If you have an antenna now, the same one will most likely work for HD. But out on the fringe, you might have to experiment some to get good reception, especially in the hills & valleys or in a concrete jungle. The way you will be impacted by or can take advantage of things such as multipath, reflected signals, knife edge diffraction and so on will be a bit different, because with DTV you generally won't have instant visual feedback when you are experimenting with antenna positioning and orientation.
But there is no special magic in HDTV antennas. The common split boom design, with a sort of log periodic section for VHF, and corner reflector Yagi section for UHF, is still the norm - and the farther out you are, the bigger and more directional you will need to go.
In my location there are 6 local stations broadcasting 11 or 12 separate channels of programming from two locations - nearby hilltops that are about 110 degrees apart with respect to my location. The hill to the South is line of sight and also the closer of the two, but the hill to the NE is blocked from view by a thicket of large trees. My small directional antenna is aimed straight at the NE site through the trees, and I pick up the South site off the side. I didn't change a thing when I bought my digital TV a year ago - I just plugged it in and began enjoying more channels and a crystal clear picture on all - and for most it's just that simple.
Tarpon is also right about OTA DTV being superior to cable - and it's likely to remain that way unless and until cable starts delivering by fiber direct to your house. I'm not up to date on satellite tech, it may have similar limitations.
It's been my experience if you can get a “good low noise picture” with analog, the same channel's digital signal should be good to go. The FCC are also allowing increased power from the digital stations after the cutoff.
You would be surprised what you can do with a 2x4, coat hangers, screws and washers. You will also find that most channels are using some of their sub-channels which adds to what you can get. Locally the weather is broadcast on one stations sub channel, and on the others it's mostly the standard definition version of the same programming for now.
I emailed the local stations, their OTA signals are 1080i, which compared to local Comcast cable, which is mostly lossy compressed 720i or so, really look a lot better. I have to set up the antenna so the wife can watch American Idol OTA, the sound is also much much better. ^_^ Got to keep the wife happy.