In 2012, Building Local Capacity for Delivery of HIV Services in Southern Africa (BLC) and Livelihoods and Food Security Technical Assistance II (LIFT) recognized their potential synergies and began to evaluate opportunities to integrate Nutrition Assessment, Counseling and Support (NACS) into HIV care and treatment services in Lesotho. The LIFT-BLC partnership has directly supported health and ES/L/FS service providers, community councils and the Government of Lesotho leadership to better integrate referrals into the continuum of care for PLHIV. Focusing on issues associated with HIV care and treatment and the needs of orphans and vulnerable children (OVC), LIFT and BLC have explored the relationship between health interventions and ES/L/FS assistance. Through the two clinic-to-community referral approaches utilized, LIFT, BLC and local partners have sought to (1) improve access to ES/L/FS services for PLHIV, (2) strengthen community services as a component of the continuum of care, (3) increase policy influence and advocacy for clinic to community linkages for PLHIV, and (4) increase adherence to ART and retention in clinical care and treatment for PLHIV through referrals and service linkages. This document highlights the lessons learned in establishing multi-sector referral processes in Lesotho from 2012-2015.