Nothing could reek more of Hollywood self-congratulation than a film about cowboys, with boots filled by Matthew McConaughey and Jennifer Garner, being nominated for the Best Picture Oscar. It’s something of a miracle that screenwriters Craig Borten and Melisa Wallack have produced something that so consistently eschews schmaltz, that refuses to milk the sob story in favour of something harder, uglier, at times darkly comic.

Said sob story is that of Ron Woodroof (McConaughey), the real-life Texan cowboy who in 1985, just as the tidal wave of AIDS began to break across America, became a victim of the rodeo high life. Defiant against his diagnosis, and with the hospital’s refusal to treat him with non-FDA approved antiretroviral drugs, he decides to get hold of the meds by hook or by crook. A few trips to Mexico later and he’s started up his own ‘buyers’ club’, a (short-lived) legal loophole that bypasses drug-dealing laws and allows Woodroof to make a small fortune dripfeeding desperate Texans.

Yves Bélanger’s photography follows Woodroof’s breakdown unflinchingly from the start, following every dip and sway of McConaughey’s (unbeknownst to him) HIV-addled, skeletal frame. Apparently McConaughey lost 30 pounds for the role, and it desperately shows: McConaughey’s visible frailty is such that we feel the embattlement of his existence.

Woodroof is as filthily homophobic as you’d expect from any redneck. Yet as he begins to realise that the gay community is where the drug money is, he teams up with resident queen and unlikely business partner Rayon (Jared Leto). Ultimately, it’s the relationship between Leto and McConaughey that holds the film together. It’s what takes Woodroof from being, in Rayon’s words, a ‘homophobic asshole’, to getting his old friend T.J. (Kevin Rankin) into a headlock and forcing him to shake hands with said drag queen.

It is this change in Woodroof, the conversion from hard-nosed black-market businessman to a man who genuinely wants to help others, that Rayon brings about. But it’s to the film’s credit that it manages to choke back the tears, allowing the pathos to shine through the comedy.

In one fell swoop, Woodroof demonstrates his playful affection for the man whose ilk he once despised, while reminding us that he’s still no saint: “Would you stop starin’ at her tits, Rayon, you’re startin’ to look normal.”