto plays Rayon, a transsexual and fellow AIDS patient who becomes Ron’s business partner. The movie treats their relationship without sentimentality or treacle. Rayon is playfully flirtatious, knowing how uncomfortable it makes Ron (he’s the sole ray of comedy in a fairly grim film). As their business thrives, so does the number of people living with AIDS. But their success gets the attention of the government and big pharmaceutical companies, who were poised to make a fortune if AZT was approved.

Dallas Buyers Club is, on one level, a fascinating dramatization of small businesses versus large corporations and how difficult survival can be for the little guy without deep pockets. But the movie ultimately rests on McConaughey’s able, emaciated shoulders, who never once plays to the audience’s sympathies. This is a straight-up portrait of a man who figured out a way to cling to life longer than anyone expected and, in the process, learned to let the world in.

Cast: Matthew McConaughey, Jared Leto, Jennifer Garner, Denis O’Hare, Dallas Roberts, Steve Zahn, Griffin Dunne.

Director: Jean-Marc Vallée.

Screenwriters: Craig Borten, Melisa Wallack.

Producers: Robbie Brenner, Rachel Winter.

A Focus Features release. Running time: 117 minutes. Vulgar language, sexual situations, nudity, drug use, adult themes. Opens Friday Nov. 15 in Miami-Dade: Sunset, South Beach, Aventura; in Broward: Gateway, Palace; in Palm Beach: Boynton Beach, Marketplace, Downtown.