I have had my iPhone replaced due to crashing issues, so I am currently on my second iPhone 4. Neither one of them has had any reception issues (both have been BETTER than my old 3G was), though, of note, I have had the same SIM in both since the Apple store swapped the old one into the new phone.
I am tempted to open the phone and see the placement, but am afraid that, by doing so, I will inadvertently induce the problem I currently don't have.
Speculating on why this fixes the problem: the original speculation about the problem I read was the baseband in the new phone has a problem switching frequencies. Touching it with your hand causes antenna issues, the phone tries to switch over and something goes wrong, you lose signal.
Perhaps the issue is not with the baseband but with the SIM, since the two contacts are potentially shorted out? The phone can't switch frequencies because it is getting wrong/invalid data from the microSIM, and when you reposition it, it can now switch find and mitigate the touching.
I find it hard to believe that the antenna is shorting the SIM. I know the SIM tray is made of metal, but I suspect that it's electrically isolated from the SIM. If the tray were part of the antenna, even if it weren't shorting the SIM, I think the variable electrical field in the antenna as you make calls, etc, would induce a magnetic field in the SIM, perhaps causing all kinds of SIM reading errors. Instead, the SIM is shorted out inside the phone, but still isolated from the antenna.
To recap: 1. The shorted SIM isn't read properly by the phone, causing it to not be able to switch frequencies. 2. Shorting the antennas with your hand causes the phone to need to switch frequencies, but it can't because of the SIM problem.
The real question is, why is A) either the microSIM spec set with the contacts not right in the center or B) AT&T QC letting through so many wrongly-cut SIMs?