Continuing with the epidemiological metaphor, there are several possible vectors for the content to spread, and the prevalence of each depends on the particular circumstances of specific hosts or communities of hosts. For example, if the vector of "Alice advising Bob to consume it on subscription service X" is effective in a particular community (and this effectiveness obviously depends on several different parameters), then piracy wouldn't be an issue there. But if all such legal vectors are ineffective in that community, while the content is still very potent in its memetic properties, then it will still spread out, in one of several forms of alternative less legal vectors.
To paraphrase John Gilmore's famous quote about the internet, society treats inconvenient content providers as if they weren't there and routes around them, creating alternative distribution methods.