IIRC, XEN said that 32bit HVM VMs are not affected by Meltdown, and so probably don't get impacted by AWS' patches. They still require Linux kernel updates to protect the kernel space, so changes might still be seen there.
64-bit PV is unaffected and won't suffer a performance penalty (more precisely, it was already suffering it!!!), hence my original question, but a 64-bit PV guest can use Meltdown to attack the hypervisor. The fix is to update Xen, though I am not sure if fixes are already publicly available.
Yes, but XEN said 64bit PV aren't affected either because they already run in KPTI like environment. So I assume 64bit HVM like ours aren't impacted for our work load.