The tuberculosis (TB) bacillus, Mycobacterium tuberculosis (Mtb) and HIV-1 are known to act synergistically, however, the mechanisms by which Mtb exacerbates HIV-1 pathogenesis are not well known. Here, using in vitro and ex vivo cell culture system, we show that human M(IL-10) anti-inflammatory macrophages, present in TB-associated microenvironments, produced high levels of HIV-1. These M(IL-10) macrophages form direct cell-to-cell bridges, which we identified as tunneling nanotubes (TNTs). TNT formation required the IL-10/STAT3 signaling pathway and targeted inhibition of TNTs substantially reduced the enhanced HIV-1 cell-tocell transfer and overproduction in M(IL-10) macrophages. In vivo, M(IL-10) macrophages were expanded in the lungs of co-infected non-human primates and their number orrelates with disease severity. Furthermore, soluble CD163 and MerTK receptors, markers for the M(IL-10) macrophages, accumulate in the blood of co-infected patients. Our study reveals that TNTs facilitate viral amplification and transfer between macrophages, implicating TNTs as potential therapeutic targets for TB/AIDS co-morbidity.