We're still working the details out upstream but the TL;DR is that the way to address Meltdown with Xen PV is to use nested virtualization so that the outer guest is an HVM or PVH guest.
As with all virtual and physical machines, patches are necessary to protect against process-to-process Meltdown within the OS itself. Those are starting to roll out from the respective vendors although it will take time for those to work inside a PV instance.