EDWIN CAMERON, appointed a High Court judge by Nelson Mandela soon after apartheid ended in 1994, pulled to the side of the road, leaned his head on the steering wheel and was overcome by deep, shattering sobs, he recently recalled. It was 1999 and he had just decided to publicly disclose he was H.I.V.-positive at the very moment he sought to fulfill his life’s ambition: to serve on South Africa’s highest tribunal, the Constitutional Court.

“I am not dying of AIDS,” he told the stunned judicial commission that was deciding whether to recommend his elevation. “I am living with AIDS.”

On that day a decade ago, he became the first — and still remains the only — senior office holder anywhere in southern Africa, and perhaps in all of Africa, to announce he was infected with H.I.V.

Mr. Cameron, hale and hearty at age 55, finally ascended to the Constitutional Court this month.

In the years that have yawned between his original act of revelation and his current triumph lies the story of a gay, white South African wrestling with the divisive politics of AIDS here at the heart of the world’s pandemic.

Not long after he divulged that he was H.I.V.-positive, Mr. Cameron made another fateful decision, one that was extremely rare among public officials here: he openly challenged President Thabo Mbeki — who held the power to decide whether to name him to the Constitutional Court — on his ideas about AIDS.

Mr. Mbeki had begun questioning the scientific consensus that AIDS is a sexually transmitted disease caused by H.I.V., suggesting that those who held such views were motivated by racist ideas about sexually promiscuous black men.

Mr. Mbeki’s government also delayed giving antiretroviral drugs to treat and prevent the disease for years — a decision that led to 365,000 premature deaths, Harvard researchers recently concluded.

So why did Mr. Cameron, who believes judges should generally stay out of the political fracases of the day, take on Mr. Mbeki, most likely delaying his promotion to the Constitutional Court for years, if not scuttling it entirely?

“I suppose it was a sense of dismayed outrage that this man with so much intellectual promise, who held out such high ideals for the African continent, should betray it so profoundly on its major moral question,” Mr. Cameron said in a recent interview.

Mr. Cameron, the first judge named to the Constitutional Court since Mr. Mbeki was deposed as president by his own party four months ago, seems an unlikely rebel. A Rhodes scholar described by some colleagues as his generation’s finest legal intellectual in South Africa, he is a courtly, judicious man who serves tea with impeccable gentility.

One of his closest friends, Zackie Achmat, an advocate for AIDS patients, described him affectionately as “a tetchy old spinster.”

Mr. Achmat recalled that the day he started working for Mr. Cameron as a paralegal at the AIDS Law Project, which Mr. Cameron founded in the early 1990s, Mr. Cameron looked him over — Mr. Achmat was wearing jeans and a T-shirt — and acerbically asked when he was starting the job.

“You don’t come to work dressed like that,” Mr. Cameron told him severely. “This is a legal firm. Wear a tie and jacket,” then later laughed when Mr. Achmat turned up in a tie emblazoned with condoms.

Mr. Cameron’s sense of right and wrong has its roots in a difficult childhood. His father, an electrician of Scottish descent, was what Mr. Cameron called “a catastrophic alcoholic.” His mother, an Afrikaner, was unable to cope. At age 7, he was sent away to a home for orphans and destitute children until he was 11.

HIS mother was not the most competent parent, he said, but he credited her with one transformative gift. She set her mind to getting him into one of the nation’s elite public schools. She moved to Pretoria, got a job as a receptionist at a seedy hotel and helped him win admission to the whites-only Pretoria Boy’s High School.

“In my second year there, one of the school masters said to me, ‘You’ve got to apply for a Rhodes scholarship,’ ” Mr. Cameron said. “The idea of Oxford was embedded in my mind at age 15.”

At Stellenbosch University, where he studied in his native Afrikaans, Mr. Cameron said he had remained “a quiescent white conformist.” But in 1977, the year after he arrived at Oxford as a Rhodes scholar, Steve Biko, the black student activist and thinker, was murdered by the South African police. Mr. Cameron read Mr. Biko’s writings, which were banned in South Africa, and got involved in the antiapartheid movement.

Upon his return to South Africa in 1982 after earning a law degree at Oxford, he joined the fight against apartheid, representing township youths arrested for throwing stones at the police and white students who refused to serve in the military on political grounds.

And when Mr. Mandela became president of a democratic South Africa in 1994, Mr. Cameron was one of the first people he named to the High Court. After disclosing he was H.I.V.-positive and taking on President Mbeki, Mr. Cameron was promoted to the appellate court, but never sought again to win appointment to the Constitutional Court until last year, assuming until then that his clash with Mr. Mbeki over AIDS would ruin his chances — an assumption fellow judges and lawyers say was almost certainly accurate.

This year, a lawyer, Vuyani Ngalwana, argued in a 20-page brief to the judicial service commission that Mr. Cameron did not yet have “the pith and substance” to be on the nation’s highest court, and raised the question of whether a white man should replace a departing black judge, without giving a definitive answer.

“Justice Cameron will have another opportunity to throw his name in the hat for consideration,” Mr. Ngalwana wrote. “It is hoped that by then he will have demonstrated the requisite standard for elevation.”

Mr. Ngalwana’s critique did not have much impact — the commission recommended Mr. Cameron’s promotion — but Mr. Cameron’s reaction to it was telling. For a man whose friends describe as possessing an exquisite sensitivity to others, he can also be a sharp-tongued advocate capable of demolishing a critic’s argument, even as he defends that critic’s right to speak out.

“I think the first 15 pages really are a coded way of raising the racial issue while denying it,” Mr. Cameron said in an interview in his new Constitutional Court office. “It’s conceptually incoherent. And what he’s really saying is that ‘there are two white vacancies available next year. Why don’t you wait till then?’ ”

MR. CAMERON makes no secret of his delight in finally having reached the Constitutional Court, but he may ultimately be most remembered for speaking with intimate candor about his personal experiences with H.I.V. — the fear and sense of contamination in a society where AIDS bears a crushing stigma — in interviews and in his memoir, “Witness to AIDS” (Tafelberg Publishers, 2005).

In it, he writes about how the antiretroviral drugs he began taking in 1997 chased away the physical symptoms of sickness and the specter of death — a reality he described as “fetid, frightening, intrusive.”

Much of the burden of AIDS then fell away for him, he said, as he realized it was, after all, caused by “just a virus.” And so in the years that followed, when the government denied his countrymen and women the medicines that had saved him, he decided to act.

“Here I was, blessed with renewed vigor and life and health and energy and joy,” he said. “I mean, it’s an extraordinary experience. I think some cancer survivors also experience it. Here I had my life given back to me. How could I keep quiet?”

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