It just cares because it's going to draw the card
It's the sort of card that is good in discard-centered decks, like Captain Howler, Sea Scourge, Flubs, the Fool, and Raffine, Scheming Seer
In the rare case where enough -1/-1 counters are put on Aerith Gainsborough at the same time to make its toughness 0 or less, the number of +1/+1 counters on it before it got those -1/-1 counters will be used to determine the value of X in Aerith Gainsborough's third ability
It's a slow starter if you don't have a curated first hand, and I would say that it's such a situational deck that even pulling generally good cards off the top of your deck can feel a little jarring when you haven't got your board set up right to play and/or protect it
So you are definitely incentivized to get him to a location and then you can just start questing away with him