The adjective Refined has 6 senses:
1. (used of persons and their behavior) cultivated and genteel
2. freed from impurities by processing
3. showing a high degree of refinement and the assurance that comes from wide social experience
4. made pure
5. suggesting taste, ease, and wealth
6. free from what is tawdry or unbecoming
In the African countries where HIV/AIDS is a big problem the economies have big problems. People that have it are usually young people, they lack the physical power and the concentration to be effective workers, or they can not work at all, and this affects the economy because the efficiency is very low or non existent from the people that have HIV/AIDS. Also, this means that this people need medical care, an expensive one, and they usually do not have the resources to pay for it, so the governments spend big amounts of money on this as well.
C is the best answer for this
