Background: Quality of life is an important outcome of long-term HIV care and is shaped by clinical, psychological, social, and health-service factors. Nurses are positioned to support people living with HIV (PLHIV) through care coordination, education, counselling, advocacy, and psychosocial support, yet evidence on these service-related factors remains limited in West Sumatra, Indonesia. Objective: To examine the associations of patients’ perceptions of nurses’ roles and nurse-provided psychosocial support with quality of life among PLHIV receiving outpatient HIV care. Methods: This single-centre analytical cross-sectional study was conducted at the Serunai Clinic, Dr. Achmad Mochtar Regional General Hospital, Bukittinggi, Indonesia, from 7 March to 7 April 2026. Total sampling included 80 PLHIV. Quality of life was measured using the Indonesian WHOQOL-HIV BREF; patients’ perceptions of nurses’ roles and nurse-provided psychosocial support. Associations were examined using Pearson’s chi-square test and a two-predictor binary logistic model in which each nursing-related exposure was adjusted only for the other; demographic, clinical, and psychosocial confounders were not included. Results: Among 80 participants, 42 (52.5%) rated nurses’ roles as inadequate, 45 (56.3%) rated nurse-provided psychosocial support as inadequate, and 43 (53.8%) had poor quality of life. Adequate nurses’ roles were associated with higher odds of good quality of life (OR=738.00; 95% CI 64.21–8482.70; p<0.001), as was adequate psychosocial support (OR=85.33; 95% CI 18.95–384.33; p<0.001). In the two-predictor logistic model, nurses’ roles remained associated with quality of life (AOR=262.61; 95% CI 19.28–3577.91; p<0.001), and psychosocial support also remained associated (AOR=18.60; 95% CI 1.43–241.95; p=0.026). Conclusion: Patients’ perceptions of nurses’ roles and nurse-provided psychosocial support were strongly associated with quality of life. Strengthening therapeutic communication, counselling, and person-centred biopsychosocial care is warranted, alongside larger studies that adjust for clinical and psychosocial confounders.