This film from writer-director Ira Sachs gives us premium-strength, undiluted Rami Malek – but I have to say that his overripe performance and self-conscious mannerisms here are perhaps even more oppressively insistent for being conveyed relatively quietly in spoken dialogue. And not quietly at all in the singing scenes. Malek is a performer whose style is as distinctive as those of John Malkovich or Jeff Goldblum. But it works best with a light touch in the direction and material. Things never really come together here.

The Man I Love is a film about gay culture in 1980s New York, at the height of the reactionary homophobia of Reagan’s America, with HIV-positive men coming to terms with their condition and with the callous bigotry of the political zeitgeist. In one hospital scene, we see the authorities’ icily unsympathetic attitude. Malek plays Jimmy George, a much admired and charismatic actor and performance artist in New York who has just emerged from a three-week stay in hospital after a life-threatening HIV-related crisis. Now he is starring in a new stage piece based on André Brassard’s 1974 film Once Upon a Time in the East, playing the stormy and defiant Hélène, who sings with a band.

Jimmy lives in an apartment with his partner Dennis (Tom Sturridge), who has the stressful and demanding task of caring for him, and Dennis is instantly suspicious of their hot new British neighbour Vincent (Luther Ford), who appears to be enamoured of Jimmy. A hookup between them, Dennis resentfully fears, would trigger new bouts of compulsive behaviour that would endanger what chance Jimmy has of recovery. Jimmy’s sister Brenda (Rebecca Hall) comes to visit with her son and disapprovingly straitlaced husband Gene (Ebon Moss-Bachrach), and she and their parents are to be the witnesses of Jimmy’s complicated and painful state of health and state of mind.

It is not at all clear that the new stage piece, with Jimmy playing in an exuberant blonde wig – sometimes with the sketchiest idea of what he’s supposed to be doing – will be a new start for him. In fact, it is probably and heartbreakingly to be his swansong; an exhausting final performance that will consume what is left of his health. We see Jimmy perform a strident version of What Have They Done to My Song Ma at a family get-together, not entirely on-key. And then there is the excruciating, chaotic stage show itself.

There are some nice moments here. At a party at Jimmy and Dennis’s apartment, the guests all have to do a turn and Brenda sweetly performs the cod-Irish song How Are Things in Glocca Morra? from Finian’s Rainbow. Malek’s declamation of some of the St Crispin’s Day speech from Henry V towards the end of the film has a lot of spirit, better in many ways than anything else he is seen performing. Sachs creates a lot of madeleine moments to bring back the 80s and it’s impossible to hear Talking Heads’ Crosseyed and Painless without a rush back to that time.

The Man I Love is an honestly intended and conceived movie, but that faintly baffling and strenuous lead performance sits uncomfortably.