Someone mentioned before that the rep says H+ is an enhanced 3G technology. He was right. From a technical standpoint HSPA+ is not 4G.
HSPA+ is comprised of two technologies, HSDPA (which is enabled) and HSUPA.
For whatever reasons unknown to me, AT&T disables HSUPA on their smartphones (except the iPhone 4). HSUPA enables the higher upload speeds you see iPhone 4 users getting (most times 1+Mbps). Other positive side effects (YMMV) include lower latencies and sometimes higher download speeds. Without HSUPA, the highest cellular upload speeds you will see will be around 400Kbps.
Finally, there is not special SIM card for HSPA+ AFAIK. If you have a recent 3G SIM card, well you should be able to use that same SIM card in yout HSPA+ enabled device, because again, HSPA+ is a 3G technology. The only reason you would need a new SIM is if the one you have is ridiculously old or a 2G SIM (like my wife's SIM when we traded in her BB 7XXX, LOL). You will however need a new SIM when you make the transition to an LTE device.
HSPA+ is not simply HSDPA and HSUPA, HSDPA was defined in rel 5 of the spec, HSUPA in rel 6, and HSPA+ in rel 7 and beyond.
HSDPA allows for a device to receive up to 7.2 mbps by using 10 of the available 16 spreading codes on a 5 MHz channel at iirc a code rate of 3/4 and using up to 16QAM modulation. I talk about this in more detail in another post.
HSUPA is the reverse channel version of this. It allows for uplink of around 5 mbps.
HSPA+ in rel 7 allows for use of 64QAM and 15 of 16 spreading codes or 16QAM, 10 codes, and MIMO, for 21 mbps or 28 mbps in 5 mhz channels, respectivly.
Future versions of HSPA+ allow for 42 mbps with 64QAM, MIMO and 15 codes (35/36 code rate also) or dual carrier (that is, using 2x 5 MHz carriers for forward channel).
Finally the end all be all of HSPA+ allows for about 80 Mbps for all the techniques listed above and to include dual carrier (64 qam, mimo, 15 codes, 35/36 rate). This should exceed the performance for download of the LTE network that verizon is currently deploying.
It's also important to note that HSPA+ implies some back end packet handling features (not just backhaul but making it more "all IP") that is lacking in HSUPA+HSDPA.